利用外周刺激减轻C2介导的枕部头痛疼痛：初步报告。

Using peripheral stimulation to reduce the pain of C2-mediated occipital headaches: a preliminary report.

作者信息

Melvin Eugene A, Jordan F Richard, Weiner Richard L, Primm David

机构信息

Pain Center of Central Florida, Orlando, FL 32806, USA.

出版信息

Pain Physician. 2007 May;10(3):453-60.

PMID:17525779

Abstract

BACKGROUND

Peripheral nerve stimulation (PNS) is an accepted treatment for neuropathic pain. Recent studies have focused on its potential for relieving headache pain.

OBJECTIVES

To investigate the effectiveness of PNS in reducing occipital headache pain.

DESIGN

A prospective, 12-week pilot study involving 11 patients evaluated before and after implantation of PNS systems to treat C2-mediated occipital headaches.

METHODS

Prior to and at 4 and 12 weeks after implantation, patients completed the Short-Form McGill Pain Questionnaire (SF-MPQ), Visual Analog Scale (VAS), and Present Pain Index (PPI). Patients also answered questionnaires and kept diaries to record stimulator use, medication consumption, and numbers of headaches.

RESULTS

A comparison of pre- and post-implantation evaluations showed statistically significant declines in scores on the SF-MPQ (64%; p = 0.0013), VAS (67%; p < 0.0001), and PPI (68%; p = 0.0009). Most patients (91% and 64% respectively) reported reductions in medication use and numbers of headaches. Patients also reported a reduction in headache symptoms and the impact of headaches on activities. Two adverse events were encountered, one due to a loose connection and, the other caused by lead migration.

CONCLUSIONS

PNS reduced headache pain, headache frequency and medication use.

摘要

背景

周围神经刺激（PNS）是一种被认可的治疗神经性疼痛的方法。最近的研究聚焦于其缓解头痛疼痛的潜力。

目的

研究PNS减轻枕部头痛疼痛的有效性。

设计

一项前瞻性的、为期12周的试点研究，涉及11名患者，在植入PNS系统治疗由C2介导的枕部头痛之前和之后进行评估。

方法

在植入前以及植入后4周和12周，患者完成简短麦吉尔疼痛问卷（SF-MPQ）、视觉模拟量表（VAS）和当前疼痛指数（PPI）。患者还回答问卷并记日记，以记录刺激器使用情况、药物消耗情况和头痛次数。

结果

植入前后评估的比较显示，SF-MPQ评分（64%；p = 0.0013）、VAS评分（67%；p < 0.0001）和PPI评分（68%；p = 0.0009）在统计学上有显著下降。大多数患者（分别为91%和64%）报告药物使用和头痛次数减少。患者还报告头痛症状减轻以及头痛对活动的影响减轻。遇到两例不良事件，一例是由于连接松动，另一例是由导联移位引起。