de Quintana-Schmidt Cristian, Casajuana-Garreta Edgar, Molet-Teixidó Joan, García-Bach Marcel, Roig Carles, Clavel-Laria Pablo, Rodríguez-Rodríguez Rodrigo, Oliver-Abadal Bartolomé, Bartumeus-Jené Frederic
Servicio de Neurocirugía, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, España.
Rev Neurol. 2010 Jul 1;51(1):19-26.
To evaluate the occipital nerve stimulation therapy in as a treatment for drug-resistant cluster headache.
Prospective study of four patients, three males and one female. Mean age of 42 years. Patients complained of a cluster headache lasting between one and 16 years, with suboptimal control of the attacks with medication. In all cases octopolar electrodes were placed percutaneously in the occipital region bilaterally. Follow-up of 6 months.
At 6 months, there was a 56% (range: 25-95%) reduction in the frequency, a 48.8% (range: 20-60%) decrease in the intensity and a 63.8% (range: 0-88.8%) reduction in the duration of the attacks. Worsening or progression of the illness was not observed in any case. All patients referred a 15.4% (range: 6-31.5%) improvement in their quality of life compared to their previous basal situation in SF-36. In all cases but one there was a significant reduction in the amount and dosage of medication required. Postoperative complications were not observed. All patients would recommend the procedure.
Occipital nerve stimulation may be considered a safe and effective therapeutic option in the drug-resistant cluster headache. However, studies with more patients and a longer follow-up are required to evaluate the efficacy of the technique.
评估枕神经刺激疗法作为难治性丛集性头痛的一种治疗方法。
对4例患者进行前瞻性研究,其中男性3例,女性1例。平均年龄42岁。患者主诉丛集性头痛持续1至16年,药物治疗对发作的控制效果欠佳。所有病例均经皮在双侧枕部放置八极电极。随访6个月。
6个月时,发作频率降低了56%(范围:25%-95%),强度降低了48.8%(范围:20%-60%),发作持续时间缩短了63.8%(范围:0%-88.8%)。未观察到任何病例病情恶化或进展。与SF-36量表中之前的基础情况相比,所有患者均表示生活质量提高了15.4%(范围:6%-31.5%)。除1例患者外,所有病例所需药物的数量和剂量均显著减少。未观察到术后并发症。所有患者均会推荐该治疗方法。
枕神经刺激可被认为是难治性丛集性头痛一种安全有效的治疗选择。然而,需要更多患者参与且随访时间更长的研究来评估该技术的疗效。