Division of Neurosurgery, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.
Headache. 2014 Mar;54(3):430-44. doi: 10.1111/head.12292. Epub 2014 Feb 14.
Patients with medically refractory headache disorders are a rare and challenging-to-treat group. The introduction of peripheral neurostimulation (PNS) has offered a new avenue of treatment for patients who are appropriate surgical candidates. The utility of PNS for headache management is actively debated. Preliminary reports suggested that 60-80% of patients with chronic headache who have failed maximum medical therapy respond to PNS. However, complications rates for PNS are high. Recent publication of 2 large randomized clinical trials with conflicting results has underscored the need for further research and careful patient counseling. In this review, we summarize the current evidence for PNS in treatment of chronic migraine, trigeminal autonomic cephalagias and occipital neuralgia, and other secondary headache disorders.
患有药物难治性头痛障碍的患者是一类罕见且治疗难度大的群体。外周神经刺激（PNS）的引入为适合手术的患者提供了一种新的治疗途径。PNS 在头痛管理中的效用仍存在争议。初步报告表明，60-80%的经最大药物治疗失败的慢性头痛患者对 PNS 有反应。然而，PNS 的并发症发生率较高。最近发表的两项大型随机临床试验结果相互矛盾，突显了进一步研究和仔细的患者咨询的必要性。在这篇综述中，我们总结了 PNS 在治疗慢性偏头痛、三叉神经自主神经性头痛和枕神经痛以及其他继发性头痛障碍方面的现有证据。
