枕神经刺激治疗药物难治性慢性阵发性半边头痛。
Occipital Nerve Stimulation for Medically Refractory Chronic Paroxysmal Hemicrania.
机构信息
Headache Group, Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
Department of Neurosurgery, Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
出版信息
Headache. 2017 Nov;57(10):1610-1613. doi: 10.1111/head.13187. Epub 2017 Oct 5.
OBJECTIVE
To describe the outcome of a patient with refractory chronic paroxysmal hemicrania (CPH) to occipital nerve stimulation (ONS).
BACKGROUND
CPH is a primary headache disorder exquisitely sensitive to indomethacin. In patients unable to tolerate indomethacin, the therapeutic options are limited. ONS is a promising therapy for other refractory headache conditions. We report the first patient with medically refractory CPH treated with ONS.
METHODS
Following implantation of the occipital nerve stimulator in 2006, the patient kept prospective headache diaries. Outcome was assessed by daily attack frequency.
RESULTS
After a follow-up of over 10 years, the patient reported a sustained efficacy of more than 50% reduction in attack frequency and was pain-free at final follow-up. The patient was able to stop indomethacin completely. The patient had three successful pregnancies during follow-up. One system revision was undertaken alongside an expected battery replacement to treat unequal paresthesia and pain over the electrodes.
CONCLUSION
ONS may offer an effective long-term treatment for CPH in patients where indomethacin cannot be tolerated.
目的
描述一位对枕神经刺激（ONS）治疗难治性慢性阵发性头痛（CPH）患者的疗效。
背景
CPH 是一种对吲哚美辛高度敏感的原发性头痛疾病。对于不能耐受吲哚美辛的患者，治疗选择有限。ONS 是治疗其他难治性头痛疾病的一种有前途的治疗方法。我们报告了首例接受 ONS 治疗的药物难治性 CPH 患者。
方法
2006 年植入枕神经刺激器后，患者持续记录头痛日记。通过每日发作频率评估疗效。
结果
随访超过 10 年后，患者报告头痛发作频率持续减少超过 50%，最终随访时无痛。患者能够完全停止使用吲哚美辛。在随访期间，该患者成功怀孕三次。进行了一次系统修订和一次预期的电池更换，以治疗电极部位的不等麻木和疼痛。
结论
对于不能耐受吲哚美辛的 CPH 患者，ONS 可能是一种有效的长期治疗方法。
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