Navarro-Fernández Gonzalo, de-la-Puente-Ranea Lucía, Gandía-González Marisa, Gil-Martínez Alfonso
Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid 28023, Spain.
Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid 28023, Spain.
Brain Sci. 2019 Mar 12;9(3):60. doi: 10.3390/brainsci9030060.
The aim of this paper is to describe the progressive changes of chronic cluster headaches (CHs) in a patient who is being treated by a multimodal approach, using pharmacology, neurostimulation and physiotherapy.
A male patient, 42 years of age was diagnosed with left-sided refractory chronic CH by a neurologist in November 2009. In June 2014, the patient underwent a surgical intervention in which a bilateral occipital nerve neurostimulator was implanted as a treatment for headache.
Case report.
Primary findings included a decreased frequency of CH which lasted up to 2 months and sometimes even without pain. Besides this, there were decreased levels of anxiety, helplessness (PCS subscale) and a decreased impact of headache (HIT-6 scale). Bilateral pressure pain thresholds (PPTs) were improved along with an increase in strength and motor control of the neck muscles. These improvements were present at the conclusion of the treatment and maintained up to 4 months after the treatment.
A multimodal approach, including pharmacology, neurostimulation and physiotherapy may be beneficial for patients with chronic CHs. Further studies such as case series and clinical trials are needed to confirm these results.
本文旨在描述一名采用药理学、神经刺激和物理治疗的多模式方法进行治疗的慢性丛集性头痛（CH）患者的病情进展变化。
一名42岁男性患者于2009年11月被神经科医生诊断为左侧难治性慢性丛集性头痛。2014年6月，该患者接受了一项外科手术，植入双侧枕神经神经刺激器以治疗头痛。
病例报告。
主要发现包括丛集性头痛发作频率降低，持续长达2个月，有时甚至无痛。除此之外，焦虑、无助感（PCS分量表）水平降低，头痛影响（HIT - 6量表）减轻。双侧压痛阈值（PPTs）得到改善，同时颈部肌肉力量和运动控制增强。这些改善在治疗结束时出现，并在治疗后维持长达4个月。
包括药理学、神经刺激和物理治疗的多模式方法可能对慢性丛集性头痛患者有益。需要进一步开展如病例系列研究和临床试验等研究来证实这些结果。
