Treatment of intractable chronic cluster headache by occipital nerve stimulation: a cohort of 51 patients.
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| Title: | Treatment of intractable chronic cluster headache by occipital nerve stimulation: a cohort of 51 patients. |
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| Authors: | Miller, S., Watkins, L., Matharu, M. |
| Source: | European Journal of Neurology. Feb2017, Vol. 24 Issue 2, p381-390. 10p. |
| Subjects: | Treatment of cluster headaches, Neural stimulation, Occipital lobe, Quality of life, Follow-up studies (Medicine), Adverse health care events, Chronic disease treatment, Physiology |
| Abstract: | Background and purpose Chronic cluster headache is a rare, highly disabling primary headache condition. When medically intractable, occipital nerve stimulation can offer effective treatment. Open-label series have provided data on small cohorts only. Methods We analyzed 51 subjects to evaluate the long-term outcomes of highly intractable chronic cluster headache with occipital nerve stimulation. Patients with intractable chronic cluster headache were implanted with occipital nerve stimulators during the period 2007-2014. The primary endpoint was improvement in daily attack frequency. Secondary endpoints included attack severity, attack duration, quality-of-life measures, headache disability scores and adverse events. Results We studied 51 patients [35 males; mean age at implant 47.78 (range 31-70) years; mean follow-up 39.17 (range 2-81) months]. Nineteen patients had other chronic headache types in addition in chronic cluster headache. At final follow-up, there was a 46.1% improvement in attack frequency ( P < 0001) across all patients, 49.5% ( P < 0.001) in those with cluster headache alone and 40.3% ( P = 0.036) in those with multiple phenotypes. There were no significant differences in response in those with or without multiple headache types. The overall response rate (defined as at least a 50% improvement in attack frequency) was 52.9%. Significant reductions were also seen in attack duration and severity. Improvements were noted in headache disability scores and quality-of-life measures. Triptan use of responders dropped by 62.56%, resulting in significant cost savings. Adverse event rates were highly favorable. Conclusion Occipital nerve stimulation appears to be a safe and efficacious treatment for highly intractable chronic cluster headache even after a mean follow-up of over 3 years. [ABSTRACT FROM AUTHOR] |
| Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 120810663 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Treatment of intractable chronic cluster headache by occipital nerve stimulation: a cohort of 51 patients. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Miller%2C+S%2E%22">Miller, S.</searchLink><br /><searchLink fieldCode="AR" term="%22Watkins%2C+L%2E%22">Watkins, L.</searchLink><br /><searchLink fieldCode="AR" term="%22Matharu%2C+M%2E%22">Matharu, M.</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Feb2017, Vol. 24 Issue 2, p381-390. 10p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Treatment+of+cluster+headaches%22">Treatment of cluster headaches</searchLink><br /><searchLink fieldCode="DE" term="%22Neural+stimulation%22">Neural stimulation</searchLink><br /><searchLink fieldCode="DE" term="%22Occipital+lobe%22">Occipital lobe</searchLink><br /><searchLink fieldCode="DE" term="%22Quality+of+life%22">Quality of life</searchLink><br /><searchLink fieldCode="DE" term="%22Follow-up+studies+%28Medicine%29%22">Follow-up studies (Medicine)</searchLink><br /><searchLink fieldCode="DE" term="%22Adverse+health+care+events%22">Adverse health care events</searchLink><br /><searchLink fieldCode="DE" term="%22Chronic+disease+treatment%22">Chronic disease treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Physiology%22">Physiology</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background and purpose Chronic cluster headache is a rare, highly disabling primary headache condition. When medically intractable, occipital nerve stimulation can offer effective treatment. Open-label series have provided data on small cohorts only. Methods We analyzed 51 subjects to evaluate the long-term outcomes of highly intractable chronic cluster headache with occipital nerve stimulation. Patients with intractable chronic cluster headache were implanted with occipital nerve stimulators during the period 2007-2014. The primary endpoint was improvement in daily attack frequency. Secondary endpoints included attack severity, attack duration, quality-of-life measures, headache disability scores and adverse events. Results We studied 51 patients [35 males; mean age at implant 47.78 (range 31-70) years; mean follow-up 39.17 (range 2-81) months]. Nineteen patients had other chronic headache types in addition in chronic cluster headache. At final follow-up, there was a 46.1% improvement in attack frequency ( P < 0001) across all patients, 49.5% ( P < 0.001) in those with cluster headache alone and 40.3% ( P = 0.036) in those with multiple phenotypes. There were no significant differences in response in those with or without multiple headache types. The overall response rate (defined as at least a 50% improvement in attack frequency) was 52.9%. Significant reductions were also seen in attack duration and severity. Improvements were noted in headache disability scores and quality-of-life measures. Triptan use of responders dropped by 62.56%, resulting in significant cost savings. Adverse event rates were highly favorable. Conclusion Occipital nerve stimulation appears to be a safe and efficacious treatment for highly intractable chronic cluster headache even after a mean follow-up of over 3 years. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/ene.13215 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 10 StartPage: 381 Subjects: – SubjectFull: Treatment of cluster headaches Type: general – SubjectFull: Neural stimulation Type: general – SubjectFull: Occipital lobe Type: general – SubjectFull: Quality of life Type: general – SubjectFull: Follow-up studies (Medicine) Type: general – SubjectFull: Adverse health care events Type: general – SubjectFull: Chronic disease treatment Type: general – SubjectFull: Physiology Type: general Titles: – TitleFull: Treatment of intractable chronic cluster headache by occipital nerve stimulation: a cohort of 51 patients. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Miller, S. – PersonEntity: Name: NameFull: Watkins, L. – PersonEntity: Name: NameFull: Matharu, M. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 02 Text: Feb2017 Type: published Y: 2017 Identifiers: – Type: issn-print Value: 13515101 Numbering: – Type: volume Value: 24 – Type: issue Value: 2 Titles: – TitleFull: European Journal of Neurology Type: main |
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