Sphenopalatine ganglion stimulation in cluster headaches
Cluster headaches are characterized by severe debilitating pain which is often refractory to treatment. It is described in the ICDH-3 Beta headache criteria as consisting of attacks of severe, strictly unilateral pain which is orbital, supraorbital, temporal or in any combination of these sites, lasting 15-180 minutes and occurring from once every other day to eight times a day. The sphenopalatine ganglion (SPG) has been implicated in the pathophysiology of cluster headache, and therefore has been targeted to treat cluster headaches. In an article published in Cephalalgia, authors Láinez Marti reviewed the published literature on SPG stimulation and cluster headaches. An SPG stimulator is a device inserted by a minimally invasive procedure in which a neurostimulator directly and reversibly stimulates the area of the SPG. They found evidence that demonstrated that SPG stimulation is a safe and effective treatment for chronic refractory cluster headache patients, effective in both acute at- tacks and as a preventative treatment.
Read more here:http://journals.sagepub.com/doi/full/10.1177/0333102416644968
High Cervical Spinal Cord Stimulation for Refractory Headaches
High cervical spinal cord stimulation is a novel promising approach for the treatment of refractory chronic Cluster and Migraine headaches. This approach works by delivering electrical stimulation to trigeminocervical complex through implantable leads. The HF10 device was FDA approved in 2015 for chronic intractable trunk and/or extremity pain. Based on Trial results it is superior to conventional spinal cord stimulators in treatment for chronic back and leg pain as they do not produce uncomfortable paresthesias. Prospective open label study of using this system in refractory chronic migraine patients has shown at least 50% improvement in headache days. Feasibility studies for HF10 device in treatment of refractory chronic Migraine are ongoing.
Read more here: https://thejournalofheadacheandpain.springeropen.com/articles/10.1186/s10194-016-0657-2
