Hybrid Peripheral Neurostimulation to Treat Chronic Post-Meningitis Headache- A Case Report

Abstract

Introduction: Chronic post-meningitis headaches present clinically with persistent symptoms often mirroring migraines or tension-type headaches. These frequently include photophobia, phonophobia, and associated nausea and vomiting, similar to other primary headache disorders. Central to the pathology of viral meningitis is the inflammation of the meninges—the intricate protective sheaths encasing the brain and spinal cord. Case: This case study details a 56-year-old female patient experiencing chronic daily headaches and facial pain following an episode of self-resolving viral meningitis. Traditional therapeutic interventions failed to achieve satisfactory symptom control for the patient. In response to the treatment-resistant nature of the patient’s condition, a neurostimulator strategy was implemented providing over 95% symptom relief reported at week 12 post-implantation. This strategy employed a hybrid approach combining high cervical and occipital lead placements, with the goal of enhancing neurostimulator coverage and mitigating the patient’s persistent symptoms. Conclusion: Preliminary observations suggest a potential avenue for further research and exploration in the domain of refractory headaches. Hybrid peripheral neurostimulation, as an emerging paradigm in neuromodulation, draws from the principles of neural plasticity and targeted neuromodulation. This case serves as an exemplar for refractory post-meningitis headaches, offering an innovative solution when traditional therapies have failed to provide relief