Abstract
BackgroundParesthesia-free cervical 10 kHz spinal cord stimulation (HF10 SCS) may constitute a novel treatment modality for headache disorders, when pharmacological approaches fail. We report the results of a retrospective analysis assessing the long-term safety, tolerability and efficacy of HF10 SCS in a group of patients with chronic refractory primary headache disorders.FindingsFour patients with chronic migraine (CM), two with chronic SUNA (Short-lasting Unilateral Neuralgiform headache attacks with Autonomic symptoms) and one with chronic cluster headache (CCH) refractory to medical treatments, were implanted with cervical HF10 SCS. Pre- and post-implantation data were collected from the medical notes and from headache charts. At an average follow-up of 28 months (range: 12–42 months) we observed an improvement of at least 50 % in headache frequency and/or intensity in all CM patients. One SUNA patient became pain free and the other reported at least 50 % improvement in attacks frequency an duration. The CCH patient reported a significant reduction in CH attacks duration. Two patients underwent a surgical revision due to lead migration.ConclusionsParesthesia-free high cervical HF10 SCS appears to be a long-term safe and likely effective therapeutic approach for patients with chronic refractory primary headache disorders. These results warrant further prospective studies in larger series of patients.
Highlights
Paresthesia-free cervical 10 kHz spinal cord stimulation (HF10 SCS) may constitute a novel treatment modality for headache disorders, when pharmacological approaches fail
But possibly more disabling primary Chronic daily headache (CDH) conditions include the chronic forms of trigeminal autonomic cephalalgias (TACs)
We report here the long-term follow-up of the patients treated in our headache centre with cervical HF10 SCS
Summary
Paresthesia-free cervical 10 kHz spinal cord stimulation (HF10 SCS) may constitute a novel treatment modality for headache disorders, when pharmacological approaches fail. But possibly more disabling primary CDH conditions include the chronic forms of trigeminal autonomic cephalalgias (TACs) This group encompasses cluster headache (CH), short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT), short-lasting unilateral neuralgiform headache attacks with cranial autonomic features (SUNA), paroxysmal hemicrania (PH) and hemicrania continua (HC) [4]. CCH chronic cluster headache; CI conjunctival injection, GONB greater occipital nerve block, IV intravenous, MCNB multiple cranial nerve block, SC subcutaneous, SPG sphenopalatine ganglion, SUNA short-lasting unilateral neuralgiform headache attacks with autonomic symptoms, VRS verbal rating scale, V1 ophthalmic trigeminal division, V2 maxillary trigeminal division, V3 mandibular trigeminal division aPatient 2 declined any further pharmacological treatments intensity (VRS 6/10). After 42 months, she continues to report almost complete resolution of both the SUNA attacks and the chronic migraine, with no adverse events
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
