Occipital Nerve Stimulation for Pain Modulation in Drug-Resistant Chronic Cluster Headache
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Variables and Definitions
2.3. Data Collection
2.4. Surgical Procedures
2.5. Statistical Analysis
3. Results
3.1. Patients Characteristics
3.2. ONS Effect on Number of Weekly CH Attacks
3.3. ONS Effect on Pain Severity
3.4. Overall Perceived Improvement
3.5. Preventive Medication Use
3.6. Triptan Use
3.7. Adverse Events
3.8. Non-Responders
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Age | Gender | Duration of CH (Years) | Duration of Chronic CH (Years) | Preventive Oral Treatment Trials Prior to ONS | Therapeutic Techniques Prior to ONS | Prior to ONS Trial (Baseline) | Time of ONS Trial (Weeks) | ||
---|---|---|---|---|---|---|---|---|---|
Days of Pain per Month | Attacks per Day | Attack VAS Score | |||||||
37 | Female | 3 | 1 | 3 | None | 20 | 1 | 8 | 3 |
34 | Male | 23 | 9 | 3 | None | 30 | 10 | 10 | 7 |
38 | Female | 14 | 11 | 3 | OnabotA | 30 | 8 | 10 | 3 |
36 | Male | 8 | 5 | 4 | None | 30 | 2 | 10 | 2 |
Patient No. | Age | Gender | Duration of CH (Years) | Duration of Chronic CH (Years) | Preventive Oral Treatment Trials Prior to ONS | Therapeutic Techniques Prior to ONS | Prior to ONS (Baseline) | ||
---|---|---|---|---|---|---|---|---|---|
Days of Pain per Month | Attacks per Day | Attack VAS Score | |||||||
1 | 54 | Female | 10 | 7 | 4 | OnabotA, GON TENS, SPG RFT, GON block | 30 | 4 | 9 |
2 | 31 | Female | 4 | 2 | 3 | GON block | 30 | 1 | 10 |
3 | 36 | Female | 17 | 11 | 6 | GON block | 30 | 10 ¶ | 10 |
4 | 49 | Female | 31 | 22 | 6 | GON block | 30 | 1 | 10 |
5 | 45 | Male | 33 | 25 | 5 | GON block | 30 | 5 | 10 |
6 | 39 | Female | 23 | 16 | 3 | None | 30 | 9 ¶ | 8 |
7 | 61 | Male | 44 | 10 | 4 | None | 30 | 2 | 10 |
8 | 34 | Female | 2 | 1 | 5 | None | 30 | 4 | 9 |
9 | 37 | Female | 3 | 2 | 3 | OnabotA | 30 | 16 ¶ | 10 |
10 | 31 | Male | 4 | 3 | 4 | None | 10 | 1 | 10 |
11 | 41 | Male | 4 | 3 | 3 | None | 30 | 14 ¶ | 10 |
12 | 43 | Male | 4 | 2 | 8 | OnabotA | 30 | 3 | 10 |
13 | 42 | Male | 6 | 4 | 3 | None | 30 | 2 | 9 |
14 | 33 | Male | 4 | 1 | 3 | GON block | 30 | 7 | 10 |
15 | 31 | Male | 9 | 6 | 4 | GON block, OnabotA | 30 | 3 | 10 |
16 | 43 | Male | 7 | 5 | 8 | Gon block, OnabotA | 30 | 3 | 10 |
17 | 51 | Male | 11 | 6 | 5 | GON block, OnabotA | 30 | 5 | 10 |
Patient No. | Follow-Up * | Adverse Effects | 3 Months after ONS | 1 Year after ONS | At the End of Follow-Up | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Days of Pain per Month | Attacks per Day | Attack VAS Score | Overall Perceived Improvement | Days of Pain per Month | Attacks per Day | Attack VAS Score | Overall Perceived Improvement | Days of Pain per Month | Attacks per Day | Attack VAS Score | Overall Perceived Improvement | |||
1 | 4 years (deactivated) | None | 3 | 1 | 3 | >70% | 3 | 1 | 3 | >70% | 9 | 30 µ | 4 | <30% |
2 | 5 years (deactivated) | Electrode migration | 1 | 1 | 10 | >70% | 1 | 1 | 10 | >70% | 30 | 1 | 10 | <30% |
3 | 5 years (removed) | None | 30 | 10 | 10 | <30% | 30 | 10 | 10 | <30% | 30 | 10 | 10 | <30% |
4 | 12 years (ongoing) | Posttraumatic disconnection (reintervention needed) | 0 | 0 | NA | >70% | 0 | 0 | NA | >70% | Once every 3 months | Once every 3 months | 3 | >70% |
5 | 9 years (ongoing) | Mild pain on surgery site | 30 | 5 | 10 | <30% | 15 | 5 | 6 | 30–50% | Once every 3 months | Once every 3 months | 6 | >70% |
6 | 8 years (removed) | None | 30 | 9 | 7 | <30% | 30 | 9 | 7 | <30% | 30 | 9 | 7 | <30% |
7 | 10 years (ongoing) | None | 30 | 2 | 7 | 30–50% | 30 | 2 | 7 | 30–50% | 30 | 2 | 7 | 30–50% |
8 | 3 years (removed) | None | 30 | 4 | 7 | <30% | 30 | 6 | 9 | <30% | 30 | 6 | 9 | <30% |
9 | 7 years (ongoing) | Electrode migration | 30 | 5 | 6 | 30–50% | 0 | 0 | NA | >70% | 0 | 0 | NA | >70% |
10 | 9 years (removed) | None | 30 | 5 | 10 | <30% | 30 | 1 | 10 | <30% | 30 | 1 | 7 | <30% |
11 | 6 years (ongoing) | None | 30 | 1 | 6 | 50–70% | 30 | 10 | 8 | 30–50% | 30 | 2 | 10 | 30–50% |
12 | 5 years (ongoing) | Surgical site infection | 30 | 1 | 6 | 30–50% | 30 | 1 | 7 | 30-50% | 30 | 2 | 8 | 30–50% |
13 | 2 years (removed) | Surgical site infection | 20 | 2 | 9 | 30–50% | 30 | 2 | 10 | <30% | 30 | 2 | 10 | <30% |
14 | 12 years (ongoing) | None | 15 | 1 | 5 | >70% | 5 | 3 | 5 | >70% | 3 | 1 | 5 | >70% § |
15 | 3 years (removed) # | None | 30 | 3 | 10 | <30% | 10 | 3 | 5 | >70% | Once every 6 months | 1 | 5 | >70% |
16 | 5 years (removed) | Electrode infection | 30 | 3 | 10 | <30% | 10 | 1 | 5 | >70% | 30 | 1 | 5 | 30–50% |
17 | 7 years (ongoing) | None | 30 | 5 | 10 | <30% | 30 | 5 | 10 | <30% | 30 | 3 | 3 | 30–50% |
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Díaz-de-Terán, J.; Membrilla, J.A.; Paz-Solís, J.; de Lorenzo, I.; Roa, J.; Lara-Lara, M.; Gil-Martínez, A.; Díez-Tejedor, E. Occipital Nerve Stimulation for Pain Modulation in Drug-Resistant Chronic Cluster Headache. Brain Sci. 2021, 11, 236. https://doi.org/10.3390/brainsci11020236
Díaz-de-Terán J, Membrilla JA, Paz-Solís J, de Lorenzo I, Roa J, Lara-Lara M, Gil-Martínez A, Díez-Tejedor E. Occipital Nerve Stimulation for Pain Modulation in Drug-Resistant Chronic Cluster Headache. Brain Sciences. 2021; 11(2):236. https://doi.org/10.3390/brainsci11020236
Chicago/Turabian StyleDíaz-de-Terán, Javier, Javier A. Membrilla, José Paz-Solís, Iñigo de Lorenzo, Javier Roa, Manuel Lara-Lara, Alfonso Gil-Martínez, and Exuperio Díez-Tejedor. 2021. "Occipital Nerve Stimulation for Pain Modulation in Drug-Resistant Chronic Cluster Headache" Brain Sciences 11, no. 2: 236. https://doi.org/10.3390/brainsci11020236
APA StyleDíaz-de-Terán, J., Membrilla, J. A., Paz-Solís, J., de Lorenzo, I., Roa, J., Lara-Lara, M., Gil-Martínez, A., & Díez-Tejedor, E. (2021). Occipital Nerve Stimulation for Pain Modulation in Drug-Resistant Chronic Cluster Headache. Brain Sciences, 11(2), 236. https://doi.org/10.3390/brainsci11020236