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Endogenous Neurostimulation and Physiotherapy in Cluster Headache: A Clinical Case

1
Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid 28023, Spain
2
Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid 28023, Spain
3
Servicio de Neurocirugía, Hospital Universitario La Paz, Madrid 28046, Spain
4
Hospital La Paz Institute for Health Research, Madrid 28046, Spain
*
Author to whom correspondence should be addressed.
Brain Sci. 2019, 9(3), 60; https://doi.org/10.3390/brainsci9030060
Received: 15 February 2019 / Revised: 6 March 2019 / Accepted: 8 March 2019 / Published: 12 March 2019
(This article belongs to the Special Issue Surgery for Spine Disease and Intractable Pain)
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Abstract

Objective: The aim of this paper is to describe the progressive changes of chronic cluster headaches (CHs) in a patient who is being treated by a multimodal approach, using pharmacology, neurostimulation and physiotherapy. Subject: A male patient, 42 years of age was diagnosed with left-sided refractory chronic CH by a neurologist in November 2009. In June 2014, the patient underwent a surgical intervention in which a bilateral occipital nerve neurostimulator was implanted as a treatment for headache. Methods: Case report. Results: Primary findings included a decreased frequency of CH which lasted up to 2 months and sometimes even without pain. Besides this, there were decreased levels of anxiety, helplessness (PCS subscale) and a decreased impact of headache (HIT-6 scale). Bilateral pressure pain thresholds (PPTs) were improved along with an increase in strength and motor control of the neck muscles. These improvements were present at the conclusion of the treatment and maintained up to 4 months after the treatment. Conclusions: A multimodal approach, including pharmacology, neurostimulation and physiotherapy may be beneficial for patients with chronic CHs. Further studies such as case series and clinical trials are needed to confirm these results. View Full-Text
Keywords: cluster headache; neurosurgery; pressure pain threshold; physiotherapy cluster headache; neurosurgery; pressure pain threshold; physiotherapy
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Navarro-Fernández, G.; de-la-Puente-Ranea, L.; Gandía-González, M.; Gil-Martínez, A. Endogenous Neurostimulation and Physiotherapy in Cluster Headache: A Clinical Case. Brain Sci. 2019, 9, 60.

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