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Occipital Nerve Stimulation

Denys Fontaine, Serge Blond, Christian Lucas, Jean Regis, Anne Donnet, Stéphane Derrey, Evelyne Guegan-Massardier, Bechir Jarraya, Bich Dang-Vu, Frederic Bourdain, Dominique Valade, Caroline Roos, Christèle Creach, Stéphan Chabardes, Pierric Giraud, Jimmy Voirin, Jocelyne Bloch, Alda Rocca, Sophie Colnat-Coulbois, Francois Caire, Coralie Roger, Sylvie Romettino, Michel Lanteri-Minet
BACKGROUND: Occipital nerve stimulation (ONS) has been proposed to treat chronic medically-intractable cluster headache (iCCH) in small series of cases without evaluation of its functional and emotional impacts. METHODS: We report the multidimensional outcome of a large observational study of iCCH patients, treated by ONS within a nationwide multidisciplinary network ( NCT01842763), with a one-year follow-up. Prospective evaluation was performed before surgery, then three and 12 months after...
October 3, 2016: Cephalalgia: An International Journal of Headache
Kevin D'Ostilio, Delphine Magis
Chronic primary headaches are widespread disorders which cause significant quality of life and socioprofessional impairment. Available pharmacological treatments have often a limited efficacy and/or can generate unbearable side effects. Electrical nerve stimulation is a well-known non-destructive method of pain modulation which has been recently applied to headache management. In this review, we summarise recent advances in invasive and non-invasive neurostimulation techniques targeting pericranial structures for the treatment of chronic primary headaches, chiefly migraine and cluster headache: occipital nerve, supraorbital nerve, vagus nerve, and sphenopalatine ganglion stimulations...
November 2016: Current Pain and Headache Reports
Olga A Lyubashina, Sergey S Panteleev, Alexey Y Sokolov
Electrical stimulation of the greater occipital nerve (GON) has recently shown promise as an effective non-pharmacological prophylactic therapy for drug-resistant chronic primary headaches, but the neurobiological mechanisms underlying its anticephalgic action are not elucidated. Considering that the spinal trigeminal nucleus (STN) is a key segmental structure playing a prominent role in pathophysiology of headaches, in the present study we evaluated the effects of GON electrical stimulation on ongoing and evoked firing of the dura-sensitive STN neurons...
September 27, 2016: Journal of Neural Transmission
Thomas P Pittelkow, Gabriel L Pagani-Estevez, Bradford Landry, Matthew J Pingree, Jason S Eldrige
BACKGROUND: Occipital neuromodulation is a promising treatment modality for refractory headache, but lead migration remains a frequent surgical complication. OBJECTIVES: The primary objective was to identify surgical techniques that may minimize adverse events, particularly lead migration. We hypothesized that a surgical technique employing 2-point anchoring of stimulator leads designed to provide a tension-relief loop and the use of ultrasound for lead placement would decrease the complication rate...
September 2016: Pain Physician
P-J Finiels, D Batifol
OBJECTIVE: To present the current treatment options for occipital neuralgia based on a retrospective series of 111 patients, who were offered one or more treatment methods, not mutually exclusive. METHODS: All patients, who previously had their diagnosis confirmed by undergoing an anesthetic nerve block (0.25mL bupivacaine/2mL cortivazol), were treated by radiofrequency denaturation in 78 cases, injection of botulinum toxin in 37 cases and implantation of a nerve stimulation system in 5 cases...
August 18, 2016: Neuro-Chirurgie
Sarah Miller, Harith Akram, Susie Lagrata, Marwan Hariz, Ludvic Zrinzo, Manjit Matharu
Short-lasting unilateral neuralgiform headache attacks are primary headache disorders characterized by short-lasting attacks of unilateral pain accompanied by autonomic features. A small minority are refractory to medical treatment. Neuroimaging studies have suggested a role of the posterior hypothalamic region in their pathogenesis. Previous case reports on deep brain stimulation of this region, now understood to be the ventral tegmental area, for this disorder are limited to a total of three patients. We present a case series of 11 new patients treated with ventral tegmental area deep brain stimulation in an uncontrolled, open-label prospective observational study...
August 14, 2016: Brain: a Journal of Neurology
Sarah Miller, Laurence Watkins, Manjit Matharu
BACKGROUND: Chronic migraine affects up to 2 % of the general population and has a substantial impact on sufferers. Occipital nerve stimulation has been investigated as a potentially effective treatment for refractory chronic migraine. Results from randomised controlled trials and open label studies have been inconclusive with little long-term data available. METHODS: The long-term efficacy, functional outcome and safety of occipital nerve stimulation was evaluated in an uncontrolled, open-label, prospective study of 53 intractable chronic migraine patients...
December 2016: Journal of Headache and Pain
Shannon Wang Clark, Lalit Venkatesan, David Boorman, Nathan Fried, Michael Oshinsky, Ashwini Dayal Sharan, Melanie Elliott
INTRODUCTION: Burst stimulation is a new paradigm that eliminates paresthesias typically observed with traditional tonic stimulation. We used a rodent model of episodic migraine to compare the efficacy of tonic and burst stimulation in treating trigeminal allodynia. METHODS: Twelve Sprague-Dawley rats with spontaneous trigeminal allodynia1 were implanted with miniaturized paddle leads over the occipital nerves, and the leads connected to a pulse generator located dorsally...
August 2016: Neurosurgery
Ian Thomas Walling, Lucy Gee, Paul Neubauer, Lance Frith, Emery Williams, Clif Burdette, Julie G Pilitsis
INTRODUCTION: Chronic migraines (CM) afflict approximately 16.6% of adults and negatively impact quality of life. Furthermore, although some CM can be treated with steroids, occipital nerve block, radiofrequency therapy, or medical therapy, approximately 15% of patients remain refractory to treatment. We explore focused high-intensity ultrasound (HIU) as a therapy allowing for ablation or pulse modulation of the occipital nerve in a validated rodent model of CM. METHODS: Male Sprague-Dawley rats received inflammatory media via an epidural cannula over 3 weeks to induce a CM state...
August 2016: Neurosurgery
Hans H Kornhuber, Lüder Deecke
A method of chronological data storage and reverse computation is described by which bio-electrical phenomena preceding 'spontaneous' events within the nervous system can be analysed if these events appear repeatedly and are capable of triggering a computer.Slow brain potentials accompanying voluntary and passive movements of the limbs were analysed by this method. These potentials were recorded from different points of the scalp from 12 healthy subjects in 94 experiments with more than 100 movements in each record...
July 2016: Pflügers Archiv: European Journal of Physiology
Dong Cheng, Lei Hu, Feng Xian, Jian Zhong, Yuejuan Zhang, Gangwei Wang, Jiyuan Ma, Hao Xu
OBJECTIVE: To observe the clinical effects of needle-pricking therapy, a newly medical and minimally invasive technique, for functional retrograde ejaculation and to explore its mechanism. Methods Thirty-six patients with functional retrograde ejaculation were randomly divided into an observation group(19 cases) and a control group(17 cases) In the observation group,needle-pricking therapy was used at Guanyuan(CV 4) and bilateral sacral plexus nerve,lumbar 1 nerve and greater occipital nerve stimulating points,once a week...
February 2016: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
Delphine Magis, Kevin D'Ostilio, Aurore Thibaut, Victor De Pasqua, Pascale Gerard, Roland Hustinx, Steven Laureys, Jean Schoenen
BACKGROUND AND AIM: A recent sham-controlled trial showed that external trigeminal nerve stimulation (eTNS) is effective in episodic migraine (MO) prevention. However, its mechanism of action remains unknown. We performed 18-fluorodeoxyglucose positron emission tomography (FDG-PET) to evaluate brain metabolic changes before and after eTNS in episodic migraineurs. METHODS: Twenty-eight individuals were recruited: 14 with MO and 20 healthy volunteers (HVs). HVs underwent a single FDG-PET, whereas patients were scanned at baseline, directly after a first prolonged session of eTNS (Cefaly®) and after three months of treatment (uncontrolled study)...
June 23, 2016: Cephalalgia: An International Journal of Headache
Munevver Celik Gokyigit, Ibrahim Ercan, Selma Seker, Lale Gundogdu Celebi, Cumhur Ertekin
In this study, the responses of thyroarytenoid (TA) and cricopharyngeus (CP) muscles were simultaneously recorded to peripheral magnetic stimulation of the vagus nerve. Recordings were performed in 13 subjects by means of concentric needle EMG electrodes inserted in the TA and CP. Magnetic shocks were delivered to the vagus nerve with a round coil placed occipitally, while EMG was silent in the TA. In all subjects, clear-cut responses were obtained simultaneously in both muscles. In TA compared to CP, the maximum amplitude of the responses were higher, whereas the onset latency was shorter...
June 2016: Neurophysiologie Clinique, Clinical Neurophysiology
Massimo Leone, Alberto Proietti Cecchini, Giuseppe Messina, Angelo Franzini
INTRODUCTION: Chronic cluster headache is rare and some of these patients become drug-resistant. Occipital nerve stimulation has been successfully employed in open studies to treat chronic drug-resistant cluster headache. Data from large group of occipital nerve stimulation-treated chronic cluster headache patients with long duration follow-up are advantageous. PATIENTS AND METHODS: Efficacy of occipital nerve stimulation has been evaluated in an experimental monocentric open-label study including 35 chronic drug-resistant cluster headache patients (mean age 42 years; 30 men; mean illness duration: 6...
June 1, 2016: Cephalalgia: An International Journal of Headache
Stéphan Chabardès, Romain Carron, Eric Seigneuret, Napoleon Torres, Laurent Goetz, Alexandre Krainik, Brigitte Piallat, Pascale Pham, Olivier David, Pierrick Giraud, Alim Louis Benabid
BACKGROUND: The third ventricle (3rd V) is surrounded by centers related to satiety, homeostasis, hormones, sleep, memory, and pain. Stimulation of the wall of the 3rd V could be useful to treat disorders related to dysfunction of the hypothalamus. OBJECTIVE: To assess safety and efficacy of endoventricular electrical stimulation of the hypothalamus using a floating deep brain stimulation (DBS) lead laid on the floor of the 3rd V to treat refractory cluster headaches (CH)...
May 26, 2016: Neurosurgery
Sarah Miller, Alex J Sinclair, Brendan Davies, Manjit Matharu
There is increasing interest in using neurostimulation to treat headache disorders. There are now several non-invasive and invasive stimulation devices available with some open-label series and small controlled trial studies that support their use. Non-invasive stimulation options include supraorbital stimulation (Cefaly), vagus nerve stimulation (gammaCore) and single-pulse transcranial magnetic stimulation (SpringTMS). Invasive procedures include occipital nerve stimulation, sphenopalatine ganglion stimulation and ventral tegmental area deep brain stimulation...
October 2016: Practical Neurology
Dagny Holle-Lee, Charly Gaul
The efficacy of invasive vagal nerve stimulation as well as other invasive neuromodulatory approaches such as deep brain stimulation, occipital nerve stimulation, and ganglion sphenopalatine stimulation has been shown in the treatment of headache disorders in several studies in the past. However, these invasive treatment options were quite costly and often associated with perioperative and postoperative side effects, some severe. As such, they were predominantly restricted to chronic and therapy refractory patients...
May 2016: Therapeutic Advances in Neurological Disorders
Matthew S Robbins, Richard B Lipton
Noninvasive and minimally invasive extracranial stimulation has now been widely investigated for the treatment of primary headache disorders, particularly migraine. In this review, we describe methodological challenges in studying occipital and supraorbital stimulation devices. We explore the efficacy and safety of implantable occipital nerve stimulation for primary headache disorders, including the 3 randomized, sham-controlled clinical trials for chronic migraine treatment. We also review noninvasive supraorbital transcutaneous stimulation as a preventive therapy for episodic migraine...
April 28, 2016: Headache
Il Choi, Sang Ryong Jeon
Occipital neuralgia is defined by the International Headache Society as paroxysmal shooting or stabbing pain in the dermatomes of the greater or lesser occipital nerve. Various treatment methods exist, from medical treatment to open surgical procedures. Local injection with corticosteroid can improve symptoms, though generally only temporarily. More invasive procedures can be considered for cases that do not respond adequately to medical therapies or repeated injections. Radiofrequency lesioning of the greater occipital nerve can relieve symptoms, but there is a tendency for the pain to recur during follow-up...
April 2016: Journal of Korean Medical Science
Harith Akram, Sarah Miller, Susie Lagrata, Jonathan Hyam, Marjan Jahanshahi, Marwan Hariz, Manjit Matharu, Ludvic Zrinzo
OBJECTIVE: To present outcomes in a cohort of medically intractable chronic cluster headache (CCH) patients treated with ventral tegmental area (VTA) deep brain stimulation (DBS). METHODS: In an uncontrolled open-label prospective study, 21 patients (17 male; mean age 52 years) with medically refractory CCH were selected for ipsilateral VTA-DBS by a specialist multidisciplinary team including a headache neurologist and functional neurosurgeon. Patients had also failed or were denied access to occipital nerve stimulation within the UK National Health Service...
May 3, 2016: Neurology
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