[Stimulation of the occipital nerve in the treatment of drug-resistant cluster headache].
OBJECTIVE
To evaluate the occipital nerve stimulation therapy in as a treatment for drug-resistant cluster headache.


METHODS
Prospective study of four patients, three males and one female. Mean age of 42 years. Patients complained of a cluster headache lasting between one and 16 years, with suboptimal control of the attacks with medication. In all cases octopolar electrodes were placed percutaneously in the occipital region bilaterally. Follow-up of 6 months.


RESULTS
At 6 months, there was a 56% (range: 25-95%) reduction in the frequency, a 48.8% (range: 20-60%) decrease in the intensity and a 63.8% (range: 0-88.8%) reduction in the duration of the attacks. Worsening or progression of the illness was not observed in any case. All patients referred a 15.4% (range: 6-31.5%) improvement in their quality of life compared to their previous basal situation in SF-36. In all cases but one there was a significant reduction in the amount and dosage of medication required. Postoperative complications were not observed. All patients would recommend the procedure.


CONCLUSIONS
Occipital nerve stimulation may be considered a safe and effective therapeutic option in the drug-resistant cluster headache. However, studies with more patients and a longer follow-up are required to evaluate the efficacy of the technique.
de Quintana-Schmidt
Cristian
C
Servicio de Neurocirugía, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, España. cquintana@santpau.es
Casajuana-Garreta
Edgar
E
Molet-Teixidó
Joan
J
García-Bach
Marcel
M
Roig
Carles
C
Clavel-Laria
Pablo
P
Rodríguez-Rodríguez
Rodrigo
R
Oliver-Abadal
Bartolomé
B
Bartumeus-Jené
Frederic
F
D000328:Adult; D003027:Cluster Headache / Q000601:surgery*; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009778:Occipital Lobe / Q000033:anatomy & histology*; D010525:Peripheral Nerves / Q000503:physiopathology*; D011446:Prospective Studies; D016896:Treatment Outcome