title: [Vagus nerve stimulation in patients with migraine].
abstract: BACKGROUND
  Vagus nerve stimulation (VNS) has been approved for the treatment of refractory epilepsy when resective surgery is not possible, and has proved to be highly effective. Series published in the literature suggest a beneficial effect of VNS in the treatment of migraine.
  
  
  OBJECTIVE
  To determine the degree to which headaches improve in patients with migraine after the placement of VNS to treat refractory epilepsy, and to evaluate what variables are associated with an increased chance of success with this measure.
  
  
  METHODS
  An observation-based retrospective study was conducted from 1st January 1999 until 31st December 2010. Patients with VNS for refractory epilepsy were contacted by telephone, after selecting those who fulfilled International Headache Society criteria for migraine. Data collected included age, gender, year of placement, age at onset of epilepsy and migraine, improvement of seizures and migraine, presence of migraine with aura and coexistence of anxious-depressive syndrome. Ninety-four patients with VNS were contacted and 13 patients with migraine were selected.
  
  
  RESULTS
  Following placement of the VNS, the number of episodes of migraine was seen to decrease by at least 50% in nine patients (69%) (p = 0.004) and there was a drop in the number of episodes of migraine in those patients who had also reduced their epileptic seizures (p = 0.012). No statistically significant associations were observed as regards sex, age, length of disease history, existence of migraine with aura or coexistence of anxious-depressive syndrome.
  
  
  CONCLUSIONS
  VNS could have beneficial effects for patients with migraine, especially in cases that are difficult to control. Due to the type of study, these conclusions must be taken with caution. Prospective clinical studies are needed before introducing the technique into daily clinical practice.
authors.affiliation: Hospital Universitario de la Princesa, 28006 Madrid, Espana.
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: Mosqueira
authors.forename: Lydia
authors.initials: L
authors.lastname: López-Manzanares
authors.forename: Beatrice
authors.initials: B
authors.lastname: Canneti
authors.forename: Alejandro
authors.initials: A
authors.lastname: Barroso
authors.forename: Eduardo
authors.initials: E
authors.lastname: García-Navarrete
authors.forename: Antonio
authors.initials: A
authors.lastname: Valdivia
authors.forename: José
authors.initials: J
authors.lastname: Vivancos
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000150:complications / Q000628:therapy; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000150:complications / Q000628:therapy; D004351:Drug Resistance; D004828:Epilepsies, Partial / Q000150:complications / Q000188:drug therapy / Q000523:psychology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007031:Hypothalamus / Q000503:physiopathology; D008032:Limbic System / Q000503:physiopathology; D008297:Male; D008881:Migraine Disorders / Q000150:complications / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D012189:Retrospective Studies; D017552:Solitary Nucleus / Q000503:physiopathology; D013787:Thalamic Nuclei / Q000503:physiopathology; D016896:Treatment Outcome; D014276:Trigeminal Nerve / Q000503:physiopathology; D014630:Vagus Nerve / Q000503:physiopathology*; D055536:Vagus Nerve Stimulation; D055815:Young Adult
chemical_list: D000927:Anticonvulsants