title: Safety and efficacy of cervical 10 kHz spinal cord stimulation in chronic refractory primary headaches: a retrospective case series.
abstract: BACKGROUND
  Paresthesia-free cervical 10 kHz spinal cord stimulation (HF10 SCS) may constitute a novel treatment modality for headache disorders, when pharmacological approaches fail. We report the results of a retrospective analysis assessing the long-term safety, tolerability and efficacy of HF10 SCS in a group of patients with chronic refractory primary headache disorders.
  
  
  RESULTS
  Four patients with chronic migraine (CM), two with chronic SUNA (Short-lasting Unilateral Neuralgiform headache attacks with Autonomic symptoms) and one with chronic cluster headache (CCH) refractory to medical treatments, were implanted with cervical HF10 SCS. Pre- and post-implantation data were collected from the medical notes and from headache charts. At an average follow-up of 28 months (range: 12-42 months) we observed an improvement of at least 50 % in headache frequency and/or intensity in all CM patients. One SUNA patient became pain free and the other reported at least 50 % improvement in attacks frequency an duration. The CCH patient reported a significant reduction in CH attacks duration. Two patients underwent a surgical revision due to lead migration.
  
  
  CONCLUSIONS
  Paresthesia-free high cervical HF10 SCS appears to be a long-term safe and likely effective therapeutic approach for patients with chronic refractory primary headache disorders. These results warrant further prospective studies in larger series of patients.
authors.affiliation: The Headache Centre, Pain Management and Neuromodulation Department, Guy's and St Thomas' NHS Foundation Trust, London, UK. giorgio.lambru@gstt.nhs.uk.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Lambru
authors.affiliation: The Headache Centre, Pain Management and Neuromodulation Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Michele
authors.initials: M
authors.lastname: Trimboli
authors.affiliation: The Headache Centre, Pain Management and Neuromodulation Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Stefano
authors.initials: S
authors.lastname: Palmisani
authors.affiliation: The Headache Centre, Pain Management and Neuromodulation Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Smith
authors.affiliation: The Headache Centre, Pain Management and Neuromodulation Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Adnan
authors.initials: A
authors.lastname: Al-Kaisy
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D020773:Headache Disorders / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000000981:diagnostic imaging* / Q000628:therapy*; D011446:Prospective Studies; D012189:Retrospective Studies; D062187:Spinal Cord Stimulation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Chronic migraine; Cluster headache; Neurostimulation; Refractory headaches; SUNA syndrome; Spinal cord stimulation