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Chronic Bilateral Sphenopalatine Ganglion Stimulation for Intractable Bilateral Chronic Cluster Headache: A Case Report

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机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Tiantan Xili 6, Beijing 100050, Peoples R China; [2]Capital Med Univ, Beijing Neurosurg Inst, Beijing, Peoples R China; [3]Beijing Fengtai Hosp, Dept Neurosurg, Beijing, Peoples R China; [4]Capital Med Univ, Beijing Tiantan Hosp, Dept Anesthesiol & Pain Management, Beijing, Peoples R China
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关键词: Cluster headache sphenopalatine ganglion SPG neuromodulation side shift stimulation

摘要:
A cluster headache (CH) is an excruciating pain centered on the periorbital region and is accompanied by autonomic symptoms. Despite the best currently available medical therapy, many patients still suffer from these headaches. Some patients also experience CH with side shift of attacks, which makes treatment more difficult. In light of the pathophysiological mechanism of CH, the sphenopalatine ganglion (SPG) is a promising therapeutic target for its management. SPG ablation and non-ablation techniques have been the preferred treatment for CH in recent decades. However, few articles have reported the effectiveness of acute SPG stimulation for CH, and no studies have demonstrated the safety and efficacy of bilateral continuous SPG stimulation for CH. In this article, we report on a 59-year-old chronic cluster headache (CCH) patient who had side shifts of attacks and was treated with bilateral continuous SPG stimulation. The patient suffered from CCH for 9 years, and the intensity of pain and the frequency of attacks had gradually increased over time. At the time of admission, he experienced daily attacks. Medical therapy and SPG blocks were offered, but he only achieved transient pain relief. After a careful preoperative examination and discussion with the patient, we provided bilateral SPG stimulation. The electrode was implanted under C-arm fluoroscopic guidance. After continuous stimulation, the patient experienced significant reductions in headache severity. The frequency of attacks was reduced from daily to less than once per week. He also discontinued all of the related drugs that he was taking. This is the first report of bilateral continuous SPG stimulation for CCH. This report indicates that continuous SPG stimulation is a feasible therapeutic option for CCH. However, large-scale and long-term studies are required to elucidate the efficacy of SPG stimulation.

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出版当年[2015]版:
大类 | 2 区 医学
小类 | 2 区 麻醉学 2 区 临床神经病学
最新[2023]版:
大类 | 2 区 医学
小类 | 3 区 麻醉学 3 区 临床神经病学
JCR分区:
出版当年[2014]版:
Q1 CLINICAL NEUROLOGY Q1 ANESTHESIOLOGY
最新[2023]版:
Q2 CLINICAL NEUROLOGY Q2 ANESTHESIOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2014版] 出版当年五年平均 出版前一年[2013版] 出版后一年[2015版]

第一作者:
第一作者机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Tiantan Xili 6, Beijing 100050, Peoples R China;
通讯作者:
通讯机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Tiantan Xili 6, Beijing 100050, Peoples R China;
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