Abstract:
OBJECTIVE:To describe the outcome of a patient with refractory chronic paroxysmal hemicrania (CPH) to occipital nerve stimulation (ONS). BACKGROUND:CPH is a primary headache disorder exquisitely sensitive to indomethacin. In patients unable to tolerate indomethacin, the therapeutic options are limited. ONS is a promising therapy for other refractory headache conditions. We report the first patient with medically refractory CPH treated with ONS. METHODS:Following implantation of the occipital nerve stimulator in 2006, the patient kept prospective headache diaries. Outcome was assessed by daily attack frequency. RESULTS:After a follow-up of over 10 years, the patient reported a sustained efficacy of more than 50% reduction in attack frequency and was pain-free at final follow-up. The patient was able to stop indomethacin completely. The patient had three successful pregnancies during follow-up. One system revision was undertaken alongside an expected battery replacement to treat unequal paresthesia and pain over the electrodes. CONCLUSION:ONS may offer an effective long-term treatment for CPH in patients where indomethacin cannot be tolerated.
journal_name
Headachejournal_title
Headacheauthors
Miller S,Lagrata S,Watkins L,Matharu Mdoi
10.1111/head.13187subject
Has Abstractpub_date
2017-11-01 00:00:00pages
1610-1613issue
10eissn
0017-8748issn
1526-4610journal_volume
57pub_type
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