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- Title
[Deep brain stimulation in the posterior hypothalamus for chronic cluster headache. Case report and review of the literature].
- Authors
Rasche, D; Foethke, D; Gliemroth, J; Tronnier, V M
- Abstract
Primary chronic cluster headache (CCH) is a rare but severe pain syndrome and pathophysiological explanations are still missing. PET studies revealed activation in the hypothalamus and therefore it became a target for therapeutic deep brain stimulation (DBS). A case of a 39-year-old woman and a literature review are presented. The patient suffered from left-sided primary CCH for 14 months. The headache was resistant to any pharmacological therapy or treatment was limited by major drug side effects. Using a stereotactic approach a quadripolar lead was inserted in the left posterior hypothalamus. A test trial was performed and attack frequency, intensity, and adverse events were noted. Intraoperative test stimulation evoked typical side effects like tachycardia, diplopia and panic attacks. During the trial test a marked reduction in frequency and intensity of CCH was recorded. After 7 days the stimulation device was implanted subcutaneously. DBS with implantation of a lead in the ipsilateral inferior posterior hypothalamus is an experimental treatment option and should be offered to selected patients in a prospective controlled clinical trial. Data concerning the long-term follow-up need to be collected.
- Publication
Schmerz (Berlin, Germany), 2006, Vol 20, Issue 5, p439
- ISSN
0932-433X
- Publication type
Journal Article
- DOI
10.1007/s00482-005-0462-3