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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> DBS - Try this first?
        
(Message started by: cluster on Aug 4^th, 2006, 6:40pm)

Title: DBS - Try this first?
Post by cluster on Aug 4^th, 2006, 6:40pm

Quote:

From the University of Milan Italy (g.f.).

The diagnosis of chronic cluster headache (CH), the most painful form of headache, is based on typical clinical features characterized by strictly unilateral pain with no side shift and ipsilateral oculofacial autonomic phenomena. The attacks occur several times a day for periods of 1 to 2 months in the episodic form of the disease or less frequently on a daily basis in the chronic form. The pathogenesis of CH involves the activation of parasympathetic nerve structures located within the sphenopalatine ganglion (SPG), which explains many of the associated symptoms, whereas the activation of the ipsilateral hypothalamic gray matter may explain its typical circadian and circannual periodicity. A number of surgical approaches have been tried in cases of chronic CH resistant to pharmacologic therapy, of which SPG blockade has been shown to have certain efficacy. We have adopted a new technique based on endoscopic ganglion blockade that approaches the pterigo-palatine fossa by way of the lateral nasal wall and consists of the injection of a mixture of local anesthetics and corticosteroids, which was performed in 20 selected patients with chronic CH, according to the International Headache Society criteria (18 male, 2 female; mean age 40 yr), who were selected for SPG blockade because they were totally drug resistant. The symptoms improved significantly, but always only temporarily, in 11 cases. These results should be considered rather good because, unlike other frequently used techniques, SPG blockade is not invasive and should therefore always be attempted before submitting patients to more invasive surgical approaches.

PMID: 16885751 [PubMed - in process]

(Source: PubMed Laryngoscope. 2006 Aug;116(8)) (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16885751&itool=iconabstr&itool=pubmed_DocSum)

Title: Re: DBS - Try this first?
Post by thebbz on Aug 4^th, 2006, 7:27pm

And the question is? [smiley=huh.gif]

Title: Re: DBS - Try this first?
Post by unsolved1 on Aug 5^th, 2006, 2:28am

If you're asking if you should try a SPG blockade before you try the DBS surgery ... the answer is YES. Although the SPG blockade procedure is horrific ... it's still considered minimally invasive ... much easier to do than the DBS. It only takes a few minutes to do ... no cutting or sedation required. They just try to get a jel like mixture WAY UP your nose (both sides) to the base of your brain ! :-/

I've had 2 SPG blockades and they were both terrifying .... not to mention the headaches got much worse and more frequent. I thought I doomed myself permenantly !

Goodluck

UNsolved

Title: Re: DBS - Try this first?
Post by Lizzie2 on Aug 6^th, 2006, 1:09am

Try deep brain surgery first? No... Try that last... Try something easier first!

Title: Re: DBS - Try this first?
Post by Pinkfloyd on Aug 6^th, 2006, 2:03am

I believe he was suggesting to people that were considering the DBS, to consider the nerve block first (before the DBS)

Bobw

Title: Re: DBS - Try this first?
Post by cluster on Aug 6^th, 2006, 10:35am

Hello all,

sorry for creating some confusion. I found the above report quite interesting because it is from the "inventors" of DBS at the Istituto Nazionale Neurologico Carlo Besta, Milano, Italy. See: Abstract: Hypothalamic stimulation for intractable cluster headache :Long-term experience - Neurology. 2006 Jul 11;67(1):150-2 (http://www.neurology.org/cgi/content/abstract/67/1/150)

They suggest: "SPG blockade is not invasive and should therefore always be attempted before submitting patients to more invasive surgical approaches." This is only ment for patients, if all other methods and medications have failed.

Also I was trying to ask for your experience with and opinions about this treatment. Promise: Next time I will write at least one full sentence to make clear what I am after. ;)

Regards and painfree times,
Friedrich

Title: Re: DBS - Try this first?
Post by Carl1958 on Aug 6^th, 2006, 1:57pm

on 08/06/06 at 10:35:39, cluster wrote:

This is only ment for patients, if all other methods and medications have failed.

Friedrich

Hello Friedrich,
do they include Pcilocybin/LSD, & LSA in there statement of all other Med's. that have failed I wonder. ::)

Take care.
CArl. 8)

Title: Re: DBS - Try this first?
Post by cluster on Aug 6^th, 2006, 5:05pm

on 08/06/06 at 13:57:25, Carl1958 wrote:

Hello Friedrich,
do they include Pcilocybin/LSD, & LSA in there statement of all other Med's. that have failed I wonder. ::)

Take care.
CArl. 8)

Hello Carl,

I am a fraid knot.

Pain free wishes!
Friedrich

(And please excuse my spelling.)

Title: Re: DBS - Try this first?
Post by Globi on Aug 7^th, 2006, 2:27am

SPG blockage?
Is that the procedure with a needle (with a tip that can heat up) trough your cheek up to your nose?
That was HELL. I had it done two times.

DBS should be the last resort. But I am thinking about it as well. But..the risks are considerable…….one patient died (Belgium) and damaging you brains is also an option. Next to this, what scares me off as well, is the length of the operation and the fact (as I understand) that you will have to be awake most of the time during the procedure. Although it doesn’t hurt…..the thought of having someone ‘poking’ around in your brains while being awake……