Clusterheadaches.com Message Board


    
      
        Clusterheadaches.com Message Board
        (http://www.clusterheadaches.com/cgi-bin/yabb/YaBB.cgi)
      

        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> DEEP BRAIN STIMULATION
        
(Message started by: tony-PA on Jan 30^th, 2008, 9:15pm)

Title: DEEP BRAIN STIMULATION
Post by tony-PA on Jan 30^th, 2008, 9:15pm

hi everybody,
there is any of the few people in the word (21 if i'm correct) undergone dbs, in this board?
I would love to know something about the results and what is your opinion about this very ultimate resource.

p.s.: i always try to do the search before asking, but some time (like this one) i fail :-[. thank you

Title: Re: DEEP BRAIN STIMULATION
Post by Bob_Johnson on Jan 31^st, 2008, 9:06am

Brain. 2005 Apr;128(Pt 4):940-7. Epub 2005 Feb 2.

Hypothalamic stimulation in chronic cluster headache: a pilot study of efficacy and mode of action.

Schoenen J, Di Clemente L, Vandenheede M, Fumal A, De Pasqua V, Mouchamps M, Remacle JM, de Noordhout AM.

Headache Research Unit, University Department of Neurology, CHR Citadelle, Bd du XIIeme de Ligne, B-4000 Liege, Belgium. j.schoenen@ulg.ac.be

We enrolled six patients suffering from refractory chronic cluster headache in a pilot trial of neurostimulation of the ipsilateral ventroposterior hypothalamus using the stereotactic coordinates published previously. After the varying durations needed to determine optimal stimulation parameters and a mean follow-up of 14.5 months, the clinical outcome is excellent in three patients (two are pain-free; one has fewer than three attacks per month), but unsatisfactory in one patient, who only has had transient remissions. Mean voltage is 3.28 V, diplopia being the major factor limiting its increase. When the stimulator was switched off in one pain-free patient, attacks resumed after 3 months until it was turned on again. In one patient the implantation procedure had to be interrupted because of a panic attack with autonomic disturbances. Another patient died from an intracerebral haemorrhage that developed along the lead tract several hours after surgery; there were no other vascular changes on post-mortem examination. After 1 month, the hypothalamic stimulation induced resistance against the attack-triggering agent nitroglycerin and tended to increase pain thresholds at extracephalic, but not at cephalic, sites. It had no detectable effect on neurohypophyseal hormones or melatonin excretion. We conclude that hypothalamic stimulation has remarkable efficacy in most, but not all, patients with treatment-resistant chronic cluster headache. Its efficacy is not due to a simple analgesic effect or to hormonal changes. Intracerebral haemorrhage cannot be neglected in the risk evaluation of the procedure. Whether it might be more prevalent than in deep-brain stimulation for movement disorders remains to be determined.

Publication Types:
Evaluation Studies

PMID: 15689358
=========================

Neurol Sci. 2005 May;26 Suppl 2:s138-9.

Deep brain stimulation and cluster headache.

Leone M, Franzini A, Felisati G, Mea E, Curone M, Tullo V, Broggi G, Bussone G.

Headache Centre, C. Besta National Neurological Institute, Via Celoria 11, I-20133, Milan, Italy. leone@istituto-besta.it

In recent years, neuroimaging data have greatly improved the knowledge on trigeminal autonomic cephalalgias' (TACs) central mechanisms. Positron emission tomography studies have shown that the posterior inferior hypothalamic grey matter is activated during cluster headache attacks as well as in short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT). Voxel-based morphometric MRI has also documented alteration in the same area in cluster headache patients. These data suggest that the cluster headache generator is located in this region and leads us to hypothesise that stimulation of this brain area could relieve intractable cluster headache just as deep brain stimulation improves intractable movements disorders. This view received support by the observation that high frequency stimulation of the ipsilateral hypothalamus prevented attacks in an otherwise intractable chronic cluster headache patient previously treated unsuccessfully by surgical procedures to the trigeminal nerve. So far, 16 patients with intractable cronic cluster headache (CCH) and one intractable SUNCT patient have been successfully treated by hypothalamic stimulation. The procedures were well tolerated with no significant adverse events. Hypothalamic DBS is an efficacious and safe procedure to relieve otherwise intractable CCH and SUNCT.

Publication Types:
Review

PMID: 15926012 [PubMed]

Title: Re: DEEP BRAIN STIMULATION
Post by Charlotte on Jan 31^st, 2008, 10:17am

thank you, Bob. Have I told you lately how much I appreciate you?

Having SUNCT in my combo plate menu, I am always starving for info. Do not think I would want to try this one, though. Not enough success. SUNCT is a real bitch, I will tell you. Not a beast, just a bitch.

Charlotte

Title: Re: DEEP BRAIN STIMULATION
Post by tony-PA on Jan 31^st, 2008, 12:30pm

on 01/31/08 at 10:17:23, Charlotte wrote:

Not enough success.

yes indeed :( we have (in our forum) 3 friends who did that and keep having lot of troubles of any kind.
But I was curious to know if you have any direct personal testimony ( not just medical reports ;))

p.s.: personally I'd rather have a bullet in my little brain instead of a microchip. sorry :-[

Title: Re: DEEP BRAIN STIMULATION
Post by thebbz on Jan 31^st, 2008, 2:18pm

I would rather eat barbed wire and shit spikes.
Oops wrong thread. ;)
thebb