Posted by Kevin (206.31.190.1) on May 16, 2001 at 16:40:59:
that a mediacl producer referred to me
ectrical Stimulation Cured Cluster Headaches in Italian Man
By
Neil Osterweil
WebMD Medical News
May 15, 2001 (Philadelphia) -- Talk about being wired: A 39-year-old man
with severe, disabling cluster headaches that didn't respond to any available
medications had his headaches completely disappear after surgeons
implanted a slim wire into his brain and hooked it up to an electrical
stimulator. The first-of-its kind procedure was reported by Italian surgeons
here for the annual meeting of the American Academy of Neurology.
Since the surgery, "his life has completely changed; he was totally disabled
and unable to work for five years," Massimo Leone, MD, tells WebMD.
Within 48 hours of receiving the wire -- and the three volts of electrical
stimulation it carried to the brain region where the headaches occurred -- the
man experienced complete relief. When the stimulator was turned off on two
occasions when the patient required surgery on one of his eyes, the
headaches returned within 24-48 hours, but were again relieved when the
stimulator was switched back on.
The patient, a heavy equipment operator, has been free of headaches for
nearly a year and has been able to return to work, says Leone says, who
works in the department of neurology and neurosurgery at Carlo Besta
National Neurological Institute in Milan, Italy.
Chris Janson, MD, from the department of neurosurgery at Thomas Jefferson
University in Philadelphia, tells WebMD that similar operations are often
deemed to be successful if the patient is able to significantly reduce his
medications after the procedure.
"In this case it seems that you could wean somebody completely off his or
her drugs, and at least in this one individual it works pretty well," says
Janson, who was not involved in the Italian study.
Cluster headache is a rare but serious form of headache, so-called because
it occurs in clusters or groups. "It is probably one of the worst types of pain
that man can suffer from," Leone says.
Unlike migraines, which occur more frequently in women than in men,
cluster headaches are a predominantly male affliction, by a factor of about
5:1.
Cluster headaches can occur in episodes of one or two a year, or in the
case of the Italian man, they can recur frequently. Although some patients
get relief from drugs such as those used to treat migraine, some people with
this frequently recurring type require surgery to cut or destroy one of the
nerves in the face. This isn't necessarily a cure, however, for these nerves
can eventually regenerate.
The Italian man's physicians had tried nearly all of these options, and all had
failed, so the surgeons decided to try a different approach (with the patient's
consent), called deep brain stimulation, which has been shown to be
successful in some cases of Parkinson's disease and other movement
disorders.
Recent brain imaging studies have shown that a certain area of the brain
appears to be highly active during a cluster headache attack. The surgeons
used a three-dimensional imaging technique to precisely place the wire into
that region. The wire runs under the skin of the patient's scalp and is
connected to a small electrical stimulator implanted under the collarbone.
The surgeons have since performed the procedure on two additional
patients, with similar success, says Givonanni Broggi, MD, chairman of
neurosurgery at the Carlo Besta Institute, in an interview with WebMD