Hypothalamic deep brain stimulation and bilateral occipital nerve stimulation - new invasive procedures may help treat patients with chronic refractory headache (cluster headache). This is one of the conclusions reached by Charly Gaul and co-authors from the Department of Neurology at the University Medical Center Essen.
Cluster headache is the commonest trigemino-autonomic headache. Typically, patients suffer unilateral short attacks, which are accompanied by restlessness. The causes of cluster headache are not clear. Men are affected more often than women, with a ratio of 3.5:1.
Treating the pain attacks with trioptans or inhalation of pure oxygen is effective and well supported by scientific evidence. According to the authors, verapamil is the medication of choice for the purpose of prophylaxis, with onset of effectiveness within the first week. Lithium is an alternative, especially for treating the chronic disease.
The study has been published in the current issue of Deutsches Arzteblatt International.