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Neurostimulation for Headache That Has Become Difficult to Treat

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Handbook of Headache

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Abstract

The acute and preventive medical treatment of patients with primary headache syndromes such as chronic migraine is challenging and side effects frequently complicate the course of medical treatment. Recently there has been considerable progress in neurostimulation techniques in medically intractable chronic headache syndromes. It is very well known that a non-painful stimulation of peripheral nerves can elicit analgesic effects. This phenomenon has been used in certain pain syndromes using non-invasive high- or low-frequency transcutaneous electrical nerve stimulation (TENS), percutaneous electrical nerve stimulation (PENS/acupuncture-like TENS or AL-TENS), and spinal cord stimulation (SCS). The analgesic effect is critically dependent on the intensity of the electrical stimulation. In recent years, minimally invasive neurostimulation techniques and neuromodulatory techniques, such as transcranial magnetic stimulation, have also been applied to patients with chronic headaches. This chapter summarizes the current concepts and outcome data of neurostimulation and neuromodulatory approaches. The studies suggest suboccipital neurostimulation can have an effect even decades after onset of headaches thus representing a possible therapeutic option in chronic patients with headaches difficult to treat and that do not respond to any medication. In a subset of patients with chronic cluster headaches, hypothalamic deep brain stimulation may be a treatment option.

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Authors and Affiliations

  1. Department of Neurology, University Hospital Schleswig-Holstein, University of Kiel, Schittenhelmstr. 10, 24105, Kiel, Germany

    Dr. Thorsten Bartsch M.D.

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  1. Dr. Thorsten Bartsch M.D.
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Correspondence to Thorsten Bartsch M.D. .

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Editors and Affiliations

  1. Department of Medical and Molecular Sciences, School of Health Sciences, Sapienza University of Rome, Rome, Italy

    Paolo Martelletti

  2. Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway

    Timothy J. Steiner

  3. Department of Neuroscience, Faculty of Medicine, Imperial College London, London, UK

    Timothy J. Steiner

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© 2011 Lifting The Burden

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Bartsch, T. (2011). Neurostimulation for Headache That Has Become Difficult to Treat. In: Martelletti, P., Steiner, T.J. (eds) Handbook of Headache. Springer, Milano. https://doi.org/10.1007/978-88-470-1700-9_34

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  • DOI: https://doi.org/10.1007/978-88-470-1700-9_34

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1699-6

  • Online ISBN: 978-88-470-1700-9

  • eBook Packages: MedicineReference Module Medicine

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