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Topic: Deep Brain Stimulation: German report (Read 365 times) |
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Bob_Johnson
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Deep Brain Stimulation: German report
« on: Feb 23rd, 2008, 10:48am » |
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Given the outcomes, think you need pretty desperate to go this route.
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Cephalalgia. 2008 Mar;28(3):285-95.
Hypothalamic deep brain stimulation for cluster headache: experience from a new multicase series.
Bartsch T, Pinsker MO, Rasche D, Kinfe T, Hertel F, Diener HC, Tronnier V, Mehdorn HM, Volkmann J, Deuschl G, Krauss JK.
Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany. t.bartsch@neurologie.uni-kiel.de
Deep brain stimulation (DBS) of the posterior hypothalamus was found to be effective in the treatment of drug-resistant chronic cluster headache. We report the results of a multicentre case series of six patients with chronic cluster headache in whom a DBS in the posterior hypothalamus was performed. Electrodes were implanted stereotactically in the ipsilateral posterior hypothalamus according to published coordinates 2 mm lateral, 3 mm posterior and 5 mm inferior referenced to the mid-AC-PC line. Microelectrode recordings at the target revealed single unit activity with a mean discharge rate of 17 Hz (range 13-35 Hz, n = 4).
OUT OF SIX PATIENTS, FOUR SHOWED A PROFOUND DECREASE OF THEIR ATTACK FREQUENCY AND PAIN INTENSITY ON THE VISUAL ANALOGUE SCALE DURING THE FIRST 6 MONTHS. OF THESE, ONE PATIENT WAS ATTACK FREE FOR 6 MONTHS UNDER NEUROSTIMULATION BEFORE RETURNING TO THE BASELINE WHICH LED TO ABORTION OF THE DBS. TWO PATIENTS HAD EXPERIENCED ONLY A MARGINAL, NON-SIGNIFICANT DECREASE WITHIN THE FIRST WEEKS UNDER NEUROSTIMULATION BEFORE RETURNING TO THEIR FORMER ATTACK FREQUENCY. AFTER A MEAN FOLLOW-UP OF 17 MONTHS, THREE PATIENTS ARE ALMOST COMPLETELY ATTACK FREE, WHEREAS THREE PATIENTS CAN BE CONSIDERED AS TREATMENT FAILURES.
The stimulation was well tolerated and stimulation-related side-effects were not observed on long term. DBS of the posterior inferior hypothalamus is an effective therapeutic option in a subset of patients. Future controlled multicentre trials will need to confirm this open-label experience and should help to better define predictive factors for non-responders.
PMID: 18254897 [PubMed]
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Bob Johnson
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George_J
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Re: Deep Brain Stimulation: German report
« Reply #1 on: Feb 23rd, 2008, 7:38pm » |
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You're right. Doesn't sound as if the odds of a positive outcome are all that great, given the present state of the technology--at least, according to this study.
As always, many thanks for the report, Bob. They are appreciated.
Best wishes,
George
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Ah! The foreigners put on such airs
Wearing the tangerine suits
And their harlequin eyes.
The pain they inspire
Draws in harmonica melodies
And the feathers of birds
Which flame up at their touch.
It all comes to light in the sheer
Debonair.
(Ellen)
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thebbz
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Re: Deep Brain Stimulation: German report
« Reply #2 on: Feb 23rd, 2008, 9:41pm » |
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Three patients almost pain-free.
nuckin futs
thebb
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It wasn't me I didn't do it
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Ray
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Re: Deep Brain Stimulation: German report
« Reply #3 on: Feb 24th, 2008, 2:58pm » |
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Hello Clusterville:
I've said it before, and I'll probably say it again....
Because of the relatively poor chances of relief, and the relatively high chances of side effects including death, I would not try this unless I were on the verge of suicide. Then again, I probably would not be considered by the doctors as a good candidate if I were suicidal.
When the number of these proceedures goes up, and experience grows, perhaps the proceedure will be more successful and more viable. Until then, no thanks!
Wishing you well,
Ray
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You have my prayers and compassion-I'm right there with you.
Dum tempus habemus, operemur bonum
*While we have the time, let us do good*
http://www.myspace.com/rayplace
http://www.shadesgarden.com
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