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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Deep Brain Stimulation: German report
        
(Message started by: Bob_Johnson on Feb 23^rd, 2008, 10:48am)

Title: Deep Brain Stimulation: German report
Post by Bob_Johnson on Feb 23^rd, 2008, 10:48am

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]

Title: Re: Deep Brain Stimulation: German report
Post by George_J on Feb 23^rd, 2008, 7:38pm

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

Title: Re: Deep Brain Stimulation: German report
Post by thebbz on Feb 23^rd, 2008, 9:41pm

Three patients almost pain-free.
nuckin futs
thebb

Title: Re: Deep Brain Stimulation: German report
Post by Ray on Feb 24^th, 2008, 2:58pm

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