Safety and efficacy of percutaneous pulsed radiofrequency treatment at the C1 –C2 level in chronic cluster headache: a retrospective analysis of 21 cases

AbstractWe performed a study of the safety and efficacy of percutaneous pulsed radiofrequency (PRF) treatment directed at C1 and C2 levels as performed at our local pain clinic in refractory chronic cluster headache (CCH) patients. We identified 21 CCH patients treated with PRF (240  s, max. 45 V, max. 42 °C) directed at the ganglion and/or nerve root of C1 and C2. Data were collected through retrospective analysis of patients’ files and include demographic variables, onset and duration of the headache, mean attack frequency, and prior pharmacological treatment. Safety an d reduction of attack frequency in the first 3 months after a first PRF treatment was the primary outcome parameter of this study. All patients had been treated with at least two prophylactic drugs and 19 (90%) had previously been treated with verapamil, lithium, and topiramate. Ten patients (47.6% ) reported no meaningful effect, four patients (19%) reported a meaningful reduction of
Source: Acta Neurologica Belgica - Category: Neurology Source Type: research

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ConclusionsThese results are promising, despite the limited evidence available. We consider it essential for research to continue into the safety and efficacy of SPG stimulation for patients with refractory chronic cluster headache. In cases where this intervention may be indicated, treatment should be closely monitored.ResumenIntroducciónEl objetivo es evaluar la eficacia y seguridad de los neuroestimuladores periféricos del ganglio esfenopalatino (GEP) para el tratamiento de la cefalea en racimos crónica refractaria al tratamiento.DesarrolloRevisión sistemática de la literatura cient&ia...
Source: Neurologia - Category: Neurology Source Type: research
Conclusion: Although pericranial nerve blocks have been tried in chronic PH cases with positive influences, this case indicated that repetitive nerve blocks were not always a successful therapy option.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
AbstractPurpose of ReviewChronic headache is a significant worldwide problem despite advances in treatment options. Chronic headaches can have significant a detrimental impact on the activities of daily living.Recent FindingsPatients who do not obtain relief from chronic head and neck pain from conservative treatments are commonly being managed with interventional treatments. These interventional treatment options include botulinum toxin A, injections, local occipital nerve anesthetic and corticosteroid infiltration, occipital nerve subcutaneous stimulation and occipital nerve pulsed radiofrequency (PRF), sphenopalatine ga...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
We present a patient with cluster headache presenting with chronic ipsilateral facial pain with nasal congestion and left eye pain who achieved sustained pain relief with an ultrasound-guided injection into the pterygopalatine fossa in conjunction with an ultrasound-guided pulsed radiofrequency ablation procedure involving the C2 dorsal root ganglion.
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports Source Type: research
Purpose of review Cluster headache stands among the worst debilitating pain conditions. Available treatments for cluster headache have often disabling side effects, are not tolerated, or are ineffective. The management of drug-refractory chronic forms is challenging. New treatments are warranted and reported here. Recent findings In cluster headache acute treatment, delivery systems like Demand Valve Oxygen or nonrebreather-type masks could enhance the effectiveness of inhaled oxygen therapy. Noninvasive vagus nerve stimulation relieves cluster headache pain at short-term in episodic patients. Sphenopalatine ganglion ...
Source: Current Opinion in Neurology - Category: Neurology Tags: HEADACHE: Edited by Messoud Ashina and Henrik Winther Schytz Source Type: research
We examined the expression of TRPV1 in peripheral tissue and DRG neurons of CPIP model rats and we studied whether CPIP model could induce peripheral sensitization of TRPV1 channel and enhance DRG neuron excitability. Then we examined the therapeutic effects of locally applied TRPV1 specific antagonist AMG9810 on pain responses of CPIP model rats. Lastly, we explored the effects of AMG9810 on DRG neuron hyperexcitability and spinal glial activation induced by CPIP. Our results demonstrate that TRPV1 plays an important role in mediating the behavioral hypersensitivity of CPIP model rats via promoting peripheral nociceptor a...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Tomoya Nakamachi1*, Ayano Tanigawa1, Norifumi Konno1, Seiji Shioda2 and Kouhei Matsuda1 1Laboratory of Regulatory Biology, Graduate School of Science and Engineering, University of Toyama, Toyama, Japan 2Innovative Drug Discovery, Global Research Center for Innovative Life Science, Hoshi University, Tokyo, Japan Pituitary adenylate cyclase-activating polypeptide (PACAP) is a neuropeptide with potent suppressive effects on feeding behavior in rodents, chicken, and goldfish. Teleost fish express two PACAPs (PACAP1, encoded by the adcyap1a gene, and PACAP2, encoded by the adcyap1b gene) and two PACAP receptors (PAC...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
Conclusion and Perspectives Since their cloning 20 years ago, the physiological importance of TREK-1 channels has continued to grow (Figure 3). Today, TREK-1 channels have been shown to be important and their presence is essential in a number of physiopathological processes. Their involvement in these different processes demonstrate the necessity to design pharmacological modulators, activators or inhibitors, of these channels to correct any TREK-1-related dysfunctions. Despites a number of studies and many molecule screenings, only few putative new drugs were identified. The activators belonging to the ML and BL series ...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
This study aims at investigating the still poorly clear pathogenesis of migraine and the potential role of anti-CGRP mAbs in the scenario of prophylaxis of migraine. Introduction: Migraine Clinic Migraine consists in unilateral headache accompanied by a cluster of other sensory, autonomic and cognitive symptoms and it has been identified by the global burden of disease (GBD) study 2016 as the sixth most prevalent disorder and one of the main causes of disability all over the world, often occuring in working age and in young adult and middle-aged women (Collaborators, 2018). Hence, migraine represents a very serious...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Small subsets of patients who fail to respond to pharmacological treatment may benefit from alternative treatment methods. In the last decade, neurostimulation is being explored as a potential treatment option for the patients with chronic, severely disabling refractory primary headaches. To alleviate pain, specific nerves and brain areas have been stimulated, and various methods have been explored: deep brain stimulation, occipital nerve stimulation, and sphenopalatine ganglion stimulation are among the more invasive ones, whereas transcranial magnetic stimulation and supraorbital nerve stimulation are noninvasive. Vagal ...
Source: Acta Neurologica Scandinavica - Category: Neurology Authors: Tags: REVIEW ARTICLE Source Type: research
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