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60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

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High cervical epidural neurostimulation for bilateral cluster headache: case report

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  • T. Wolter - Interdisziplinäres Schmerzzentrum, Universitätsklinikum Freiburg
  • K. Kieselbach - Interdisziplinäres Schmerzzentrum, Universitätsklinikum Freiburg
  • H. Kaube - Interdisziplinäres Schmerzzentrum, Universitätsklinikum Freiburg

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocP07-08

doi: 10.3205/09dgnc324, urn:nbn:de:0183-09dgnc3245

Published: May 20, 2009

© 2009 Wolter et al.
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Outline

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Objective: Cluster Headache belongs to the most disabling vasomotor pain conditions. Treatment usually implies medical treatment and oxygen application in case of acute pain attacks. Even with maximal therapy patients often remain physically and mentally handicapped, sometimes even unable to work.

SCS (spinal cord stimulation) has been introduced into therapy of various neuropathic pain conditions, and is performed at the lumbar spine as well as at the cervical spine with good results.

Methods: Here we describe a case of severe chronic cluster headache. This patient had several different medical therapies, physiotherapies and interventions without sufficient pain relief. With epidural neurostimulation she experienced a substantial pain relief.

Results: The patient suffered from left sided chronic cluster headache. With high cervical epidural stimulation cluster headache was significantly relieved. After three months intractable cluster headache attacks on the right side occurred, while pain on the left side was still sufficiently reduced with SCS. The patient then underwent implantation of a second high cervical electrode on the right side. Since that time the right-sided cluster headache is likewise effectively reduced.

Conclusions: Bilateral high cervical neurostimulation is feasible in the treatment of rare cases of bilateral chronic cluster headache. To our knowledge this is the first report of the effects of bilateral high cervical SCS on chronic cluster headache.