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Stimulation of the Posterior Hypothalamus
for Treatment of Chronic Intractable cluster
headaches: First Reported Series
Franzini A, Ferroli P, Leone M, Broggi, G.
Posted: July 2004
Objective: To describe the results of
deep brain stimulation of the ipsilateral posterior hypothalamus
for the treatment of drug-resistant chronic cluster headaches (CHs).
A technique for electrode placement is reported.
Methods: Five patients with intractable CHs were
treated with long-term, high-frequency, electrical stimulation of
the posterior hypothalamus.
Results: Since this treatment, all five patients
continue to be pain-free after 2 to 22 months of follow-up
monitoring. Two of the five patients have remained pain-free
without any medication, whereas three of the five required low
doses of Methysergide (two patients) or verapamil (one patient).
No adverse side effects of chronic, high-frequency, hypothalamic
stimulation have been observed, and we have not encountered any
acute complications resulting from the implant procedure.
Conclusion: These preliminary results indicate a
role for posterior hypothalamic stimulation, which was
demonstrated to be safe and effective, in the treatment of
drug-resistant chronic CHs. These data point to a central
pathogenesis for chronic CHs.