[Neuromodulation in cluster headache. Clinical follow-up after deep brain stimulation in the posterior hypothalamus for chronic cluster headache, case report--Part II].

摘要: Deep brain stimulation (DBS) of the posterior hypothalamic area is a new treatment option for patients with refractory chronic cluster headache (CCH). A review literature reveals that studies based on large numbers patients, long-term observations and controlled randomised trials are still lacking. In 2006 case report first patient in Germany to be operated allow DBS was published, we now present this patient's course 6 months after operation; addition, current discussed. July 2005 lead placed left 39-year-old woman CCH. Stimulation demand achieved complete suppression attacks, no longer needed medication. After about 8 decreasing effect stimulation, only 50% reduction stimulation-induced side effects were observed. Neither reprogramming parameters nor pharmacological therapy on-demand medication reduced frequency or severity CCH attacks level experienced early postoperative stage. Because intolerable subjective tension-related pain at site connection cable, September whole system explanted request.DBS an invasive use cases any therapy. As demonstrated by report, it not possible give prognosis concerning its efficacy: despite initial excellent benefit there can even loss stimulation. The clinical results follow-up few published so far need evaluated larger multicentre trial double-blind study design.