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首页> 外文期刊>Neurosurgical focus >Dual occipital and supraorbital nerve stimulation for chronic migraine: A single-center experience, review of literature, and surgical considerations
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Dual occipital and supraorbital nerve stimulation for chronic migraine: A single-center experience, review of literature, and surgical considerations

机译：枕部和眶上神经双重刺激治疗慢性偏头痛：单中心经验，文献复习和手术注意事项

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摘要

Occipital nerve stimulation (ONS) has been studied in a few clinical trials for the treatment of chronic migraine (CM) with failure to prove sufficient efficacy. To date, peripheral nerve stimulation for the treatment of primary headache is limited to off-label use only. The authors report their institutional experience in CM therapy with combined ONS and supraorbital nerve stimulation (SONS). Fourteen patients treated with dual ONS and SONS for CM were studied with follow-up ranging from 3 to 60 months. Seventy-one percent achieved successful stimulation as defined by a 50% or greater decrease in pain severity. The mean reduction in headache-related visual analog scale (VAS) score was 3.92 ± 2.4. Half of the patients also had resolution of migraine-associated neurological symptoms and returned to normal functional capacity. The main adverse events included lead migration (42.8%), supraorbital lead allodynia (21.4%), and infection (14.2%) with a resulting high reoperation rate (35.7%). The authors' stimulation efficacy was superior to the combined 33% positive response rates (= 50% pain reduction) in the published studies of ONS for CM. This is likely due to the fact that topographical paresthesia induced by combined ONS and SONS covers the area of migraine pain better than ONS alone. The authors also discuss effective surgical techniques to prevent patient morbidity.
机译：枕神经刺激（ONS）已在一些临床试验中用于治疗慢性偏头痛（CM），但未能证明其足够的疗效。迄今为止，用于治疗原发性头痛的周围神经刺激仅限于标签外使用。作者报告了他们在ONS和眶上神经刺激（SONS）结合治疗CM方面的机构经验。研究了14位接受ONS和SONS双重治疗CM的患者，随访时间为3到60个月。 71％的患者成功实现了成功的刺激，疼痛程度降低了50％或更大。头痛相关的视觉模拟量表（VAS）得分的平均下降幅度为3.92±2.4。一半的患者也具有偏头痛相关的神经系统症状的缓解，并恢复了正常的功能。主要不良事件包括铅迁移（42.8％），眶上铅异常性疼痛（21.4％）和感染（14.2％），从而导致较高的再次手术率（35.7％）。在已发表的ONS for CM研究中，作者的刺激效果优于33％的阳性反应率（= 50％的疼痛减轻）。这可能是由于以下事实：由ONS和SONS联合引起的地形感觉异常比单独的ONS更好地覆盖了偏头痛的区域。作者还讨论了预防患者发病的有效手术技术。

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