pare che in Arizona il Dott. Dodick stia sperimentando un nuovo sistema di stimolazione elettrica (tipo quella del Besta, per intenderci)
Però, in questo caso, la stimolazione è fatta direttamente sul nervo occipitale.....quindi, in parole povere.... non ti aprono il cranio...
Per ora esiste un solo caso di sette mesi senza attacchi e con 2 elettrodi impiantati, a destra e a sinistra. Altri 2 pazienti sono stati operati, ma si attendono ancora risultati.
Sarebbe uno sviluppo veramente interessante, ed applicabile a TUTTI i sofferenti (non solo i cronici non reattivi ai farmaci)
Stiamo a vedere.....
Ecco l'articolo (sorry....in inglese):
Implanted Device Wipes Out Cluster Headaches
LONDON (Reuters Health) - An implanted device has helped a patient who was suffering up to five attacks of cluster headache daily remain headache-free for 7 months, a US-based researcher said Thursday.
The device, which is implanted under the skin and stimulates the occipital nerve at the back of the head, could be helpful for a range of difficult-to-treat headache disorders, said Dr. David Dodick of the Mayo Clinic in Scottsdale, Arizona. He reported the findings here Thursday at the Migraine Trust International Symposium.
The occipital nerve converges with the trigeminal nerve, which supplies all pain-sensitive structures within the skull, Dodick explained. Animal research has shown that stimulation of the occipital nerve inhibits trigeminal activity.
The patient, Dodick reported, a man in his 40s, had been suffering four or five attacks daily for 2 years. Cluster headaches, the most painful type of headaches, strike once a day or more for periods that can last for a week to over a year.
"He was on every conceivable medication. In fact, when I saw him he was on five medications," Dodick told Reuters Health. "We admitted him to hospital and blocked his occipital nerve and for 3 days he was pain-free, which was remarkable for him, but his attacks came back. Then we blocked him again, and for a week he was cluster-free, so then we had the idea, lets try an occipital-nerve stimulator."
The stimulator is a pacemaker-sized device that sends impulses via electrodes placed under the skin over the occipital nerves on the back of the neck, under local anaesthetic.
Currently patients with untreatable cluster headaches undergo procedures to destroy part of the trigeminal nerve. "Those are destructive procedures and while they may be effective, they have the potential for pretty serious side effects," the researcher said.
"We put a stimulating electrode in on the right side, because that's where 90% of his attacks were, and for 2 weeks he had no cluster headaches, except for one on the opposite side, which cluster patients are sometimes known to do," Dodick said.
"We then took the stimulating electrode out from around the occipital nerve, left him for 2 weeks and he went back to having his cluster headaches, so we decided then to go in and implant two electrodes, on either side over each occipital nerve. He's done remarkably well since then, and that's about 7 months ago."
In the past few weeks, another two patients have had stimulators implanted, but no results are available yet. The researcher said a study would also be under way shortly looking at the utility of occipital nerve stimulators in patients with chronic migraine.
"The trigeminal nerve is the substrate for pain experienced during migraine, cluster headache and other primary headache disorders," Dodick said. "That's why this kind of an approach may be applicable not just to cluster but to migraine, and possibly other primary headache disorders, too."
Professor Peter Goadsby, chairman of the symposium, said the neuromodulation data presented at the conference, including the work presented by Dodick and another presentation by Dr. Massimo Leone on a deep brain stimulator in the hypothalamus in 7 patients with cluster headache, was among the most exciting of the conference.
"These things turn on, and (the headache) turns off--that's pretty watershed stuff," Goadsby said.
Last Updated: 2002-09-26 12:32:52 -0400 (Reuters Health)
