Electrical stimuli for headache

Electrical stimuli may be able to relieve pain in cluster headaches and migraine attacks. The therapy relies on electrical stimuli that stimulate the nerves.

07/23/2012

The typical migraine headaches are seizure-like and pulsating and mostly affect women. Some patients go through the pain for hours or even days. In males, migraine pain is usually located behind the eye. They are often described as piercing and very strong. A new headache therapy is intended to help patients without medication to relieve pain. Electrical stimuli on the brain main nerve are said to relieve the pain, as the Society for Clinical Neurophysiology and Functional Imaging (DGKN) reports.

Electrical stimuli affect the occipital nerve
Cluster headaches can last up to 180 minutes and occur up to eight times a day. Not infrequently, those affected suffer from recurring migraine headaches for weeks and months. According to Prof. Dr. med. Andreas Straube, physician and headache expert at the University Hospital Grosshadern in Munich, suffer more than 100,000 people in Germany „several times a day under this heaviest, one-sided pain localized around the eye“. Sometimes even painkillers can not help. A new form of treatment for this particular pain indication is current therapy. „There is a new therapy in which up to two small electrodes are implanted directly under the skin on the neck“, explains Straube. The minimally invasive procedure is performed either by general anesthesia or local anesthesia. The electrical stimuli should then act directly on the occipital nerve, the so-called large occipital nerve.

Studies have shown, according to Professor Straube, that in about 70 percent of subjects with chronic cluster headache pain reduction by occipital nerve stimulation (ONS) therapy occurred. In migraine patients, one showed „significant improvement in symptoms“ in about 40 percent of cases.

In principle, health insurance companies cover the costs
According to the physician, there are up to nine specialized centers in Germany performing the procedure. A center is, for example, the renowned University Hospital Hamburg-Eppendorf. If indicated, statutory health insurance companies usually pay for the treatment costs.

However, the treatment effect does not occur immediately after the procedure. „But it may take four to six weeks for the treatment to take effect“, says Straube. If the therapy has struck, the patient is implanted a mini-current generator in the fatty tissue above the collarbone or alternatively below the costal arch or in the gluteal region. With the help of a kind „remote Control“ in the size of a bank card those affected can switch the electrodes on and off again. If a pain attack begins, those affected can turn on the power pulses with the device.

Most implants are battery powered and last between three and five years. „Even after five years, most of the cluster headache patients were painless“, stressed Straube. In migraine patients, however, there are still long-term clinical studies.

Effects still unclear
It is still unclear how the process actually works. „The electrical stimuli probably prevent the transmission of pain signals in the brainstem or activate the brain's own pain-suppressing system“, suspected Straube. Overall, be „the procedure reversible, safe and the risks manageable“, so the headache specialist. „If the stimulation fails, the electrodes are simply removed and the possible complications are not life threatening“, says Straube. From the procedure barely visible signs remain, only a small skin incision is recognizable.
A study report in the trade magazine „Current Opinion in Neurology“ reported the results of the application tests. A total of 58 people with chronic cluster headache and 200 subjects with recurrent migraine attacks participated in the study. As a result, 72 percent of cluster headache patients experienced a reduction in pain frequency. 50 percent said they noticed noticeable pain relief. In the group of migraine sufferers, 40 percent of participants said they would feel an improvement in their symptoms. However, the results must be backed up with further clinical studies. In addition, coherences still need to be explored further. (Sb)

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