Dr Javier Membrilla (University Hospital La Paz, Spain) presented results from a retrospective observational study of 22 consecutive drug-resistant CCH patients who underwent ONS in a tertiary clinic [1]. This kind of study with long follow-up is scarce. The participants had drug-resistant CCH according to the EHF 2014 criteria and underwent ONS between March 2008 and July 2020. Baseline characteristics are listed in the Table. The procedure had 2 phases: temporary ONS for 2–7 weeks, followed by definitive ONS if there was a >50% improvement. The study's primary endpoint was weekly CCH attack reduction. Secondary endpoints were pain intensity on the visual analogue scale (VAS), patient-perceived overall improvement, and a decrease in oral medication use.
Table: Baseline patient characteristics [1]
After a median follow-up of 5 years, the weekly number of CCH attacks decreased from 30 at baseline to 22.5 after 3 months (P=0.012); 7.5 after 12 months (P=0.006); and 15.0 at the end of follow-up (P=0.023). From a median of 10, the VAS score decreased to 9.0 at 3 months (P=0.011); 7.0 at 12 months (P=0.008) and 7.0 at the end of follow-up (P=0.002). After 3 and 12 months, and after the end of follow-up, 23.5%, 41.2%, and 27.8% of patients had a perceived overall improvement of 70%. Of 22 participants, 13 (59%) reduced their prophylactic oral medication, while 3 (14%) stopped taking it altogether. All 22 participants decreased triptan use, 3 (14%) stopped using it. AEs were reported by 9 of 22 patients (41%) and were all mild. The most common AE was superficial surgical wound infection (n=4).
Dr Membrilla stated that further research is needed to identify characteristics of responders, so that ONS therapy can be offered to properly selected cases.
- Membrilla J, et al. Occipital nerve stimulation in drug-resistant chronic cluster headache: a third-level hospital experience. OPR-067, EAN 2021 Virtual Congress, 19–22 June.
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Table of Contents: EAN 2021
Featured articles
Letter from the Editor
COVID-19
First evidence of brainstem involvement in COVID-19
Cognitive/behavioural alterations persistent after COVID-19
Neural base of persistent hyposmia after COVID-19
Neurological symptoms and complications of COVID-19 affect outcomes
Cerebrovascular Disease
Intracerebral haemorrhage only slightly increases mortality in COVID-19 patients
Stroke with covert brain infarction indicates high vascular risk
Expanding precision medicine to stroke care
Dexamethasone not indicated for chronic subdural haematoma
Cognitive Impairment and Dementia
Severe outcomes of COVID-19 in patients with dementia
Promising diagnostic accuracy of plasma GFAP
Sex modulates effect of cognitive reserve on subjective cognitive decline
Hypersensitivity to uncertainty in subjective cognitive decline
Epilepsy
Minimally invasive device to detect focal seizure activity
‘Mozart effect’ in epilepsy: why Mozart tops Haydn
Migraine and Headache
Factors associated with decreased migraine attack risk
Pregnant migraine patients at higher risk of complications
Occipital nerve stimulation in drug-resistant cluster headache
Rhythmicity in primary headache disorders
Multiple Sclerosis and NMOSD
Typing behaviour to remotely monitor clinical MS status
Alemtuzumab in treatment-naïve patients with aggressive MS
No higher early MS relapse frequency after stopping ponesimod
Good long-term safety and efficacy of inebilizumab in NMOSD
Neuromuscular Disorders
Inability to recognise disgust as first cognitive symptom of ALS
Pathogenic T-cell signature identified in myasthenia gravis
Parkinson’s Disease
Levodopa-carbidopa intestinal gel in patients with advanced PD
New Frontier – Navigated Transcranial Ultrasound
Exploring the possibilities
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