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WP1-1 Sphenopalatine ganglion stimulation for chronic cluster headache
  1. S Miller,
  2. S Lagrata,
  3. M Matharu,
  4. L Zrinzo
  1. The National Hospital for Neurology and Neurosurgery, London, UK

Abstract

Objectives To assess outcome of sphenopalatine ganglion stimulation (SPGS) in chronic cluster headache (CCH) in a UK centre.

Design Uncontrolled open-label single centre prospective study.

Subjects Nine patients with medically refractory CCH.

Methods Participants underwent sphenopalatine ganglion stimulator implantation, ipsilateral to CCH symptoms via a gingival incision, with fluoroscopy guidance and dyna-CT confirmation of contact location adjacent to the Vidian canal in the pterygopalatine fossa. One month after surgery, the device was programmed. Patients were instructed to provide stimulation as early as possible after attack onset and at least twice daily. The primary outcome was change in headache frequency as well as adverse events.

Results Mean follow up was 14 months (SD 11.1, range: 3–31) with median reduction in headache frequency at last follow up of 73% (IQR: 67%–88%). At 3 months post op, 4/9 (45%) had at least 50% reduction in frequency of attacks; this increased to 8/9 patients (89%) at last follow up. Two patients became pain free (after 3 and 9 months). Preventative effects were seen in 7/9 and an acute effect in 2/9. One patient suffered numbness over the V2 distribution and did not respond to SPGS. The stimulator was removed 1 year later at the patient’s request. One wound infection settled with oral antibiotics.

Conclusions Initial data from the UK confirms the results from previous studies and compares well with the results of occipital nerve stimulation for CCH.

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