Non-invasive vagal nerve stimulation in chronic paroxysmal hemicrania
Patient number | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
Age | 52 | 52 | 28 | 20 | 43 | 44 | 81 | 63 |
Sex | Male | Male | Male | Female | Female | Male | Male | Female |
Duration of CPH (years) | 3 | 11 | 3 | 6 | 22 | 11 | 8 | 5 |
Headache characteristics at diagnosis | ||||||||
Frequency | 8–12/day | 6–8/day | 5–9/day | 4–13/day | 10–20/day | 5–20/day | 4–12/day | 5–12/day |
Severity (VRS) | 10 | 5–10 | 7–10 | 8–10 | 6–10 | 4–8 | 10 | 8–10 |
Duration (min) | 15–30 | 15–45 | 15–60 | 15–120 | 5–90 | 5–120 | 5–20 | 5–45 |
Median duration (min) | 20 | 20 | 25 | 20 | 10 | 30 | 15 | 15 |
Indometacin dose | 225 mg | 100 mg | 225 mg | 75 mg | 225 mg | 225 mg | 100 mg | 225 mg |
Side effects from indometacin | Severe lethargy | colitis | Severe gastrointestinal upset | Severe gastrointestinal upset | Swollen ankles and marked lethargy | Severe gastrointestinal upset | Duodenal ulcer | Severe gastrointestinal upset |
Preventive treatments failed | 3 | 4 | 3 | 3 | 4 | 5 | 3 | 1 |
Duration of use of VNS (months) | 19 | 10 | 6 | 6 | 7 | 5 | 7 | 3 |
Baseline headaches (1 month pre-VNS) | ||||||||
Frequency | 5–10/day | 2–3/day | 5/day | 1–2/day | 5/day | 2/day | 4–5/day | 2–5/day |
Severity (VRS) | 10 | 2–6 | 7–8 | 8–10 | 4–8 | 5–9 | 10 | 9–10 |
Duration (min) | 20–30 | 30–90 | 45–60 | 15–120 | 5–80 | 60–120 | 15–20 | 30–45 |
Follow-up at 3 months | ||||||||
Frequency | 2–3 week | 1/day | 2/week | 5/month | 1/day | 1–2/day | 0 | 2–5/day |
Severity (VRS) | 5–6 | 2–3 | 4–5 | 5–9 | 1–2 | 1–2 | 0 | 9–10 |
Duration (min) | 15–20 | 30–60 | 20–30 | 5–20 | 5–30 | 30–60 | 0 | 30–45 |
Follow-up at 6 months | ||||||||
Frequency | 1/week | 1/day | 2/week | 5/month | 0 | N/A | 0 | N/A |
Severity (VRS) | 6–7 | 2–4 | 4–5 | 5–9 | 0 | N/A | 0 | N/A |
Duration (min) | 15–20 | 30–60 | 20–30 | 5–20 | 0 | N/A | 0 | N/A |
Last follow-up | ||||||||
Frequency | 1/week | 1/day | 2/week | 5/month | 0 | 1-2/day | 0 | 2–5/day |
Severity (VRS) | 6–7 | 2–4 | 4–5 | 5–9 | 0 | 1–2 | 0 | 9–10 |
Duration (min) | 20 | 30–60 | 20–30 | 5–20 | 0 | 30–60 | 0 | 30–45 |
HIT-6 | ||||||||
Baseline | 70 | 59 | 69 | 74 | 50 | 48 | 40 | 74 |
3 months | 60 | 55 | 59 | 31 | 46 | 48 | 36 | 76 |
6 months | 65 | 54 | 59 | 30 | 36 | N/A | 36 | N/A |
Last follow-up | 66 | 54 | 59 | 30 | 36 | 48 | 36 | N/A |
MIDAS | ||||||||
Baseline | 21 | 5 | 190 | 71 | 81 | 0 | 0 | 105 |
3 months | 4 | 5 | 167 | 68 | 0 | 0 | 0 | 120 |
6 months | 18 | 5 | 78 | 67 | 0 | N/A | 0 | N/A |
Last follow-up | 14 | 5 | 78 | 67 | 0 | 0 | 0 | N/A |
HADS-A | ||||||||
Baseline | 2 | 9 | 12 | 17 | 20 | 2 | 1 | 18 |
3 months | 6 | 6 | 4 | 18 | 19 | 0 | 0 | 17 |
6 months | 5 | 6 | 0 | 19 | 19 | N/A | 0 | N/A |
Last follow-up | 3 | 6 | 0 | 19 | 19 | 0 | 0 | N/A |
HADS-D | ||||||||
Baseline | 3 | 6 | 14 | 14 | 16 | 2 | 1 | 15 |
3 months | 1 | 5 | 7 | 14 | 9 | 0 | 0 | 16 |
6 months | 3 | 5 | 0 | 15 | 9 | N/A | 0 | N/A |
Last follow-up | 6 | 5 | 15 | 15 | 9 | 0 | 0 | N/A |
Patients estimate of improvement | 70% | 70% | 90% | 80% | 100% | 65% | 100% | 0% |
CPH, chronic paroxysmal hemicrania; HADS-A/D, Hospital Anxiety and Depression Scale—Anxiety/Depression; HIT-6, Headache Impact Test-6; MIDAS, Migraine Disability Assessment; N/A, no data available; VNS, vagus nerve stimulation; VRS, verbal rating scale (0–10; 0 pain free, 10 very severe pain).