Indexado en

Licencia y uso

Citaciones

Altmetrics

Grant support

Funding for article processing charges were provided by Boston Scientific. Boston Scientific has not been involved in the design, conduction or writing this nor any related manuscripts.

Análisis de autorías institucional

Compartir

Clinical predictors of therapeutic failure of occipital nerve stimulation in refractory chronic cluster headache

Publicado en:CEPHALALGIA. 44 (5): 03331024241254078- - 2024-05-01 44(5), DOI: 10.1177/03331024241254078

Autores: Membrilla, Javier A; Cuadrado, Maria-Luz; Gonzalez-Garcia, Nuria; Porta-Etessam, Jesus; Sanchez-Soblechero, Antonio; Lozano Ros, Alberto; Gonzalez-Martinez, Alicia; Gago-Veiga, Ana Beatriz; Quintas, Sonia; Rodriguez Vico, Jaime S; Jaimes, Alex; Llorente Ayuso, Lucia; Roa, Javier; Estebas, Carlos; Diaz-de-Teran, Javier

Afiliaciones

Resumen

Background: Occipital nerve stimulation (ONS) is a treatment with evidence in refractory chronic cluster headache (CCH). However, the variable response rate and cost make it necessary to investigate predictors of response. Methods: This is a cross-sectional study conducted through the review of medical records of CCH patients from six hospitals in Madrid. Epidemiological and clinical variables were compared between patients with ONS failure and the rest. ONS failure was defined as the need for device withdrawal or switch off because of lack of response or adverse events. Results: From a series of 88 CCH, 26 (29.6%) underwent ONS surgery, of whom 13/26 (50.0%) failed because lack of response. ONS failure group had an earlier headache onset (mean SD) of 27.7 +/- 6.9 vs. 36.7 +/- 11.8 years, p=0.026) and a higher smoking rate (100% vs. 42.9%, p=0.006). Stational fluctuations (58.3% vs. 7.7%, p=0.007) and nocturnal exacerbations (91.7% vs. 53.9%, p=0.035) were more frequent in the ONS failure group as well. There was no difference between groups in diagnostic delay, years of evolution prior to surgery, mental illness, comorbidity with other headache disorders or chronic pain conditions or prior response to occipital nerves anesthetic blocks. Conclusions: Some clinical features such as an early debut, smoking and seasonal or circadian fluctuations could be related to failure of ONS in refractory CCH.

Palabras clave