Neurological Sciences

, Volume 32, Supplement 1, pp 23–26 | Cite as

Neuromodulation in drug-resistant primary headaches: what have we learned?

  • Massimo LeoneEmail author
  • Alberto Proietti Cecchini
  • Angelo Franzini
  • Gennaro Bussone
ANIRCEF - HCNE Joint Meeting


In the last years neurostimulation procedures have been introduced to treat primary neurovascular headaches, namely cluster headache and migraine. Hypothalamic stimulation is now accepted as therapeutic procedure to treat drug-resistant chronic cluster headache when patients suffer from daily multiple attacks. The inadequacy of the definition of the term “chronic” according to the International Headache Society criteria for both cluster headache and migraine when it is used to select patients for neurostimulation procedures is now evident. On the same side, there is no agreement about the use of the term “drug-resistant” again when it is used to select patients for neurostimulation procedures. We have proposed that only patients suffering from daily neurovascular headaches in the last 1–2 years, with complete drug-resistance should be proposed for invasive procedures.


Cluster headache Migraine Neurostimulation Occipital nerve stimulation Deep brain stimulation 


Conflict of interest

The authors declare that there is no actual or potential conflict of interest in relation to this article.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Massimo Leone
    • 1
    Email author
  • Alberto Proietti Cecchini
    • 1
  • Angelo Franzini
    • 2
  • Gennaro Bussone
    • 1
  1. 1.Headache Centre Neurology DepartmentNational Neurological Institute (IRCCS) Foundation “C.Besta”MilanItaly
  2. 2.Neurosurgery DepartmentNational Neurological Institute (IRCCS) Foundation “C.Besta”MilanItaly

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