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Supraorbital and Supratrochlear Stimulation for Trigeminal Autonomic Cephalalgias

  • Trigeminal Autonomic Cephalalgias (M Matharu, Section Editor)
  • Published:
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Abstract

Trigeminal autonomic cephalalgias (TAC) is a rare primary headache disorder with challenging and limited treatment options for those unfortunate patients with severe and refractory pain. This article will review the conventional pharmacologic treatments as well as the new neuromodulation techniques designed to offer alternative and less invasive treatments. These techniques have evolved from the treatment of migraine headache, a much more common headache syndrome, and expanded towards application in patients with TAC. Specifically, the article will discuss the targeting of the supratrochlear and supraorbital nerves, both terminal branches of the trigeminal nerve.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders: 2nd edition. Cephalalgia. 2004;24:9–160.

    Article  Google Scholar 

  2. Rozen TD, Fishman RS. Cluster headache in the United States of America: demographics, clinical characteristic, triggers, suicidality, and personal burden. Headache. 2012;52:99–113.

    Article  PubMed  Google Scholar 

  3. Weiner RL, Reed KL. Peripheral neurostimulation for control of intractable occipital neuralgia. Neuromodulation. 1999;2:217–21.

    Article  PubMed  CAS  Google Scholar 

  4. Son BC, Yang SH, Hong JT, Lee SW. Occipital nerve stimulation for medically refractory hypnic headache. Neuromodulation. 2012;15:381–6.

    Article  PubMed  Google Scholar 

  5. Bartsch T, Pameleire K, Goadsby PJ. Neurostimulation approaches to primary headache disorders. Curr Opin Neurol. 2009;22:262–8.

    Article  PubMed  Google Scholar 

  6. Frese A, Evers S, May A. Autonomic activation in experimental trigeminal pain. Cephalalgia. 2003;23:67–8.

    Article  PubMed  CAS  Google Scholar 

  7. Dodick DW, Rozen TD, Goadsby PJ, Silberstein SD. Cluster headache. Cephalalgia. 2000;20:787–803.

    Article  PubMed  CAS  Google Scholar 

  8. Torelli P, Manzoni GC. Pain and behaviour in cluster headache. A prospective study and review of the literature. Funct Neurol. 2003;18:205–10.

    PubMed  Google Scholar 

  9. Cohen AS, Burns B, Goadsby PJ. High-flow oxygen for treatment of cluster headache: a randomized trial. JAMA. 2009;302:2451–7.

    Article  PubMed  CAS  Google Scholar 

  10. Treatment of acute cluster headache with sumatriptan. The Sumatriptan Cluster Headache. Study Group. N Engl J Med. 1991;325:322–6.

    Google Scholar 

  11. van Vliet JA, Bahra A, Martin V, et al. Intranasal sumatriptan in cluster headache: randomized placebo-controlled double-blind study. Neurology. 2003;60:630–3.

    Article  PubMed  Google Scholar 

  12. Abrams BM. Medication overuse headaches. Med Clin N Am. 2013;97:337–52.

    Article  PubMed  Google Scholar 

  13. Goadsby PJ. Trigeminal autonomic cephalalgias. Continuum. 2012;18:883–95.

    PubMed  Google Scholar 

  14. Boes CJ, Dodick DW. Refining the clinical spectrum of chronic paroxysmal hemicrania: a review of 74 patients. Headache. 2002;42:699–708.

    Article  PubMed  Google Scholar 

  15. Boes CJ, Vincent M, Russell D. Chronic paroxysmal hemicrania. In: Olesen J, Goadsby PJ, Ramadan NM, et al., editors. The headaches. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 815–22.

    Google Scholar 

  16. Silberstein SD, Vodovskaia N. Trigeminal autonomic cephalalgias other than cluster headache. Med Clin N Am. 2013;97:321–8.

    Article  PubMed  Google Scholar 

  17. Cohen AS, Goadsby PJ. Paroxysmal hemicrania responding to topiramate. J Neurol Neurosurg Psychiatry. 2007;78:96–7.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  18. Lambru G, Matharu MS. SUNCT and SUNA: medical and surgical treatments. Neurol Sci. 2013;34 Suppl 1:75–81.

    Article  Google Scholar 

  19. Williams MH, Broadley SA. SUNCT and SUNA: clinical features and medical treatment. J Clin Neurosci. 2008;15:526–34.

    Article  PubMed  Google Scholar 

  20. Sillay KA, Sani S, Starr PA. Deep brain stimulation for medically intractable cluster headaches. Neurobiol Dis. 2010;38:361–8.

    Article  PubMed  Google Scholar 

  21. Goadsby PJ, Schoenen J, Ferrari MD, Silberstein SD, Dodick D. Towards a definition of intractable headache for use in clinical practice and trials. Cephalalgia. 2006;26:1168–70.

    Article  PubMed  CAS  Google Scholar 

  22. Hassenbusch SJ, Kunkel RS, Kosmorsky GS, Covington EC, Pillay PK. Trigeminal cisternal injection of glycerol for treatment of chronic intractable cluster headaches. Neurosurgery. 1991;29:504–8.

    Article  PubMed  CAS  Google Scholar 

  23. Morgenlander JC, Wilkins RH. Surgical treatment of cluster headache. J Neurosurg. 1990;72:866–71.

    Article  PubMed  CAS  Google Scholar 

  24. Chatterjee N, Chatterjee S, Roy C. Abducens nerve palsy after percutaneous radiofrequency ablation of gasserian ganglion. J Neurosurg Anesthesiol. 2013.

  25. Pieper DR, Dickerson J, Hassenbusch SJ. Percutaneous retrogasserian glycerol rhizolysis for treatment of chronic intractable cluster headaches: long-term results. Neurosurgery. 2000;46:363–8. discussion 368–70.

    Article  PubMed  CAS  Google Scholar 

  26. Narouze SN. Role of sphenopalatine ganglion neuroablation in the management of cluster headache. Curr Pain Headache Rep. 2010;14:160–3.

    Article  PubMed  Google Scholar 

  27. Kano H, Kondziolka D, Mathieu D, et al. Stereotactic radiosurgery for intractable cluster headache: an initial report from the North American Gamma Knife Consortium. J Neurosurg. 2011;114:1736–43.

    Article  PubMed  Google Scholar 

  28. Oomen K, Wijck AV, Hordijk G, Ru JD. Microvascular decompression of the pterygopalatine ganglion in patients with refractory cluster headache. Cephalalgia. 2011;31:1236–9.

    Article  PubMed  Google Scholar 

  29. Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150:971–9.

    Article  PubMed  CAS  Google Scholar 

  30. Shealy CN, Mortimer JT, Hagfors NR. Dorsal column electroanalgesia. J Neurosurg. 1970;32:560–4.

    Article  PubMed  CAS  Google Scholar 

  31. Hosobuchi Y, Adams JE, Rutkin B. Chronic thalamic stimulation for the control of facial anesthesia dolorosa. Arch Neurol. 1973;29:158–61.

    Article  PubMed  CAS  Google Scholar 

  32. Tsubokawa T, Katayama Y, Yamamoto T, Hirayama T, Koyama S. Treatment of thalamic pain by chronic motor cortex stimulation. Pacing Clin Electrophysiol. 1991;14:131–4.

    Article  PubMed  CAS  Google Scholar 

  33. Abejon D, Deer T, Verrills P. Subcutaneous stimulation: how to assess optimal implantation depth. Neuromodulation. 2011;14:343–8.

    Article  PubMed  Google Scholar 

  34. Cairns KD, McRoberts WP, Deer T. Peripheral nerve stimulation for the treatment of truncal pain. In: Slavin KV, editors. Peripheral nerve stimulation. Vol. 24. Progress in Neurological Surgery. Basel: Karger; 2011; p. 58–69.

  35. McRoberts WP, Wolkowitz R, Meyer DJ, et al. Peripheral nerve field stimulation for the management of localized chronic intractable back pain: results from a randomized controlled study. Neuromodulation. 2013.

  36. May A, Bahra A, Büchel C, Frackowiak RS, Goadsby PJ. Hypothalamic activation in cluster headache attacks. Lancet. 1998;352:275–8.

    Article  PubMed  CAS  Google Scholar 

  37. May A, Leone M, Boecker H, et al. Hypothalamic deep brain stimulation in positron emission tomography. J Neurosci. 2006;26:3589–93.

    Article  PubMed  CAS  Google Scholar 

  38. Burns B, Watkins L, Goadsby PJ. Successful treatment of medically intractable cluster headache using occipital nerve stimulation. Lancet. 2007;369:1099–106.

    Article  PubMed  Google Scholar 

  39. Vaisman J, Markley H, Ordia J, Deer T. The treatment of medically intractable trigeminal autonomic cephalalgia. With supraorbital/supratrochlear stimulation: a retrospective case series. Neuromodulation. 2012;15:374–80. This gathers the largest group of patients with TAC, treated with supra orbital/supratrochlear stimulation.

  40. Slavin KV, Colpan ME, Munawar N, Wess C, Nersesyan H. Trigeminal and occipital peripheral nerve stimulation for craniofacial pain: a single-institution experience and review of the literature. Neurosurg Focus. 2006;21:E5.

    Article  PubMed  Google Scholar 

  41. Amin S, Buvanendran A, Park KS, Kroin JS, Moric M. Peripheral nerve stimulator for the treatment of supraorbital neuralgia: a retrospective case series. Cephalalgia. 2008;28:355–9.

    Article  PubMed  CAS  Google Scholar 

  42. Reed KL, Black SB, Banta II CJ, Will KR. Combined occipital and supraorbital neurostimulation for the treatment of chronic migraine headaches: initial experience. Cephalalgia. 2010;30:260–71.

    PubMed  CAS  Google Scholar 

  43. Asensio-Samper JM, Villanueva VL, Perez AV, et al. Peripheral neurostimulation in supraorbital neuralgia refractory to conventional therapy. Pain Prat. 2008;8:120–4.

    Article  Google Scholar 

  44. Narouze SN, Kapural L. Supraorbital nerve electric stimulation for the treatment of intractable chronic cluster headache: a case report. Headache. 2007;47:1100–2.

    Article  PubMed  Google Scholar 

  45. Goadsby PJ. Neurostimulation in primary headache syndromes. Expert Rev Neurother. 2007;7:1785–9.

    Article  PubMed  Google Scholar 

  46. Schwedt TJ. Neurostimulation for primary headache disorders. Curr Neurol Neurosci Rep. 2009;9:101–7.

    Article  PubMed Central  PubMed  Google Scholar 

  47. Wolter T, Kaube H, Mohadjer M. High cervical epidural neurostimulation for cluster headache: case report and review of the literature. Cephalalgia. 2008;28:1091–4.

    Article  PubMed  CAS  Google Scholar 

  48. Vaisman J, Nimgade A. Refractory episodic cluster headache responsive to percutaneous cervical zygapophyseal radiofrequency ablation: a case report. Headache. 2003;43:279–81.

    Article  PubMed  Google Scholar 

  49. Ansarinia M, Rezai A, Tepper SJ, et al. Electrical stimulation of sphenopalatine ganglion for acute treatment of cluster headaches. Headache. 2010;50:1164–74.

    Article  PubMed  Google Scholar 

  50. Oluigbo CO, Makonnen G, Narouze S, Rezai AR. Sphenopalatine ganglion interventions: technical aspects and application. Prog Neurol Surg. 2011;24:171–9.

    Article  PubMed  Google Scholar 

  51. Schoenen J, Jensen R, Lanteri-Minet M. Stimulation of the sphenopalatine ganglion (SPG) for cluster headache treatment. Pathway CH-1: a randomized, sham-controlled study. Cephalalgia. 2013;33:816–30. This brings a unique and novel idea to stimulate to sphenopalatine ganglion as a target for the treatment of TAC.

  52. Mueller OM, Gaul C, Katsarava Z, et al. Occipital nerve stimulation for the treatment of chronic cluster headache—lessons learned from 18 months experience. Cent Eur Neurosurg. 2011;72:84–9.

    Article  PubMed  CAS  Google Scholar 

  53. Burns B, Watkins L, Goadsby PJ. Treatment of intractable chronic cluster headache by occipital nerve stimulation in 14 patients. Neurology. 2009;72:341–5.

    Article  PubMed  CAS  Google Scholar 

  54. Magis D, Allena M, Bolla M, et al. Occipital nerve stimulation for drug-resistant chronic cluster headache: a prospective pilot study. Lancet Neurol. 2007;6:314–21.

    Article  PubMed  Google Scholar 

  55. Jasper JF, Hayek SM. Implanted occipital nerve stimulators. Plain Physician. 2008;11:187–200.

    Google Scholar 

  56. Dunteman E. Peripheral nerve stimulation for unremitting ophthalmic postherpetic neuralgia. Neuromodulation. 2002;5:32–7.

    Article  PubMed  Google Scholar 

  57. Slavin K, Wess C. Trigeminal branch stimulation for intractable neuropathic pain: technical note. Neuromodulation. 2005;8:7–13.

    Article  PubMed  Google Scholar 

  58. Johnson MD, Burchiel KJ. Peripheral stimulation for treatment of trigeminal post-herpetic neuralgia and trigeminal posttraumatic neuropathic pain: a pilot study. Neurosurgery. 2004;55:135–41. discussion 141–132.

    Article  PubMed  Google Scholar 

  59. Aderjan D, Stankewitz A, May A. Neuronal mechanisms during repetitive trigemino-nociceptive stimulation in migraine patients. Pain. 2010;151:97–103.

    Article  PubMed  Google Scholar 

  60. Ordia J, Vaisman J. Subcutaneous peripheral nerve stimulation with paddle lead for the treatment of low back pain: case report. Neuromodulation. 2009;12:205–9.

    Article  PubMed  Google Scholar 

  61. Popeney CA, Alo KM. Peripheral neurostimulation for the treatment of chronic, disabling transformed migraine. Headache. 2003;43:369–75.

    Article  PubMed  Google Scholar 

  62. Serra G, Marchioretto F. Randomized trial occipital nerve stimulation for chronic migraine: a randomized trial. Plain Physician. 2012;15:245–53.

    Google Scholar 

  63. Silberstein S, Dodick D, Saper J, et al. Safety and efficacy of peripheral nerve stimulation of the occipital nerves for the management of chronic migraine: results from a randomized, multicenter, double-blinded, controlled study. Cephalalgia. 2012;16:1165–79.

    Article  Google Scholar 

  64. Schoenen J, Vandersmissen B, Jeangette S, et al. Migraine prevention with a supraorbital transcutaneous stimulator : a randomized controlled trial. Neurology. 2013;80:697. [Epub February 6, 2013].

    Article  PubMed  Google Scholar 

  65. Fontaine D, Lazorthes Y, Mertens P, et al. Safety and efficacy of deep brain stimulation in refractory cluster headache: a randomized placebo-controlled double-blind trial followed by a 1-year open extension. J Headache Pain. 2010;11:23–31.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  66. Leone M, Franzini A, Broggi G, Bussone G. Hypothalamic stimulation for intractable cluster headache: long-term experience. Neurology. 2006;67:150–52.

    Google Scholar 

  67. Leone M, May A, Franzini A, et al. Deep brain stimulation for intractable chronic cluster headache: proposals for patient selection. Cephalalgia. 2004;24:934–7.

    Article  PubMed  CAS  Google Scholar 

  68. Schoenen J, Di Clemente L, Vandenheede M, et al. Hypothalamic stimulation in chronic cluster headache: a pilot study of efficacy and mode of action. Brain. 2005;128:940–7.

    Article  PubMed  CAS  Google Scholar 

  69. Schoenen J, Allena M, Magis D. Neurostimulation therapy in intractable headaches. Handb Clin Neurol. 2010;97:443–50.

    Article  PubMed  Google Scholar 

  70. May A. Cluster headache: pathogenesis, diagnosis, and management. Lancet. 2005;366:843–55.

    Article  PubMed  Google Scholar 

  71. Fernandez-de-Las-Penas C, Ortega-Santiago R, Cuadrado ML, Lopez-de-Silanes C, Pareja JA. Bilateral widespread mechanical pain hypersensitivity as sign of central sensitization in patients with cluster headache. Headache. 2011;51:384–91.

    Article  PubMed  Google Scholar 

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Julien Vaisman declares that he has no conflict of interest. Edrick Lopez declares that he has no conflict of interest. Nicholas K. Muraoka declares that he has no conflict of interest.

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Correspondence to Julien Vaisman.

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This article is part of the Topical Collection on Trigeminal Autonomic Cephalalgias

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Vaisman, J., Lopez, E. & Muraoka, N.K. Supraorbital and Supratrochlear Stimulation for Trigeminal Autonomic Cephalalgias. Curr Pain Headache Rep 18, 409 (2014). https://doi.org/10.1007/s11916-014-0409-4

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