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Neuromodulation for Trigeminal Autonomic Cephalalgias

  • Tsinsue Chen
  • Manjit Matharu
  • Ludvic Zrinzo
Chapter

Abstract

Trigeminal autonomic cephalalgias (TAC) include chronic cluster headache (CCH), short lasting unilateral neuralgiform headaches with autonomic symptoms (SUNHA), paroxysmal hemicrania and hemicrania continua. Neuromodulation for the treatment of TACs can involve both peripheral and central targets. Peripheral targets include stimulation of the sphenopalatine ganglion and the greater occipital nerve. Central targeting includes deep brain stimulation of ventral tegmental area, which has also been described as the “posterior hypothalamus”, as well as high cervical spinal cord stimulation. This chapter explores the mechanisms, operative techniques and clinical evidence supporting each method, with an emphasis on central neuromodulation techniques.

Keywords

Trigeminal autonomic cephalgia Chronic cluster headache SUNCT SUNHA SUNA Hemicrania continua Paroxysmal hemicrania Deep brain stimulation Spinal cord stimulation Occipital nerve stimulation Sphenopalatine ganglion stimulation Sphenopalatine ganglion ablation 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Tsinsue Chen
    • 1
    • 2
  • Manjit Matharu
    • 3
    • 4
  • Ludvic Zrinzo
    • 1
    • 5
  1. 1.Victor Horsley Department of NeurosurgeryNational Hospital of Neurology and NeurosurgeryLondonUK
  2. 2.Division of NeurosurgeryBarrow Neurological Institute, St. Joseph’s Hospital and Medical CenterPhoenixUSA
  3. 3.Department of NeurologyNational Hospital of Neurology and NeurosurgeryLondonUK
  4. 4.UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Headache GroupLondonUK
  5. 5.Unit of Functional Neurosurgery, Department of Movement DisordersUCL Institute of Neurology, University College LondonLondonUK

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