Electrical stimuli for headaches

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Electrical stimuli can possibly relieve pain associated with cluster headaches and migraine attacks. The therapy relies on electrical stimuli that are supposed to stimulate the nerves.

The typical migraine headache occurs like a seizure and pulsates and mostly affects women. Some patients experience the pain for hours or even days. In men, migraine pain is mostly localized behind the eye. They are often described as stinging and very strong. A new headache therapy is said to help patients to relieve pain without medication. Electrical stimuli to the main brain nerve are said to alleviate the pain, as reported by the Society for Clinical Neurophysiology and Functional Imaging (DGKN).

Electrical stimuli act on the occipital nerve. Cluster headaches can persist for up to 180 minutes and occur up to eight times a day. It is not uncommon for those affected to suffer from recurring migraine headaches for weeks and months. According to Prof. Dr. Andreas Straube, doctor and headache expert at the University Hospital Großhadern in Munich, suffers more than 100,000 people in Germany "several times a day from this most severe, one-sided pain localized around the eye". Sometimes even strong painkillers can't help. A new form of treatment for this special pain indication is current therapy. "There is a new therapy in which up to two small electrodes are planted directly under the skin on the neck," explains Straube. The minimally invasive procedure is performed either with general anesthesia or local anesthesia. The electrical stimuli should then act directly on the occipital nerve, the so-called large occipital nerve.

According to Professor Straube, studies have shown that around 70 percent of subjects with chronic cluster headaches experienced pain relief using occipital nerve stimulation (ONS) therapy. In migraine patients, there was a "significant improvement in symptoms" in around 40 percent of the cases.

In principle, health insurance companies cover the costs. According to the doctor, there are up to nine specialized centers in Germany that carry out the procedure. One of the centers, for example, is the renowned University Clinic Hamburg-Eppendorf. If indicated, the statutory health insurance companies usually cover the treatment costs.

However, the treatment effect does not occur immediately after the procedure. "But it can take four to six weeks for the therapeutic effect to set in," says Straube. Once the therapy has started, the patient is implanted with a mini power generator in the fatty tissue above the collarbone or, alternatively, below the costal arch or in the buttock region. With the help of a kind of “remote control” the size of a credit card, those affected can switch the electrodes on and off again. If a pain attack begins, those affected can start the current impulses with the device.

Most implants are battery operated and last between three and five years. "Even after five years, the majority of cluster headache patients were pain-free," stressed Straube. Long-term clinical studies are still pending in migraine patients.

Effects still unclear
It is still unclear how the procedure actually works. "The electrical stimuli probably prevent the pain signals from being transmitted to the brain stem or activate the brain's own pain-suppressing system," Straube suspects. Overall, "the procedure is reversible, safe and the risks manageable," says the headache specialist. "If the stimulation does not work, the electrodes are simply removed and the possible complications are not life-threatening," says Straube. There are hardly any visible signs of the operation, only a small skin incision is visible.
A study report in the magazine "Current Opinion in Neurology" reported on the results of the application tests. A total of 58 people with chronic cluster headaches and 200 subjects with recurrent migraine attacks participated in the study. The result showed that 72 percent of cluster headache patients experienced a reduction in the frequency of pain. 50 percent said they noticed a noticeable pain relief. In the group of migraine sufferers, 40 percent of the participants stated that they would feel an improvement in their symptoms. However, the results must be backed up with further clinical studies. In addition, relationships still need to be researched. (sb)

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