gms | German Medical Science

Objective: Cluster Headache belongs to the most disabling vasomotor pain conditions. Treatment usually implies medical treatment and oxygen application in case of acute pain attacks. Even with maximal therapy patients often remain physically and mentally handicapped, sometimes even unable to work.

SCS (spinal cord stimulation) has been introduced into therapy of various neuropathic pain conditions, and is performed at the lumbar spine as well as at the cervical spine with good results.

Methods: Here we describe a case of severe chronic cluster headache. This patient had several different medical therapies, physiotherapies and interventions without sufficient pain relief. With epidural neurostimulation she experienced a substantial pain relief.

Results: The patient suffered from left sided chronic cluster headache. With high cervical epidural stimulation cluster headache was significantly relieved. After three months intractable cluster headache attacks on the right side occurred, while pain on the left side was still sufficiently reduced with SCS. The patient then underwent implantation of a second high cervical electrode on the right side. Since that time the right-sided cluster headache is likewise effectively reduced.

Conclusions: Bilateral high cervical neurostimulation is feasible in the treatment of rare cases of bilateral chronic cluster headache. To our knowledge this is the first report of the effects of bilateral high cervical SCS on chronic cluster headache.