A microstimulator for certain headache types

Cluster headache  is a headache disorder characterized very intense pain attacks centred on one eye and accompanied by ipsilateral autonomic signs. Among affected subjects , primarily men, 10% have the chronic form of the disease which has a relentless course with daily. The majority of chronic cluster headache sufferers become resistant to available drug treatments. There may some good news for them, however; researchers have succeeded in reducing the burden of the disease thanks to an implantable microstimulator of the sphenopalatine ganglion.

migraine medocMost headache disorders reduce quality of life, but none of them is nearly as painful as cluster headache. It is associated with recurring unilateral facial and head pain that is usually unbearable. The attacks may occur several times per day; they are often nocturnal and last between 30 minutes and three hours. In addition to the pain, they are accompanied by ipsilateral redness of the eye, lacrimation, swelling of the eyelids and nasal congestion/running nose. « Cluster headache affects one person in every thousand, n prevalence comparable to that of multiple sclerosis.  In the vast majority of subjects, the most efficient treatment to abort the attack is sub-cutaneous injection of sumatriptan with an auto-injector and/or inhalation of 100% oxygen by mask. However some patients cannot receive sumatriptan because of cardio-vascular risk factors and, in addition, 10% of patients develop the chronic form of the disease and become resistant to drugs. These patients have their lives destroyed by the illness and many become suicidal. » explains Jean Schoenen, director of the Headache Research Unit at the University of Liège (University Department of Neurology - Citadelle Hospital and GIGA-Neurosciences - University Hospital Sart Tilman). It is clear that the development of novel effective therapies where available treatments have failed is an urgent priority!

A micro-stimulator that you can activate yourself

The precise cause of cluster headache is not completely understood, but for several years researchers have suspected that the sphenopalatine ganglion plays an important role in the onset and continuation of attacks. This autonomic ganglion which is located in the pterygoplatine fossa behind the upper jaw and innervates the glands and mucosae of one side of the face, is connected with the trigeminal nerve which conducts the pain. "The attacks are associated with activation of the sphenopalatine ganglion which explains the lacrimation, redness of the eye, swelling of the eyelids and nasal congestion. Greenfield Sluder, an American ENT specialist, was the first to point out the role of the sphenopalatine ganglion in 1903. Since then, we know that we can interrupt an attack by touching the upper inside of the nostril with a cotton ball soaked in Bonain’s solution, which paralyses the nearby ganglion. Based on this information, Dr Jean-Claude Devoghel of the University of Liège developed in the nineteen eighties a treatment based on the injection of alcohol into the sphenopalatine ganglion via the temple", explains Jean Schoenen. As this technique yielded good but transitory results, researchers tried to find a more lasting way to change the functioning of the ganglion.

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