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Clinical Trial
Peripheral nerve field stimulation for chronic headache: 60 cases and long-term follow-up.
- Paul Verrills, Rebecca Rose, Bruce Mitchell, David Vivian, and Adele Barnard.
- Metro Spinal Clinic, Caulfield South, Vic., Australia.
- Neuromodulation. 2014 Jan 1;17(1):54-9.
ObjectiveThe objective of this study is to evaluate the efficacy of peripheral nerve field stimulation (PNFS) for the treatment of chronic headache conditions.Materials And MethodsFor more than a four-year period, 83 patients underwent a trial of a PNFS system targeting the nerve regions including occipital and supraorbital and infraorbital nerves, which best corresponded with their area of head pain. Sixty patients reported a successful trial and underwent a subsequent implant of the PNFS system. Questionnaires, along with patients' charts, were used to assess outcomes as follows: pain (11-point numerical pain rating scale), analgesic use, depression (Zung Depression Scale), disability (Neck Disability Index), patient satisfaction, and surgical complications. Patients were followed up for an average of 12.9 ± 9.4 months (range 3-42 months).ResultsAn average pain reduction of 4.8 ± 2.3 pain scale points was observed (preimplant 7.4 ± 1.6; follow-up 2.6 ± 2.1 [p ≤ 0.001]). Of the 60 patients implanted, 41 reported >50% pain relief. Medication use was reduced in 83% of patients who were previously taking analgesics or prophylactic medications. Similarly, reductions in degree of disability and depression also were observed. Of the 60 cases, ten surgical revisions were required; however, no long-term complications were reported.ConclusionsPNFS for chronic headache is an evolving therapy. This study demonstrates that this reversible and effective treatment can be a promising pain relief strategy for this often intractable condition.© 2013 International Neuromodulation Society.
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