Headache: a world first at Liège University

There is new hope for sufferers of cluster headache, a headache so severe that it is also known as ‘suicide’ headache. A team of researchers at Liège University is currently testing a new treatment for sufferers of this chronic condition, which does not respond to available drug therapies.

Migranous neuralgie, or ‘cluster headache’, as it is known in international medical terminology, is a very debilitating condition. Typical symptoms are intense stabbing pain around one eye, tearing, redness in the eye, swelling of the eyelid and rhinorrhea. The headache is recognised as being so unbearable that it can sometimes lead to suicide.Sufferers - mostly men - may have headache episodes several times a day or night each lasting 45 minutes on average. Cluster headache affects about two people in every thousand. It tends to be cyclical for the majority of sufferers, with periods of remission between cluster headache periods.10% of patients present with the chronic form, characterised by the absence of remission periods.

The sphenopalatine ganglion in the autonomic nervous system plays a key role in cluster headache.30 years ago in Liège, Dr JC Devoghel introduced a technique of infiltration of this ganglion, which provides relief, but only temporarily.The California-based company, Autonomic Technologies, has developed a new neurostimulation system to deliver stimulation to the sphenopalatine ganglion. Professor Jean Schoenen, Director of the Headache Research Unit at the University of Liège, is currently coordinating the first multi-centre trials of this system.

The neurostimulateur is a miniaturised implant the size of an almond.It is inserted next to the sphenopalatine ganglion, located in a tiny cavity behind the cheekbone, through a surgical incision in the gum.The procedure is minimally invasive and leaves no visible scar. The patient applies a remote controller, the size of a mobile phone, on the cheek to activate the implant and control the stimulation depending on the intensity of the pain.

The implant technique was developed in Liège by Drs Alain Wilmont and Sandrine Machiels at the Citadelle hospital and the first implants were inserted in Liège.At this stage of the trial, 22 patients have implants, as part of the European study, and the findings for the first seven of these were presented by Professor Schoenen at the recent Congress of the International Headache Society in Berlin.These preliminary results are very promising:in 67% of headaches treated, pain was relieved in 15 minutes, and more than 70% of patients experienced a 50% reduction in the frequency of their headaches, which was something they had not experienced for years.

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