UCL Institute of Neurology

Patients who suffer from severe cluster headaches are being offered new hope thanks to a revolutionary treatment at the National Hospital for Neurology and Neurosurgery (NHNN).

The pain of cluster headaches (CH) is notoriously excruciating and usually described as one of the most distressing conditions known to mankind. Female patients describe attacks as worse than childbirth and patients are occasionally driven to suicide. Attacks last between 15 minutes and three hours and can occur up to eight times a day.

For a small group of CH patients there has been no solution. Until now.

The treatment, known as deep brain stimulation, is already used to treat other neurological conditions such as Parkinson’s disease and dystonia. In CH patients, it is used to target a part of the brain (the posterior hypothalamus) which is overactive during the headaches. An electrode is inserted into the brain and linked to a stimulator under the chest. When the stimulator is switched on, an electric current passes into the brain, blocking the damaging signals that cause cluster headaches.

This new method of treating cluster headaches follows on from pioneering research at Queen Square, where the NHNN and the nearby Institute of Neurology at UCL are housed.

The research, which goes back a decade, pinpointed a particular region of the brain (the posterior hypothalamus) and studies revealed the presence of increased blood flow in this region during a cluster headache attack, a sure sign of increased activity.

Early pilot results of DBS in a small number of patients with unremitting chronic cluster headaches were very encouraging and this led two consultants, neurologist Manjit Matharu and neurosurgeon Ludvic Zrinzo to introduce the procedure at the NHNN.

Mr Matharu and Mr Zrinzo said: “We are really excited about the early indications from using DBS in this way. Patients who suffer from this excruciating condition come to us at their wits’ end and for many of them we are a last resort. Unless you have experienced cluster headaches you cannot underestimate the impact they have on the lives of sufferers and their families. If we can help them in any way it’s immensely rewarding,” they said.

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