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Now zap that severe headache with a remote control

Cluster headaches are severe and can cause more excruciating pain than a migraine attack. They are commonly referred to as the "suicide headache" because many people have taken the extreme step of ending their life during an attack or in anticipation of one.

Here is some heartening news for people who have tried various destructive procedures but failed miserably to find relief from intractable headaches.

A team led by an Indian-origin doctor Dr Manjit Matharu at the National Hospital for Neurology and Neurosurgery in London has pioneered a new, safe strategy to deal with cluster headaches that are difficult to treat with medication.

The latest technique, known as the occipital nerve stimulation (ONS), may soon become an option for patients who are suffering from the debilitating disorder.

What are cluster headaches?
Cluster headaches are severe and can cause more excruciating pain than a migraine attack. They are commonly referred to as the 'suicide headache' because many people have taken the extreme step of ending their life during an attack or in anticipation of one.

The shooting pain strikes suddenly without prior warning on one side of the head. Cluster headaches occur one to three times per day and the pain can last between 15 minutes and three hours. A cluster period may last two weeks to three months.

The underlying cause of cluster headaches is unknown. Recent imaging studies have shown activation or stimulation of the hypothalamus during a cluster attack. However, cluster headaches are not usually caused by an underlying condition such as a tumor or aneurysm.

Many sufferers can be helped with drugs that prevent attacks or treat them when they occur. In severe cases, some patients had anaesthetic injected into the occipital nerve, which runs from the top of the spine to the scalp and communicates pain to the brain.

However, there are still many people who do not respond to existing treatments and may be candidates for an alternative therapy.

A team led by an Indian-origin doctor Dr Manjit Matharu at the National Hospital for Neurology and Neurosurgery in London has pioneered is a new, safe strategy to deal with cluster headaches that are difficult to treat with medication.

The working of the ONS technology
The ONS technology involves implanting two tiny electrodes, an impulse generator, and connecting wires under the skin. The electrodes are implanted under each branch of the occipital nerve at the base of the head.

Then, under general anaesthetic, an electricity impulse generator, the size of a thin pocketwatch, is inserted into the skin often in the abdomen or upper chest. The device is connected by lead wires tunnelled under the skin to the electrodes.

Though the device lasts a lifetime, batteries require a change after eight years.

The whole procedure takes just an overnight stay when the generator is switched on. The patient uses a remote control to deliver electrical impulses to the occipital nerve, which aims to mask the pain.

The National Institute for Health and Clinical Excellence (NICE) has not yet assessed this treatment, and its safety and effectiveness are not yet known.

However, in a bid to evaluate whether the implanted device helps chronic migraine sufferers who failed to respond to other treatments, Dr Matharu’s team treated 150 patients suffering with debilitating condition.

The results were promising. There are no major side effects, except some temporary, localised pain in some cases where the generator was placed.

“We are seeing success rates of about 80 per cent in people who’re not responding to other traditional treatments. No one knows when NICE is going to review the treatment, but it is possible to be referred to us if the pain is severe enough,” Dr Matharu said.