Treatments That Transform Our Patients' Lives
Radiofrequency or Gamma knife surgery
This provides radiation directly to the trigeminal nerve. It may take weeks to months to be fully effective. This is used in refractory facial pain and also for the emergency management of facia pain. It is carried out in specialist services and involves a multidisciplinary team made up fo headache specialist and functional neurosurgeons who specialise in this technique.
Deep Brain Stimulation for Cluster headaches
In those patients with cluster headache who are refractory to medical treatment, Deep brain stimulator (DBS) may also be considered. It is an invasive procedure and should be undertake in specialist services buy experts in their field. Deep brain stimulation (DBS) is a surgical procedure that involves the insertion of an electrode into a patient’s brain in order to deliver electric current to a very specific area. It targets an area of the hypothalamus known to be involved in cluster headaches. It can produce a meaning full outcome with a reduction in frequency and severity of attacks in 80% of patients. Again, this is not a cure - but it can provide significant benefit to patients who are often at the end of their tether.
Occipital Nerve Stimulation
This is a surgical procedure used to treat medically resistant forms of chronic headache including chronic migraine and cluster headache. It involves the implantation of a battery-powered pulse generator under the skin. It provides neurostimulation by delivering electrical impulses near the occipital nerves. This method of neurostimulation has been used to treat other pain disorders such as neuropathic pain successfully.
Microvascular decompression (MVD) & Neurolysis
An invasive procedure used in the management of medically refractory facial pain disorders. Specialist MRI scans are performed to visualise the trigeminal nerve. If a blood vessel is in contact with the nerve it can potentially cause the facial pain. MVD involves moving blood vessels away from the trigeminal nerve. If there isn’t a blood vessel in contact, occasionally we can do a procedure known as Neurolysis where we ‘comb’ the nerve to try and cause more ‘insulation’ around the nerve to try and reduce the facial pain. This involves a multidisciplinary approach with a headache specialist and a functional neurosurgeon to ensure the most appropriate procedure is carried out. This is generally carried out in specialist centres.
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