Deep brain stimulation treatment for cluster headaches

A radical technique which involves drilling an electrode into the brain is being used to treat patients plagued by excruciating headaches.

The National Hospital for Neurology and Neurosurgery in London, external says deep brain stimulation is proving highly successful in helping reduce the frequency of so-called "cluster headaches."

This is a condition in which patients get horrendous headaches on one side of the head. They can get up to eight a day lasting from 15 minutes to three hours.

Dr Manjit Matharu, a consultant neurologist said the pain is terrible.

"We have asked female patients to describe the pain and every one who has given birth has said childbirth is just a fraction of the pain compared to cluster headaches."

Deep brain stimulation involves drilling into the top of the skull. A titanium alloy electrode is inserted into the posterior hypothalamus which is overactive during the headaches.

The electrode is linked by a wire to a pacemaker under the skin of the chest. When the stimulator is switched on, it sends a tiny electric current into the brain. The aim is to block the damaging signals which trigger the headaches - rather like blocking a radio frequency.

About 80 patients worldwide have had deep brain stimulation for cluster headaches. About six in ten have experienced significant improvement.

Barrie Wilson, aged 67, is one of five patients with cluster headaches to be treated at the hospital, in Queen Square, Bloomsbury.

He has had the condition for 14 years and like other sufferers, has no idea why the headaches started.

"It is like someone getting a red hot poker and pushing it into your eye and wiggling it about. You get no warning, no aura, it just comes on like that. You can't stand still, sit down or go to bed, nothing helps - it is like being tortured." he said.

But all that has now changed. It is nearly four months since his operation and in that time Mr Wilson has had just one headache, instead of the daily barrage.

He says he feels liberated. "It is a weight off my shoulders - amazing. It is just an utter relief and a weight off my shoulders."

Mr Wilson says he and his wife are hopeful that they can now plan their future free of the horrendous headaches which used to dominate their routine.

Deep brain stimulation has been used for many years for the treatment of Parkinson's disease and other movement disorders. But now it is also being used for other conditions.

Ludvic Zrinzo, the neurosurgeon who operated on Mr Wilson said: "It is also being used for chronic pain, for depression, obsessive-compulsive disorder, and Tourette's Syndrome. We are starting to understand a little more about what goes wrong, not only in neurological conditions, by neuropsychiatric ones, and how surgery can help when medication cannot."

The treatment for cluster headaches costs about £25-30,000 but Mr Zrinzo says that must be compared with the terrible suffering that patients experience.

NICE has not yet published guidance on the safety and efficacy of this procedure for cluster headaches, but the National Hospital for Neurology and Neurosurgery is hoping to conduct a wider trial which would fully illustrate its benefits.