Document Detail

Neuromodulation of the great auricular nerve for persistent post-traumatic headache.
MedLine Citation:
PMID:  25054403     Owner:  NLM     Status:  In-Data-Review    
Headache is the most frequent reason for referral to an outpatient neurology and pain physician practice, with post-traumatic headache (PTH) accounting for approximately 4% of all symptomatic headaches. Headache following trauma has been reported for centuries. In this unique case report we will discuss the clinical course and successful headache treatment of a 57-year-old man diagnosed with PTHs. He suffered from chronic, intractable headaches resistant to multidisciplinary medical management for 4 years. A trial of electrical neuromodulation of the C2-C3 branches within the great auricular nerve (GAN) distribution was proposed as a potential long-term treatment for his chronic, intractable headaches after having several prior headache attacks successfully aborted with ultrasound-guided GAN blocks. Six months after permanent peripheral neurostimulator implantation, the patient reported a greater than 90% reduction in headache frequency, and was able to wean off all his previous prophylactic and abortive headache medications, with the exception of over-the-counter ibuprofen as needed. Subcutaneous electrode application over the branches of C2-C3-namely greater, lesser, and the least occipital nerves-for the treatment of chronic, intractable headache is not a new concept within pain medicine literature. However, subcutaneous electrode application, specifically over the GAN, is unique. The following case report chronicles the novel application of ultrasound-guided peripheral nerve stimulation of the GAN as an effective and safe long-term treatment for chronic, intractable primary headache. The positive outcome chronicled in this case presentation suggests that peripheral nerve stimulation of the GAN should be considered for highly select cases. To our knowledge, this is the first such case report describing GAN as a target for the management of PTH in the literature.
Foad Elahi; Chandan Reddy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pain physician     Volume:  17     ISSN:  2150-1149     ISO Abbreviation:  Pain Physician     Publication Date:    2014 Jul-Aug
Date Detail:
Created Date:  2014-07-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100954394     Medline TA:  Pain Physician     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E531-6     Citation Subset:  IM    
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