Hospital first in UK to implant new device for cluster headaches

Posted on in Hospitals

The James Cook University Hospital has become the first in the UK to use a new implantable device for patients who suffer from cluster headaches.

The AnkerStim® lead and neurostimulation system applies mild electrical stimulation to the nerves via wires implanted under the skin, near the occipital nerves at the base of the head.

The wires are connected to a small battery, implanted under the collarbone, chest wall or in the buttock, which generates stimulation to interfere with pain signals.

Occipital Nerve Stimulation has been proven to reduce the frequency, duration and intensity of headache attacks and reduction in medication use in some patients. The therapy itself is not new – it has been offered at the Middlesbrough hospital for more than 15 years to patients who have not responded well to more conventional treatments.

But until now it often came with serious complications, such as the wire being prone to breaking or moving out of place, which then required another operation to correct.

This new leading-edge device is designed to reduce these complications, enhancing patient comfort and reducing the number of operations patients have to undergo. Flexible electrodes on the lead are designed to adjust to the shape of the skull, while tines on the lead help secure it in place without the use of additional anchors.

Consultant in Pain Management, Dr Ashish Gulve implanted the UK’s first AnkerStim® neurostimulator in February with support from neurosurgeon, Mr Farooq Aziz.

Dr Gulve says the advanced technology from Medtronic will make a great difference to around 15 to 20 patients a year at James Cook who suffer from intractable chronic cluster headaches.

“It’s really nice to be the first in the UK to use this truly innovative product,” he said.

“We are at the forefront for this kind of technology across the world, so when something new comes up we are often first to try innovative neuromodulation therapies.

“At the moment we are only one of the two hospitals in the country implanting this device. It is also available in a select few centres in Belgium, Netherlands, Germany and Hungary.”

The lead is implanted during a short surgical procedure after which the patient can usually go home the next day. The patient gets a controller to activate the stimulation device that is individually programmed for their needs.

The controller allows patients to adjust the strength of the sensation, which may cause a tingling feeling at the back of the head.

Cluster headache is a severe headache condition, distinct from migraine and tension-type headaches, affecting about one in 1,000 individuals.‎ Described by some as the “suicide headache”, it is characterised by extreme pain attacks on one side of the face, typically around the eye. These attacks last 15 to 180 minutes and occur one to eight times a day.‎

Anyone who thinks they may be affected by cluster headaches should contact their GP in the first instance.
Dr Gulve, Pain Psychologists and Dr Adrienn Petreczky, Consultant Neurologist, assess referred patients jointly to confirm their diagnosis and make sure the patients have tried other conventional treatments as per NICE guidance. They optimise patients’ medication use and also treat psychosocial problems caused by the headaches before considering using the implants.