Table 2.
Clinical characteristics, medical treatments and MRI outcome in Trigeminal autonomic cephalalgias patients treated with high frequency cervical spinal cord stimulation treatment
| Patient 1 | Patient 2 | Patient 3 | |
|---|---|---|---|
| Diagnosis | Chronic SUNA | Chronic SUNA | CCH |
| Side of pain | Left | Right | Left |
| Site of pain | V1-V2-V3-C2 | V3-V2-V1 | V1 |
| Pain character | Stabbing | Stabbing | Stabbing |
| Attack duration | 2–600 s | 180–300 s | 40–180 min |
| Attack frequency (daily) | 30–50 | 50–60 | 1–10 |
| Pain severity (VRS) | 8–10/10 | 10/10 | 10/10 |
| Ipsilateral autonomic features | - Ptosis - Rhinorrhoea - Facial oedema - Facial redness |
- Blocked nose - Rhinorrhoea - Facial oedema - Facial redness |
- CI - Lacrimation - Rhinorrhoea - Facial sweating |
| Migrainous symptoms | Yes | Yes | No |
| Cutaneous triggers | Yes | No | No |
| Background pain | Yes | Yes | Yes |
| Effect of indometacin | None | None | None |
| Failed treatments | - Lamotrigine - Carbamazepine - Oxcarbazepine - Prednisolone - Topiramate - Gabapentin - Pregabalin - Duloxetine - Amitriptyline - Flunarizine |
- Lamotrigine - Carbamazepine - Gabapentin - Pregabalin - Amitriptylinea |
- Oxygen - Sumatriptan sc - Verapamil - Lithium - Prednisolone - Gabapentin - Pregabalin - Topiramate - Melatonin - Indometacin - Baclofen - Sodium Valproate - Levetiracetam - GONB - MCNB - SPG block - IV lidocaine |
| MRI brain | Normal | Normal | Normal |
CCH chronic cluster headache; CI conjunctival injection, GONB greater occipital nerve block, IV intravenous, MCNB multiple cranial nerve block, SC subcutaneous, SPG sphenopalatine ganglion, SUNA short-lasting unilateral neuralgiform headache attacks with autonomic symptoms, VRS verbal rating scale, V1 ophthalmic trigeminal division, V2 maxillary trigeminal division, V3 mandibular trigeminal division
aPatient 2 declined any further pharmacological treatments