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Paroxysmal sneezing after hypothalamic deep brain stimulation for cluster headache
Farooq H Maniyar1, Philip Starr, Peter J Goadsby
1University of California, USA.
Cephalalgia : an International Journal of Headache
|April 25, 2012
Summary
Deep brain stimulation (DBS) for chronic cluster headache (CH) can cause sneezing. Adjusting stimulation parameters may reduce this side effect, offering insights into brain function.
Area of Science:
- Neurology
- Neurosurgery
- Headache Medicine
Background:
- Cluster headache (CH) is a severe primary headache disorder.
- Trigeminal autonomic cephalalgias (TACs) include CH, characterized by unilateral pain and autonomic symptoms.
- Chronic CH affects 10-15% of patients, often requiring advanced treatments.
Observation:
- Deep brain stimulation (DBS) in the posterior hypothalamus is effective for refractory CH.
- A patient undergoing DBS for chronic CH experienced new-onset sneezing.
- Adjusting the pulse width of the DBS from 60 to 90 µs reduced the sneezing episodes.
Findings:
- Posterior hypothalamic DBS can induce sneezing, possibly via parasympathetic or trigeminal pathways.
- The trigeminohypothalamic tract may be involved in this response.
- DBS parameters, like pulse width, can modulate side effects.
Implications:
- DBS offers a tool to explore brain function and neuroanatomical pathways.
- Understanding DBS-induced side effects can refine treatment protocols for CH.
- This case highlights the complex interplay between hypothalamic stimulation and cranial autonomic functions.
