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5th Cluster Headache Award

On Behalf of the University Centre for Adaptive Disorder and Headache (UCADH) and the Casimiro Mondino Foundation of Pavia, Italy, the Cluster Headache Award is given yearly to a research group which, following the tradition of the Headache Centre over the last three decades, has given a relevant contribution in the field of cluster headache. The prize is acknowledged on the basis of a peer reviewed manuscript published the previous year. The members of the Scientific Committee are the following: G. Nappi (Chairman), K. Ekbom M. Fanciullacci, P.Goadsby, GC. Manzoni, NT. Mathew, M. Moskowitz, F. Antonaci (Secretary).

The Scientific Committee has selected and scored 34 manuscripts on Cluster headache published in 2006. The winner of the 5nd Edition (year 2008) has been the paper: Treatment of medically intractable cluster headache by occipital nerve stimulation: long-term follow-up of eight patients written by Burns, B., L. Watkins, and P.J. Goadsby,. Appeared in Lancet, 2007. 369(9567): p. 1099-106.
Cluster headache is a form of primary headache involving repeated attacks of excruciatingly severe headache usually occurring several times a day. Patients with chronic cluster headache (CCH) have an unremitting illness requiring daily preventive medical therapy. In the paper it has been described that 8patients with medically intractable CCH were implanted in the suboccipital region with electrodes for neurostimulation therapy (ONS). Stimulation occurred bilaterally during treatment.
At a median follow up of 20 months (range 6-27 months), six of eight patients reported responses that were meaningful to them sufficient to recommend ONS to similarly affected patients with CCH. Specifically, two patients noticed a marked improvement of 90% or better. Three patients noticed a moderate improvement of 40% or better and one patient recorded a mild improvement of 25%. Improvements occurred in both frequency and severity. Improvement was noticed after weeks or months, although remarkably attacks returned in days when the device malfunctioned, such as with battery depletion. Adverse events of concern were lead migrations in one patient and battery depletion requiring replacement. Therefore, occipital nerve stimulation (ONS) in cluster headache offers a safe, seemingly effective option, and may usher a new era of neurostimulation therapy for primary headache syndromes.
The prize has been delivered to the authors by Prof. F. Antonaci during the European Headache Migraine Trust International Congress held in London (7th September 2008).

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