1. 1 Electronic Aspirin Group no.3

2. 2 Cluster Headache Severe pain Chronic condition Occurs periodically Unilateral pain, usually felt around eye

3. 3 Cluster headaches-physiology Trigeminal Nerve Sphenopalatine ganglion (SPG)

4. 4 Trigeminal Nerve Three Branches of Sensory Fibers 1)Maxillary Branch 2)Opthalmic Branch 3)Mandibular Branch

5. 5 sphenopalatine ganglion (SPG) The SPG mediates functioning of Trigeminal nerve fibers that innervate the face. Role in severe headache pain has been studied for over 100 years - many therapists target the SPG -

6. 6 ATI NeuroStimulator System

7. 7

8. 8 Block Diagram Fixation plate Transducer Lead of 6 electrodes receiver RF transmitter Power Supply

9. 9 How it Works? The high Frequency stimulation (120 Hz) of the SPG paralyzes maxillary nerve sensory fibers, relieving sensation of pain in its peripheral targets.

10. 10 Why use it? Acute pain relief Reduction in Cluster Attack frequency: 68% of patients reported that Quality of Life improvement:75% of patients reported both physical and mental improvements

11. 11 Disadvantages Going through a facial surgery which might have side effects. Discomfort as it takes time to get used to. SAR.

12. 12 References Charleston, W. V., Deer, T. R., Inc, C., & Shurtleff, M., (2010). Intracranial neurostimulation for pain control: a review. Pain Physician, 13, 157–165. Fogan L. Treatment of cluster headache. A double-blind comparison of oxygen v air inhalation. Arch Neurol. 1985;42, 362–363. Friedman, A. P., & Mikropoulos, H. E. (1958). Cluster headaches. Neurology, 8(9), 653–653. DOI: 10.1212/WNL.8.9.653 Knight, G. (2014). A new migraine remedy for your #medtechtoolbox. Retrieved from http://www.fortis.edu/blog/healthcare-medical/a-new- migraine-remedy-for-your-medtechtoolbox/ Magnoux, E., Zotlik, G. (2004). Outpatient intravenous dihydroergotamine for refractory cluster headache. Headache, 44(3), 249–55. DOI: 10.1111/j.1526- 4610.2004.04055.x Top ten medical innovations: #2 neuromodulation therapy for migranes, (2013), [video file]. Cleveland Clinic. Retreived from https://www.youtube.com/watch?v=CX8kLJwxVIQ Treatment of acute cluster headache with sumatriptan (1991). The Sumatriptan Cluster Headache Study Group. N Engl J Med. 325:322–6