Device Helps Local Migraine Sufferers

PITTSBURGH (KDKA) -- If you or someone you know suffers from chronic headaches or migraines then you know sometimes the pain is so bad you'll do almost anything to get relief.

For some people, that means a drive northwest of Pittsburgh for an experimental treatment.

It's still in the clinical stages and while some doctors aren't certain about it yet, one local doctor is. Two of his patients swear it's changed their lives.

Kevin Wurster, from Knox, and Lee Johnston, of New Castle, suffered from chronic, constant headaches.

Lee's started after a car accident.

"My life had gone from a nurse doing everything to down to nothing," she said. "I couldn't enjoy my life with my kids … I wasn't cooking. I was laying on my sofa."

And Kevin's migraines were so bad they caused him to go on disability.

"It was just like I wanted to crawl into a hole, shut off all noise and just curl up into a ball," he said. "They would get that bad. And I'd have them every day, all day long."

Both of them tried the standard treatments, but some of them affected their ability to function.

"They've tried physical therapy, anticonvulsants, antidepressants and opiates," Dr. Thomas Ranieri, of Allied Pain Treatment Center, said.

After a thorough evaluation to make sure there were no other medical problems that could be causing their headaches, they decided to try something different – electrical stimulation of the nerves along the back and front of the head.

The idea is to deliver electric currents to those nerves to block pain signals from entering the brain and spinal cord.

"The patient will come here, and under a local anesthesia and sedation, have placement of the electrodes under the skin on top of the eyebrows," Dr. Ranieri said. "We place them on their stomach and we place electrodes in the back of the head."

"They go home for about a week," he continued.

If it works, the patients can then opt for a more permanent implant.

"And if they like the device, if they like the stimulation and it helps improves their headache, then they'll go on to an implantation under general anesthesia," Dr. Ranieri explained.

Dr. Ranieri has done about 200 of these implants since 1999. It's not part of any clinical trial.

In fact, the device was initially made for treating spinal cord pain and it's this unorthodox use for migraine that has some in the local medical community hesitant.

"Outside the context of a clinical trial, it is not something that we're recommending here," Dr. Robert Kaniecki, of UPMC's Headache Center, said.

Dr. Kaniecki, a neurologist and headache specialist, says the American Headache Society has issued a report stating patients and doctors should be cautious in seeking or recommending surgical therapies for chronic headaches.

"The big concern is that none of these treatments have shown any long term results for benefit," he said.

In fact, he has patients with surgical devices just like this who say their headaches have gotten worse.

And there are other concerns such as the electrodes shifting inside the body and the high risk of infection – both of which may suggest a need for well-designed clinical trials like one being done at Allegheny General Hospital.

Doctors are testing the device for head and neck pain, but not specifically migraine.

"We have patients that go out five, seven years with successful stimulation," Dr. Michael Oh, AGH Neurosurgery, said. "We know that it's working because when the battery dies, they come back."

While he's not opposed to it being used for migraine, he does believe these studies are necessary. But either way, this kind of treatment should be a last resort.

"Instead of sectioning and cutting nerves, what we're doing is trying to intervene with electrical signals, with pumps, and I think that is the future of a lot of pain treatments," Dr. Oh said.

As for Lee and Kevin, they say the device changed their lives. When their week-long trials ended, both began to experience pain again and both opted for the permanent implant.

The device is not FDA approved to treat migraines and as for the cost, it's not cheap. It runs about $18,000 and the week-long trial costs about $5,000.

But Dr. Ranieri insists he has not had any difficult getting insurance to cover it.

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More Reports By Dr. Maria Simbra
Dr. Thomas Ranieri: Allied Pain Treatment Center
Dr. Robert Kaniecki: UPMC, Chief, Headache Division
Dr. Michael Oh: AGH Neurosurgery Research