New Treatment for Chronic Head Pain

Mar 22 2004

Janice Eisen's headaches were taking over her life. "I barely functioned, and constantly had to tell people that I felt too bad to do anything," she describes. "I wasn't myself with my husband and two children, who were 7 and 2 years old at the time."

After 10 years of being prescribed an assortment of powerful painkillers and being hospitalized for head pain, Eisen reached the point where she was unable to work and responsibility for parenting fell mostly on her husband. According to a recent Chicago Tribune article, that's when her physician learned of Dr. Robert Levy's pioneering work with medicines and neurosurgery at Northwestern Memorial Hospital's pain-management clinic.

Dr. Levy pioneered a procedure known as supraorbital nerve stimulation or SOS, in which neurotransmitters are implanted into the forehead to block head pain. Tiny wires are burrowed under the skin until the precise location of pain is marked by a tingling response to electrical charge. The wires are kept in place for a week, and if pain is lessened and the patient is comfortable with the technology, neurotransmitters are surgically implanted under local anesthesia. The patient is able to control pain relief by manually adjusting the level of electrical stimulation through a hand held device.

"Our patients are desperate for relief," says Dr. Levy. "We now have treatments that open up a whole new range of possibilities. We're able to offer hope to patients who had none before. In fact, these procedures have transformed some patients almost instantaneously, allowing them to return to such everyday pursuits as running, swimming and gardening shortly after surgery."

Today, Eisen is back to freelance writing and thrilled to be able to focus on being a mother. "I woke up after the first operation and had no headache. I had almost forgotten what that felt like," says Eisen. "After the implants were in and I was off drugs, the spark came back to my personality and I hadn't even realized it was missing. My life has improved."

An estimated 20 million Americans suffer severe headaches, and as many as 10 percent of them have intractable head or facial pain. Treatment after treatment fails. Some are true migraines, which stem from inside the brain, but others result from damaged nerves along the face of scalp.

For years, doctors have long-implanted electrodes along the spinal cord to block certain kinds of pain from the neck down by interrupting those signals. However, the stimulator had to be placed above the pain site, so blocking the pain in the head was not possible.

Then, doctors discovered that stimulating head and facial nerves at skin-deep levels, not just directly against the spinal cord, could work. "This was really surprising and exciting that this implant worked so well," says Dr. Levy.

"Controlling pain is now viewed as important to a person's well being as blood pressure, temperature, respiratory rates and pulse. It is literally a fifth vital sign," says Dr. Levy.