Neuromodulation in Headache and Facial Pain Management

Giorgio Lambru is a Consultant Neurologist and clinical lead of the Headache Centre at Guy’s and St Thomas’ NHS Foundation Trust, London. The Headache Centre specialises in the diagnosis and management of headache and facial pain disorders. The Centre has pioneered the first MDT complex facial pain clinic and the first fast-track cluster headache clinic in the UK and it is one of the largest neurostimulation services in the UK and Europe for refractory headaches and other chronic pain conditions. Dr. Lambru received his degree in Medicine and Surgery from the University of Milan (Italy) in 2004 and completed his residency in Neurology at the University Hospital of Parma (Italy), during which he was trained in headache care at the prestigious Parma Headache Centre. He subsequently undertook a one-year clinical fellowship with the Headache Group at the National Hospital for Neurology and Neurosurgery, where he developed an interest in cranial neuralgiform disorders, which led him to undertake a PhD degree in 2011 at the Institute of Neurology, UCL.Dr. Lambru has authored a number of scientific papers, book chapters and presented at national and international headache conferences, and is a member of the IHS, EHF, Italian Headache Society and the British Association for the Study of Headache.Michel Lantéri-Minet is Head of the Pain Department at the CHU Nice. He is also a member of the executive committee of the “Fédération Hopitalo-Universitaire (FHU)” “InovPain” – “Innovative Solutation in Refractory Chronic Pain” and the research unit INSERM/UdA, U1107, Neuro-Dol “Migraine and Trigeminal Pain”.A specialist in neurology and pain, Dr. Lantéri-Minet was a member of the International Headache Society (IHS) subcommittees on the 3rd revision of the ICHD and on the methodology of migraine clinial trials.  He has been President of the Société Française d’Évaluation et Traitement de la Douleur, and of the Société Française d’Études des Migraines et Céphalées.Over the years, he has been awarded various research grants from the Fondation de France (2008), the Fondation APICIL (2013) and the Migraine Research Foundation (2014). The author of nearly 140 articles, Dr. Lantéri-Minet has served as a reviewer or editorial board member for a number of publications, including Brain, Cephalalgia, and the Journal of Headache and Pain.

• Part-1: Principles of neuromodulation in headache field and facial pain field. Trigeminal mechanisms of nociception and principles of neuromodulation in pain.- Definition of refractory chronic headache. Part-2: Neuromodulation approaches in headache and facial pain disorders. Hypothalamic deep brain stimulation.- Occipital nerve stimulation.- Sphanopalatine ganglion stimulation.- Vagus nerve stimulation.- Cervical spinal cord stimulation in headache.- Transcranial direct current stimulation.- Repetitive transcranial magnetic stimulation.- External trigeminal nerve stimulation. Part-3: Clinical indication for neuromodulation in headache and facial pain disorders. Neuromodulation in migraine.- Neuromodulation and other non-pharmacological approaches in tension-type headache.-  Neuromodulation in cluster headache.- Neuromodulation in other tacs and other primary headaches.- Neuromodulation in cervicogenic headache and occipital neuralgia.- Neuromodulation in classical trigeminal neuralgia and painful trigeminal neuropathy. Part-4: Challenges in neuromodulation: methodological barriers in clinical trials design and cost-effectiveness issues. Methodological difficulties in clinical trials assessing neuromodulation devices in the headache field.- Clinical and cost effectiveness of neuromodulation devices in the treatment of headaches: focus on non-invasive therapies.