DUAL PROPHYLACTIC AND ABORTIVE ELECTRICAL STIMULATION

• US 20120277823A1
• Filed: 04/26/2012
• Published: 11/01/2012
• Est. Priority Date: 04/29/2011
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gerber, Martin T., Goetz, Steven M., Poletto, Christopher
• Granted Patent: US 9,789,307 B2
• Time in Patent Office: Days
• US Class Current: 607/46
• CPC Class Codes: A61N 1/36 for stimulation
• CPC Class Codes: A61N 1/36057 adapted for stimulating afferent nerves
• CPC Class Codes: A61N 1/36075 Headache or migraine
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36132 using patient feedback

Abstract

Prophylactic stimulation and abortive electrical stimulation are delivered to a cranial nerve, including, e.g. an occipital or trigeminal nerve to treat symptoms of various conditions, including, e.g. occipital neuralgia or migraines.

Claims

1. A method comprising:

delivering prophylactic electrical stimulation to a cranial nerve based on a first range of stimulation thresholds associated with patient perception in the absence of any symptoms of a chronic condition, wherein the prophylactic stimulation is configured to inhibit onset of a symptom of the chronic condition; and

delivering abortive electrical stimulation to the cranial nerve based on a second range of stimulation thresholds associated with patient perception while a symptom of the chronic condition is occurring, wherein the abortive stimulation is configured to reduce an effect of a symptom of the chronic condition.

2. The method of claim 1, wherein delivering the prophylactic stimulation comprises delivering stimulation comprising an intensity within the first range of stimulation thresholds.

3. The method of claim 1, wherein the first range of stimulation thresholds comprises a range from a first low stimulation threshold to a first high stimulation threshold, and wherein the first low stimulation threshold comprises at least one of a second perception or a second parasthesia threshold and the first high stimulation threshold comprises at least one of a second muscle recruitment, a second discomfort, or a second pain threshold.

4. The method of claim 1, wherein delivering the abortive stimulation comprises delivering stimulation comprising an intensity within the second range of stimulation thresholds.

6. The method of claim 1, wherein delivering the abortive stimulation comprises reducing an intensity of the prophylactic stimulation from an intensity within the first range of stimulation thresholds to an intensity within the second range of stimulation thresholds.

7. The method of claim 1, wherein delivering the abortive stimulation comprises:

delivering a first abortive stimulation after onset of a symptom of the chronic condition is anticipated; and

delivering a second abortive stimulation while the symptom of the chronic condition is occurring.

8. The method of claim 7, wherein delivering the second abortive stimulation comprises delivering the second abortive stimulation after an intensity level of the symptom has increased above a level during the onset of the symptom.

9. The method of claim 1, further comprising anticipating onset of a symptom of the chronic condition.

10. The method of claim 9, wherein the abortive stimulation is delivered in response to anticipating the onset of the symptom of the chronic condition.

5. The method of claim 5, wherein the second range of stimulation thresholds comprises a range from a second low stimulation threshold to a second high stimulation threshold, and wherein the second low stimulation threshold comprises at least one of a second perception or a second parasthesia threshold and the second high stimulation threshold comprises at least one of a second muscle recruitment, a second discomfort, or a second pain threshold.

11. A system comprising:

an implantable electrical stimulation generator; and

a processor configured to control the stimulation generator to deliver prophylactic electrical stimulation to a cranial nerve based on a first range of stimulation thresholds associated with patient perception in the absence of any symptoms of a chronic condition and to deliver abortive electrical stimulation to the cranial nerve based on a second range of stimulation thresholds associated with patient perception while a symptom of the chronic condition is occurring,

wherein the prophylactic stimulation is configured to inhibit onset of a symptom of the chronic condition, and

wherein the abortive stimulation is configured to reduce an effect of a symptom of the chronic condition.

12. The system of claim 11, wherein the processor is configured to control the stimulation generator to deliver the prophylactic stimulation comprising an intensity within the first range of stimulation thresholds.

13. The system of claim 11, wherein the first range of stimulation thresholds comprises a range from a first low stimulation threshold to a first high stimulation threshold, and wherein the first low stimulation threshold comprises at least one of a second perception or a second parasthesia threshold and the first high stimulation threshold comprises at least one of a second muscle recruitment, a second discomfort, or a second pain threshold.

14. The system of claim 11, wherein the processor is configured to control the stimulation generator to deliver the abortive stimulation comprising an intensity within the second range of stimulation thresholds.

15. The system of claim 14, wherein the second range of stimulation thresholds comprises a range from a second low stimulation threshold to a second high stimulation threshold, and wherein the second low stimulation threshold comprises at least one of a second perception or a second parasthesia threshold and the second high stimulation threshold comprises at least one of a second muscle recruitment, a second discomfort, or a second pain threshold.

16. The system of claim 11, wherein the processor is configured to control the stimulation generator to deliver the abortive stimulation at least by reducing an intensity of the prophylactic stimulation from within the first range of stimulation thresholds to within the second range of stimulation thresholds.

17. The system of claim 11, wherein the processor is configured to control the stimulation generator to deliver a first abortive stimulation after onset of a symptom of the chronic condition is anticipated and deliver a second abortive stimulation while the symptom of the chronic condition is occurring.

18. The system of claim 17, wherein the processor is configured to control the stimulation generator to deliver the second abortive stimulation after an intensity level of the symptom has increased above a level during the onset of the symptom.

19. The system of claim 11, wherein the processor is configured to receive an indication of anticipating onset of a symptom of the chronic condition.

21. The system of claim 11, wherein the implantable electrical stimulation generator and the processor reside within a housing of an implantable medical device.

22. The system of claim 11, further comprising an external programmer comprising the processor.

23. A computer-readable storage medium comprising instructions for causing a programmable processor to:

deliver prophylactic electrical stimulation to a cranial nerve based on a first range of stimulation thresholds associated with patient perception in the absence of any symptoms of a chronic condition, wherein the prophylactic stimulation is configured to inhibit onset of a symptom of the chronic condition; and

deliver abortive electrical stimulation to the cranial nerve based on a second range of stimulation thresholds associated with patient perception while a symptom of the chronic condition is occurring, wherein the abortive stimulation is configured to reduce an effect of a symptom of the chronic condition.

20. The system of claim 23, wherein the processor is configured to control the stimulation generator to deliver the abortive stimulation in response to receiving the indication of anticipating the onset of the symptom of the chronic condition.