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    Jerry W. Swanson, M.D.

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Question

Occipital nerve stimulation: Effective migraine treatment?

I have chronic migraines and have had varying degrees of success with different treatments. Could occipital nerve stimulation help?

Answer

from Jerry W. Swanson, M.D.

Occipital nerve stimulation is a procedure used to treat chronic headache disorders, including chronic migraines. Although occipital nerve stimulation was first used for migraines in 1977, it is still a treatment in development.

Surgical procedures for occipital nerve stimulation vary, but in general, a small device is implanted at the base of the skull — near the occipital nerve. The device is then connected to a power source that sends electrical impulses to the occipital nerve. The power source is also implanted, often under the collarbone (clavicle), but the abdominal and gluteal areas also are options. After occipital nerve stimulation, the need for surgical revision of wire placement is common. Infection also is a risk.

Research indicates that occipital nerve stimulation may improve headaches for some people who try the therapy. However, studies on occipital nerve stimulation so far have included only a small number of participants — and long-term results aren't yet available.

The bottom line? Although there's evidence that occipital nerve stimulation can be effective in the treatment of chronic headache disorders, more studies are needed before the approach can be considered a routine headache treatment.

Next question
Migraine medications and antidepressants: A risky mix?
References
  1. Swanson JW (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 22, 2010.
  2. Trentman TL, et al. Occipital nerve stimulation: Technical and surgical aspects of implantation. Headache. 2008;48:319.
  3. Jasper J, et al. Implanted occipital nerve stimulators. Pain Physician. 2008;11:187.
  4. Schoenen J, et al. Neurostimulation therapy in intractable headaches. Handbook of Clinical Neurology. 2010;97:443.
  5. Burns B, et al. Treatment of hemicrania continua by occipital nerve stimulation with a bion device: Long-term follow-up of a crossover study. The Lancet Neurology. 2008;7:1001.
  6. Paemeleire K, et al. Occipital nerve stimulation for headache disorders. Neurotherapeutics: The Journal of the American Society for Experimental NeuroTherapeutics. 2010;7:213.
AN01937 Nov. 13, 2010

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