- With Mayo Clinic neurologist
Jerry W. Swanson, M.D.read biographyclose window
Jerry W. Swanson, M.D.Jerry W. Swanson, M.D.
Dr. Jerry Swanson is a board-certified neurologist at Mayo Clinic in Rochester, Minn. He is also board certified in headache medicine and is a professor of neurology at College of Medicine, Mayo Clinic. He has a special interest in medical education.
Dr. Swanson, a Lacon, Ill., native, was appointed to the Mayo Clinic staff in 1982 and works in the Department of Neurology with more than 90 other physicians. He formerly chaired the department's Division of Headache and continues to work with headache subspecialists around the world. He has published and lectured widely on headache disorders. He also serves as assistant dean for assessment at Mayo Medical School.
"In a manner similar to the printing press, Internet technology enables the unprecedented ability to communicate with the global community about health information," Dr. Swanson says. "There is no doubt that the knowledgeable individual contributes greatly to his or her own health care, and now we can share information much more widely.
"There is much information already available about health care on the Internet. Unfortunately, much of it is not founded on sound principles. It is exciting to be a part of the web team and contribute to the creation of a reliable and timely health resource."
Dr. Swanson is the neurology editor for "Mayo Clinic Family Health Book" and has reviewed articles for "Mayo Clinic Health Letter" and "Mayo Clinic Women's HealthSource." He is also editor-in-chief of the "Mayo Clinic on Headache" book, published in 2004. In 2008 the magazine Women's Health named him one of America's Top Doctors for Women. In 2011 he received the Mayo Medical School Dean's Recognition Award for his contributions to undergraduate medical education.
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- Migraines: Are they triggered by weather changes?
- Nighttime headaches: How can I get relief?
- Nighttime headaches: How can I get relief?
Treatments and drugs (3)
- Occipital nerve stimulation: Effective migraine treatment?
- Migraine medications and antidepressants: A risky mix?
- Migraine treatment: Can antidepressants help?
- Aerobic exercise: What's the best frequency for workouts?
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?
from Jerry W. Swanson, M.D.
Occipital nerve stimulation is a procedure that might be useful for the treatment of chronic and severe headache disorders that do not adequately respond to more conventional therapy, including chronic migraines. Although occipital nerve stimulation was first used for headaches in 1977, it's still a treatment in development.
Surgical procedures for occipital nerve stimulation vary. In general, a small device is implanted at the base of the skull, near the occipital nerve.
Your doctor connects the lead to a power source (pulse generator) that sends electrical impulses to the occipital nerve. Your doctor implants the pulse generator, often under the collarbone (clavicle), but the abdominal and buttock (gluteal) areas also are options.
After occipital nerve stimulation, the need for surgical revision of wire placement is common. Infection, pain and muscle spasms also are risks.
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 are limited.
The bottom line? Although there's evidence that occipital nerve stimulation may 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?
- Paemeleire K, et al. Occipital nerve stimulation for headache disorders. Neurotherapeutics: The Journal of the American Society for Experimental Neurotherapeutics. 2010;7:213.
- Trentman TL, et al. Occipital nerve stimulation: Technical and surgical aspects of implantation. Headache. 2008;48:319.
- Magis D, et al. Neurostimulation therapies for primary headache disorders: Present and future. Current Opinion in Neurology. 2012;25:269.
- Jenkins B, et al. Neurostimulation for primary headeache disorders, part 1: Pathophysiology and anatomy, history of neuromodulation in headache treatment, and review of peripheral neuromodulation in primary headaches. Headache. 2011;51:1254.
- Schwedt TJ (expert opinion). Mayo Clinic, Phoenix, Ariz. June 26, 2013.
- Silberstein SD, et al. Safety and efficacy of peripheral nerve stimulation of the occipital nerves for the management of chronic migraine: Results from a randomized, multicenter, double-blinded, controlled study. Cephalalgia. 2012;32:1165.
- Saper JR, et al. Occipital nerve stimulation for the treatment of intractable chronic migraine headache: ONSTIM feasibility study. Cephalalgia. 2011;31:271.
- Brewer AC, et al. Long-term outcome in occipital nerve stimulation patients with medically intractable primary headache disorders. Neuromodulation. In press. Accessed June 26, 2013.