Combined occipital and supraorbital neurostimulation for the treatment of chronic migraine headaches: Initial experience

  title={Combined occipital and supraorbital neurostimulation for the treatment of chronic migraine headaches: Initial experience},
  author={KL Reed and SB Black and C L Banta and Kritstin Will},
  pages={260 - 271}
A novel approach to the treatment of chronic migraine headaches based on neurostimulation of both occipital and supraorbital nerves was developed and reduced to clinical practice in a series of patients with headaches unresponsive to currently available therapies. Following positive trials, seven patients with chronic migraine and refractory chronic migraine headaches had permanent combined occipital nerve–supraorbital nerve neurostimulation systems implanted. The relative responses to two… 

Tables from this paper

Peripheral neurostimulation in primary headaches

The stimulation of the sphenopalatine ganglion has been used as a therapeutic target for the treatment of acute cluster headache attacks, with promising results and preliminary data in patients with epilepsy and migraine have suggested a potential efficacy of vagus nerve stimulation.

Dual occipital and supraorbital nerve stimulation for chronic migraine: a single-center experience, review of literature, and surgical considerations.

The authors' stimulation efficacy was superior to the combined 33% positive response rates (≥ 50% pain reduction) in the published studies of ONS for CM, likely due to the fact that topographical paresthesia induced by combined ONS and SONS covers the area of migraine pain better than ONS alone.

Neurostimulation for the treatment of chronic migraine and cluster headache

This review analyzes the available evidence regarding efficacy and safety of different neurostimulation modalities for the treatment of chronic migraine and cluster headache.

Combined occipital and supraorbital nerve stimulation for treatment of ptosis associated with chronic cluster headache

A 40-year-old female who presented with migraine headaches, occipital pain and experienced daily headaches behind the right eye is reported, which was associated with lacrimation of her right eye, erythema, and ptosis.

Feasibility of combined epicranial temporal and occipital neurostimulation: treatment of a challenging case of headache.

The feasibility of a novel neurostimulation technique: occipital nerve stimulation/bilateral subcutaneous temporal region stimulation to treat headache is presented and programming data reported here supports a proposed mechanism of action concerning stimulation of the auriculotemporal nerve distribution/anterior temporal region for management of refractory pain in migraine.

Occipital nerve stimulation for primary headaches.

In chronic cluster headache, several case series have shown improvement, which, combined with the safety of occipital nerve stimulation relative to deep brain stimulation, have led to published reports supporting this as the preferred surgical technique for chronic cluster headaches.

Occipital nerve stimulation for chronic migraine—interpreting the ONSTIM feasibility trial

  • T. Schwedt
  • Medicine, Psychology
    Cephalalgia : an international journal of headache
  • 2011
It is suggested that occipital nerve stimulation is a promising treatment for chronic migraine and that further clinical trials are warranted.

Neurostimulators for the treatment of primary headaches

Occipital nerve stimulation is a valid option for drug-resistant chronic cluster headache to be considered when occipitals nerve stimulation fails and several other peripheral stimulation approaches have been introduced in recent years, but results are not wholly convincing, and more extensive evaluations are required.

Neuromodulation of chronic headaches: position statement from the European Headache Federation

Any neurostimulation device should only be used in patients with medically intractable syndromes from tertiary headache centers either as part of a valid study or have shown to be effective in such controlled studies with an acceptable side effect profile.



Occipital Nerve Stimulation for Chronic Headache—Long-Term Safety and Efficacy

Occipital nerve stimulation may be effective in some patients with intractable headache, and results from prospective, randomized, sham-controlled studies in patients with medically refractory headache are needed.

Neurostimulation approaches to primary headache disorders

This review summarizes the current concepts, approaches and outcome data of invasive device-based neurostimulation approaches using occipital-nerve stimulation and deep-brain stimulation to further elucidate the clinical potential of neuro Stimulation in chronic headache.

Peripheral Nerve Stimulator for the Treatment of Supraorbital Neuralgia: A Retrospective Case Series

In selected patients, supraorbital nerve stimulation for the treatment of chronic frontal headaches appears to be efficacious.

Neurostimulation in primary headache syndromes

  • P. Goadsby
  • Medicine, Psychology
    Expert review of neurotherapeutics
  • 2007
The initial results are encouraging and given the very significant disability of medically intractable primary headaches, this is a very promising area for patients and physicians alike.

Treatment of intractable chronic cluster headache by occipital nerve stimulation in 14 patients

Improvement occurred within days to weeks for those who responded most and patients consistently reported their attacks returned within hours to days when the device was off and one patient found that ONS helped abort acute attacks.

Central neuromodulation in chronic migraine patients with suboccipital stimulators: a PET study.

The activation pattern in the dorsal rostral pons is highly suggestive of a role for this structure in the pathophysiology of chronic migraine and the localization and persistence of activity during stimulation is exactly consistent with a region activated in episodic migraine, and with the persistence of activation of that area after successful treatment.

Occipital Nerve Electrical Stimulation via the Midline Approach and Subcutaneous Surgical Leads for Treatment of Severe Occipital Neuralgia: A Pilot Study

A case series of 6 patients who had chronic headaches who underwent occipital nerve electrical stimulation lead implantation using a modified midline approach with several advantages compared with the submastoid approach used elsewhere is described.

Peripheral Neurostimulation for Treatment of Intractable Occipital Neuralgia

The beneficial effect from chronic stimulation in this series persisted in more than half of the patients for whom procedure was considered and in 80% of those who significantly improved during the trial and proceeded with internalization, suggesting chronic PNS may be a safe and relatively effective method for long-term treatment of chronic pain syndrome in patients with medically intractable ON.