Peripheral Neurostimulation in the Management of Cervicogenic Headache: Four Case Reports

Rodrigo-Royo, Maria Dolores; Azcona, Jose Miguel; Quero, J; Lorente, Maria Cristina; Acín, Pilar Aguado; Azcona, J.

doi:10.1111/j.1525-1403.2005.00032.x

Cited by 88 publications

(52 citation statements)

References 9 publications

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“…Oh et al 9 described excellent and good outcomes at the 1-month follow-up interval in all 10 of their patients with occipital neuralgia (Ͼ 75% pain relief), and that effect persisted in eight of 10 at the 6-month follow-up visit. Rodrigo-Royo et al 11 reported on three patients with occipital pain and headaches and one with postherpetic occipital pain; all of them improved after receiving occipital PNS, and this improvement persisted until their last follow-up visit 4 to 16 months postimplantation.…”

Section: Treatment Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Trigeminal and occipital peripheral nerve stimulation for craniofacial pain: a single-institution experience and review of the literature

Kv¹,

Me²,

N³

et al. 2006

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179

120

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Object Treatment of chronic neuropathic pain in the region of the head and face presents a challenge for pain specialists; patients who do not respond to conventional treatment modalities usually continue to suffer from pain due to the lack of reliable medical and surgical approaches. Peripheral nerve stimulation (PNS) has been used to treat neuropathic pain for many decades, but only recently has it been applied systematically to the craniofacial region. To advance the study of this treatment option, the authors present their initial experience with this approach, summarize published data on the use of PNS in treatment of craniofacial pain, and discuss some technical details of the craniofacial PNS procedure. Methods A review of prospectively collected data in 30 patients who underwent PNS surgery for craniofacial pain was performed. The pain location, duration, cause, and previous treatments were analyzed, along with the surgical details, initial and long-term results, complications, and repeated operations. Stimulated nerves in this group included supraorbital (seven patients), infraorbital (six), and occipital (21); in 19 patients more than one nerve was stimulated. Twenty-two patients proceeded with implantation of a permanent system after the trial. Of these, at the time of the latest evaluation (mean follow-up duration 35 months), in two patients the devices had been removed because of pain improvement over time, in three the devices were removed due to loss of effectiveness (two cases) or late infection (one), and the rest are enjoying either complete (15 patients) or partial (two patients) pain relief. Three patients underwent repeated operation due to lead erosion, infection, or migration. Conclusions Peripheral nerve stimulation appears to be a safe and effective approach in the treatment of craniofacial neuropathic pain. The growing body of literature supports a wider acceptance of this approach in the field of pain surgery.

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Section: Treatment Resultsmentioning

confidence: 99%

“…18 Placement of generators in the gluteal area, 5,11 abdominal wall, 3,22 or infraclavicular areas 4,9,22 has been described.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Trigeminal and occipital peripheral nerve stimulation for craniofacial pain: a single-institution experience and review of the literature

Kv¹,

Me²,

N³

et al. 2006

FOC

179

120

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show abstract

“…14,17,18,20 It has been well established that ONS has excellent efficacy for the treatment of occipital neuralgia or occipitally localized pain with an average of 88% of individuals attaining greater than 50% pain relief. 7,11,16,23 However, when ONS is used to treat primary headache such as cluster headache and CM, the effect has been less than ideal, with a total of 54% patients with cluster headaches and 47% with migraine headaches responding to the treatment, according to the comprehensive reviews of neurostimulation for primary headache disorders by Jenkins and Tepper.…”

Section: Discussionmentioning

confidence: 99%

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

Hann

Sharan²

2013

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Occipital nerve stimulation (ONS) has been studied in a few clinical trials for the treatment of chronic migraine (CM) with failure to prove sufficient efficacy. To date, peripheral nerve stimulation for the treatment of primary headache is limited to off-label use only. The authors report their institutional experience in CM therapy with combined ONS and supraorbital nerve stimulation (SONS). Fourteen patients treated with dual ONS and SONS for CM were studied with follow-up ranging from 3 to 60 months. Seventy-one percent achieved successful stimulation as defined by a 50% or greater decrease in pain severity. The mean reduction in headache-related visual analog scale (VAS) score was 3.92 ± 2.4. Half of the patients also had resolution of migraine-associated neurological symptoms and returned to normal functional capacity. The main adverse events included lead migration (42.8%), supraorbital lead allodynia (21.4%), and infection (14.2%) with a resulting high reoperation rate (35.7%). The authors' stimulation efficacy was superior to the combined 33% positive response rates (≥ 50% pain reduction) in the published studies of ONS for CM. This is likely due to the fact that topographical paresthesia induced by combined ONS and SONS covers the area of migraine pain better than ONS alone. The authors also discuss effective surgical techniques to prevent patient morbidity.

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“…Location of this pocket is chosen based upon the patient's and surgeon's preference. Placement of the generator into the gluteal area, 49,50 abdominal wall, 38,44 or infraclavicular areas 34,45,47,48,51,55,58 has been described. In our opinion, the infraclavicular area (routinely used for placement of DBS generators) is the preferred location for both trigeminal and occipital nerve stimulation systems.…”

Section: Surgical Techniquementioning

confidence: 99%

Peripheral Nerve Stimulation for Neuropathic Pain

Slavin

2008

Neurotherapeutics

188

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Summary: Peripheral nerve stimulation (PNS) has been used for treatment of neuropathic pain for more than 40 years. Recent resurgence of interest to this elegant surgical modality came from the introduction of less invasive implantation techniques and the wider acceptance of neuromodulation as a treatment of medically refractory cases. This article reviews the literature on the use of PNS for neuropathic pain and describes current indications and hardware choices in frequent use. Published experience indicates that neuropathic pain responds to PNS in many patients. PNS works well in both established indications, such as post-traumatic and postsurgical neuropathy, occipital neuralgia, and complex regional pain syndromes, and in relatively new indications for neuromodulation, such as migraines and daily headaches, cluster headaches, and fibromyalgia. Future research and growing clinical experience will help in identifying the best candidates for PNS, choosing the best procedure and best hardware for each individual patient, and defining adequate expectations for patients and pain specialists.

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Peripheral Neurostimulation in the Management of Cervicogenic Headache: Four Case Reports

Cited by 88 publications

References 9 publications

Trigeminal and occipital peripheral nerve stimulation for craniofacial pain: a single-institution experience and review of the literature

Trigeminal and occipital peripheral nerve stimulation for craniofacial pain: a single-institution experience and review of the literature

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

Peripheral Nerve Stimulation for Neuropathic Pain

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