Skip to main content

Occipital Nerve Stimulation

  • Chapter
  • First Online:
Neuromodulation in Headache and Facial Pain Management

Part of the book series: Headache ((HEAD))

  • 736 Accesses

Abstract

Neuromodulation is described by the International Neuromodulation Society as “The alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body”. It is an emerging class of therapy that targets the nervous system at specific sites to alter its function or to suppress abnormal activity. This is currently done by implanting small devices to specific areas of the nervous system such as the spinal cord, brain or peripheral nerves. The current process of implantation involves surgery; most techniques are minimally invasive and serious adverse events are rare. Once in place the implants have the advantage of targeting specific areas of the nervous system without systemic side effects of medication and a much longer duration of therapy compared to established preventive treatments.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Magis D, Schoenen J. Advances and challenges in neurostimulation for headaches. Lancet Neurol. 2012;11:708–19.

    Article  Google Scholar 

  2. Lambru G, Matharu MS. Occipital nerve stimulation in primary headache syndromes. Ther Adv Neurol Disord. 2012;5:57–67.

    Article  Google Scholar 

  3. Lipton R, Goadsby PJ, Cady R, Aurora S, Grosberg B, Freitag F, et al. PRISM study: occipital nerve stimulation for treatment-refractory migraine. Cephalalgia. 2009;29(Suppl 1):30.

    Google Scholar 

  4. Saper JR, Dodick DW, Silberstein SD, McCarville S, Sun M, Goadsby PJ, et al. Occipital nerve stimulation for the treatment of intractable chronic migraine headache: ONSTIM feasibility study. Cephalalgia. 2011;31(3):271–85.

    Article  Google Scholar 

  5. Silberstein SD, Dodick DW, Saper J, Huh B, Slavin KV, Sharan A, 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(16):1165–79.

    Article  Google Scholar 

  6. Burns B, Watkins L, Goadsby PJ. Treatment of intractable chronic cluster headache by occipital nerve stimulation in 14 patients. Neurology. 2009;72(4):341–5.

    Article  CAS  Google Scholar 

  7. Leone M, Proietti Cecchini A, Messina G, Franzini A. Long-term occipital nerve stimulation for drug-resistant chronic cluster headache. Cephalalgia. 2017;37(8):756–63.

    Article  Google Scholar 

  8. Miller S, Watkins L, Matharu M. Treatment of intractable chronic cluster headache by occipital nerve stimulation: a cohort of 51 patients. Eur J Neurol. 2017;24(2):381–90.

    Article  CAS  Google Scholar 

  9. Miller S, Watkins L, Matharu MS. Treatment of intractable hemicrania continua by occipital nerve stimulation. J Neurol Neurosurg Psychiatry. 2017;88(9):805–6.

    Article  Google Scholar 

  10. Lambru G, Shanahan P, Watkins L, Matharu MS. Occipital nerve stimulation in the treatment of medically intractable SUNCT and SUNA. Pain Physician. 2014;17(1):29–41.

    PubMed  Google Scholar 

  11. Miller S, Lagrata S, Watkins L, Matharu M. Occipital nerve stimulation for medically refractory chronic paroxysmal hemicrania. Headache. 2017;57(10):1610–3.

    Article  Google Scholar 

  12. Sharan A, Huh B, Narouze S, Trentman T, Mogilner A, Vaisman J, Ordia J, Deer T, Venkatesan L, Slavin K. Analysis of adverse events in the management of chronic migraine by peripheral nerve stimulation. Neuromodulation. 2015;18(4):305–12.

    Article  Google Scholar 

  13. Goadsby PJ, Knight YE, Hoskin KL. Stimulation of the greater occipital nerve increases metabolic activity in the trigeminal nucleus caudalis and cervical dorsal horn of the cat. Pain. 1997;73:23–8.

    Article  CAS  Google Scholar 

  14. Matharu MS, Bartsch T, Ward N, et al. Central neuromodulation in chronic migraine patients with suboccipital stimulators: a PET study. Brain. 2004;127:220–30.

    Article  Google Scholar 

  15. Natsis K, Baraliakos X, Appell HJ, Tsikaras P, Gigis I, Koebke J. The course of the greater occipital nerve in the suboccipital region: a proposal for setting landmarks for local anesthesia in patients with occipital neuralgia. Clin Anat. 2006;19(4):332–6.

    Article  CAS  Google Scholar 

  16. Kerr FW, Olfanson RA. Trigeminal and cervical volleys. Convergence on single units in the spinal gray at C-1 and C-2. Arch Neurol. 1961;5:171–8.

    Article  CAS  Google Scholar 

  17. Busch V, Jakob W, Juergens T, et al. Functional connectivity between trigeminal and occipital nerves revealed by occipital nerve blockade and nociceptive blink reflexes. Cephalalgia. 2006;26:50–5.

    Article  CAS  Google Scholar 

  18. Bartsch T, Goadsby PJ. Central mechanisms of peripheral nerve stimulation in headache disorders. Prog Neurol Surg. 2011;24:16–26.

    Article  Google Scholar 

  19. Trentman TL, Zimmerman RS. Occipital nerve stimulation: technical and surgical aspects of implantation. Headache. 2008;48:319–27.

    Article  Google Scholar 

  20. Barolat G, Ketcik B, He J. Long-term outcome of spinal cord stimulation for chronic pain management. Neuromodulation. 1998;1(1):19–29.

    Article  CAS  Google Scholar 

  21. Dodick DW, et al. Safety and efficacy of peripheral nerve stimulation of the occipital nerves for the management of chronic migraine: long-term results from a randomized, multicenter, double-blinded, controlled study. Cephalalgia. 2015;35(4):344–58. https://doi.org/10.1177/0333102414543331.

    Article  PubMed  Google Scholar 

  22. Doran J, Ward M, Ward B, Paskhover B, Umanoff M, Mammis A. Investigating complications associated with occipital nerve stimulation: a MAUDE study. Neuromodulation. 2018;21(3):296–301.

    Article  Google Scholar 

  23. Weiner RL, Reed KL. Peripheral neurostimulation for control of intractable occipital neuralgia. Neuromodulation. 1999;2:217–21.

    Article  CAS  Google Scholar 

  24. Popeney CA, Alo KM. Peripheral neurostimulation for the treatment of chronic, disabling transformed migraine. Headache. 2003;43:369–75.

    Article  Google Scholar 

  25. Oh M, Ortega J, Bellotte J, Whiting D, Alo KM. Peripheral nerve stimulation for the treatment of occipital neuralgia and transformed migraine using a C1-2-3 subcutaneous paddle style electrode: a technical report. Neuromodulation. 2004;7:103–12.

    Article  Google Scholar 

  26. Serra G, Marchioretto F. Occipital nerve stimulation for chronic migraine: a randomized trial. Pain Physician. 2012;15:245–53.

    PubMed  Google Scholar 

  27. Slotty PJ, Bara G, Kowatz L, Gendolla A, Wille C, Schu S, Vesper J. Occipital nerve stimulation for chronic migraine: a randomized trial on subthreshold stimulation. Cephalalgia. 2014;35(1):73–8.

    Article  Google Scholar 

  28. Wilbrink LA, Teernstra OP, Haan J, van Zwet EW, Evers SM, Spincemaille GH, et al. Occipital nerve stimulation in medically intractable chronic cluster headache. The ICON study: rationale and protocol of a randomised trial. Cephalalgia. 2013;33(15):1238–47.

    Article  Google Scholar 

  29. Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150:971–9.

    Article  CAS  Google Scholar 

  30. Magis D, Bruno MA, Fumal A, et al. Central modulation in cluster headache patients treated with occipital nerve stimulation: an FDG-PET study. BMC Neurol. 2011;11:25.

    Article  Google Scholar 

  31. Miller S, Watkins L, Matharu M. Predictors of response to occipital nerve stimulation in refractory chronic headache. Cephalalgia. 2018;38(7):1267.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David Pang .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Pang, D., Lambru, G., Al-Kaisy, A. (2020). Occipital Nerve Stimulation. In: Lambru, G., Lanteri-Minet, M. (eds) Neuromodulation in Headache and Facial Pain Management. Headache. Springer, Cham. https://doi.org/10.1007/978-3-030-14121-9_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-14121-9_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-14120-2

  • Online ISBN: 978-3-030-14121-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics