Presented at the 2012 AAPM Annual Meeting « Back

Occipital Nerve Stimulation for the Treatment of Chronic Headaches

Christopher R. Russo, MD, christopher_r_russo@yahoo.com¹, Maria-Carmen Wilson, MD², Jose E. Sarria, MD³, (1) University of South Florida, Department of Neurology, Tampa, Florida, (2) University of South Florida College of Medicine, Tampa, Florida, (3) H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida

A multidisciplinary approach produces the best long-term result when treating chronic headaches. Occipital nerve stimulation (ONS) has shown promise as documented by multiple case reports and case series studies. Rigorous formal ONS trials are currently underway. We present our experience with the use of ONS for the treatment of a variety of chronic headache disorders. This data was collected from the University of South Florida College of Medicine and its affiliated medical institutions. All patients were referred from the Tampa General Hospital Headache and Pain Center to the Interventional Pain Clinic at the H. Lee Moffitt Cancer Center and Research Institute. A medically refractory chronic headache syndrome was the referral criterion. A total of 18 patients underwent percutaneous trial ONS and 16 were implanted after completing a successful trial. The breakdown of their diagnoses included eight chronic migraine headaches, three cluster headaches, one hemicrania continua, one posttraumatic headache, one postcraniotomy headache, and one occipital neuralgia. Two trials for chronic migraine were unsuccessful. Complications included one scar revision for a painful lead site and one infection requiring system exchange. Several patients have required repeated reprogramming for shifting lead stimulation. Longest follow-up has been 9 months involving two patients who continue to report successful ONS as defined by greater than 50% overall improvement in their headache symptomatology. In summary, there is growing clinical evidence that ONS is beneficial in the treatment of chronic headache and should be considered in a well-defined subgroup of refractory chronic headache patients.

Funding: None