Occipital Nerve Stimulation Questions & Answers

1. Wolter T, Kaube H, Mohadjer M. High cervical epidural neurostimulation for cluster headache: case report and review of the literature. Cephalalgia. 2008 Oct. 28 (10):1091-4. [Medline].

2. Weiner RL, Reed KL. Peripheral neurostimulation for control of intractable occipital neuralgia. Neuromodulation. 1999 Jul. 2(3):217-21. [Medline].

3. Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965 Nov 19. 150(3699):971-9. [Medline].

4. Palmisani S, Al-Kaisy A, Arcioni R, Smith T, Negro A, Lambru G, et al. A six year retrospective review of occipital nerve stimulation practice--controversies and challenges of an emerging technique for treating refractory headache syndromes. J Headache Pain. 2013 Aug 6. 14:67. [Medline].

5. Sweet JA, Mitchell LS, Narouze S, Sharan AD, Falowski SM, Schwalb JM, et al. Occipital Nerve Stimulation for the Treatment of Patients With Medically Refractory Occipital Neuralgia: Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline. Neurosurgery. 2015 Sep. 77 (3):332-41. [Medline].

6. Yang Y, Song M, Fan Y, Ma K. Occipital Nerve Stimulation for Migraine: A Systematic Review. Pain Pract. 2015 Apr 11. [Medline].

7. Chen YF, Bramley G, Unwin G, Hanu-Cernat D, Dretzke J, Moore D, et al. Occipital nerve stimulation for chronic migraine--a systematic review and meta-analysis. PLoS One. 2015. 10 (3):e0116786. [Medline].

8. Dodick DW, Silberstein SD, Reed KL, Deer TR, Slavin KV, Huh B, 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 Apr. 35 (4):344-58. [Medline].

9. Nguyen JP, Nizard J, Kuhn E, Carduner F, Penverne F, Verleysen-Robin MC, et al. A good preoperative response to transcutaneous electrical nerve stimulation predicts a better therapeutic effect of implanted occipital nerve stimulation in pharmacologically intractable headaches. Neurophysiol Clin. 2016 Feb. 46 (1):69-75. [Medline].

10. Mammis, A and Mogilner E. Peripheral Neuromodulation for Headache and Craniofacial Pain: Indications, Outcomes, and Complications. CNS meeting. Washington DC: 2011.

11. 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 Feb. 31 (3):271-85. [Medline].

12. 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 Dec. 32 (16):1165-79. [Medline].

13. Mekhail NA, Estemalik E, Azer G, Davis K, Tepper SJ. Safety and Efficacy of Occipital Nerves Stimulation for the Treatment of Chronic Migraines: Randomized, Double-blind, Controlled Single-center Experience. Pain Pract. 2017 Jun. 17 (5):669-677. [Medline].

14. Chen YF, Bramley G, Unwin G, Hanu-Cernat D, Dretzke J, Moore D, et al. Occipital nerve stimulation for chronic migraine--a systematic review and meta-analysis. PLoS One. 2015. 10 (3):e0116786. [Medline].

15. Brewer AC, Trentman TL, Ivancic MG, Vargas BB, Rebecca AM, Zimmerman RS, et al. Long-term outcome in occipital nerve stimulation patients with medically intractable primary headache disorders. Neuromodulation. 2013 Nov-Dec. 16 (6):557-62; discussion 563-4. [Medline].

16. Dodick DW, Silberstein SD, Reed KL, Deer TR, Slavin KV, Huh B, 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 Apr. 35 (4):344-58. [Medline].

17. Doran J, Ward M, Ward B, Paskhover B, Umanoff M, Mammis A. Investigating Complications Associated With Occipital Nerve Stimulation: A MAUDE Study. Neuromodulation. 2018 Apr. 21 (3):296-301. [Medline].

18. Slotty PJ, Bara G, Kowatz L, Gendolla A, Wille C, Schu S, et al. Occipital nerve stimulation for chronic migraine: a randomized trial on subthreshold stimulation. Cephalalgia. 2015 Jan. 35 (1):73-8. [Medline].

19. Alo KM Holsheimer, J. New trends in neuromodulation for the management of neuropathic pain. Neurosurgery. 2002. 50 (4):690–704.

20. Alo’, K.M. and Popeney, C.A. Peripheral nerve stimulation (PNS) relieves the symptoms of transformed migraine and reduces associated disability. Neurocontact (Newsletter/Articles from the Editorial Board – Summarial Abstract from Headache Summer 2004, Medicus International. 2004. 43:369-73.

21. Bahra A, Matharu MS, Buchel C, Frackowiak RS, Goadsby PJ. Brainstem activation specific to migraine headache. Lancet. 2001 Mar 31. 357(9261):1016-7. [Medline].

22. Burns B, Watkins L, Goadsby PJ. Treatment of medically intractable cluster headache by occipital nerve stimulation: long-term follow-up of eight patients. Lancet. 2007 Mar 31. 369(9567):1099-106. [Medline].

23. 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 Oct. 73(1):23-8. [Medline].

24. Johnstone CS, Sundaraj R. Occipital nerve stimulation for the treatment of occipital neuralgia-eight case studies. Neuromodulation. 2006 Jan. 9(1):41-7. [Medline].

25. Krames ES, Peckham PH, Rezai AR. Neuromodulation. 2009. Volume 1:Page 132.

26. Magis D, Allena M, Bolla M, De Pasqua V, Remacle JM, Schoenen J. Occipital nerve stimulation for drug-resistant chronic cluster headache: a prospective pilot study. Lancet Neurol. 2007 Apr. 6(4):314-21. [Medline].

27. Mammis, A and Mogilner E. Peripheral Neuromodulation for Headache and Craniofacial Pain: Indications, Outcomes, and Complications. Washington DC: CNS meeting; 2011.

28. Matharu MS, Bartsch T, Ward N, Frackowiak RS, Weiner R, Goadsby PJ. Central neuromodulation in chronic migraine patients with suboccipital stimulators: a PET study. Brain. 2004 Jan. 127(Pt 1):220-30. [Medline].

29. Matharu MS, Bartsch T, Ward N, Frackowiak RS, Weiner R, Goadsby PJ. Central neuromodulation in chronic migraine patients with suboccipital stimulators: a PET study. Brain. 2004 Jan. 127(Pt 1):220-30. [Medline].

30. Melvin EA Jr, Jordan FR, Weiner RL, Primm D. Using peripheral stimulation to reduce the pain of C2-mediated occipital headaches: a preliminary report. Pain Physician. 2007 May. 10(3):453-60. [Medline].

31. Popeney CA Alo KM. C1-2-3 peripheral nerve stimulation (PNS) for the treatment of disability associated with transformed migraine. Headache 43:. 2003. 369–73.

32. Rodrigo-Royo MD, Azcona JM, Quero J, Lorente MC, Acín P, Azcona J. Peripheral neurostimulation in the management of cervicogenic headache: four case reports. Neuromodulation. 2005 Oct. 8(4):241-8. [Medline].

33. Schwedt TJ, Dodick DW, Hentz J, Trentman TL, Zimmerman RS. Occipital nerve stimulation for chronic headache--long-term safety and efficacy. Cephalalgia. 2007 Feb. 27(2):153-7. [Medline].

34. Slavin KV, Nersesyan H, Wess C. Peripheral neurostimulation for treatment of intractable occipital neuralgia. Neurosurgery. 2006 Jan. 58(1):112-9; discussion 112-9. [Medline].

35. Weiner RL, Alo, KM, Reed K. Peripheral neurostimulation for control of intractable occipital headaches. Abstracts of the World Pain Meeting 2000. San Francisco, CA: President Elliot Krames; July 2000.

36. Weiner, RL. Occipital neurostimulation (ONS) for treatment of intractable headache disorders. Pain Med. 2006. 7:S137–S139.

Antonios Mammis, MD Assistant Professor of Neurological Surgery, Director, Functional and Restorative Neurosurgery, Director, Center for Neuromodulation, Director, Rutgers Center for Headache, Orofacial, and Neuropathic Pain, Rutgers New Jersey Medical School

Antonios Mammis, MD is a member of the following medical societies: American Academy of Pain Medicine, American Association of Neurological Surgeons, American Medical Association, Medical Society of the State of New York, World Society for Stereotactic and Functional Neurosurgery, Congress of Neurological Surgeons, American Society for Stereotactic and Functional Neurosurgery

Disclosure: Nothing to disclose.

Mickey E Abraham, MSc Rutgers New Jersey Medical School

Disclosure: Nothing to disclose.

Yehuda Herschman, MD Resident Physician, Department of Neurosurgery, Rutgers New Jersey Medical School

Disclosure: Nothing to disclose.

Max Ward Rutgers New Jersey Medical School

Max Ward is a member of the following medical societies: American Association of Neurological Surgeons, American College of Surgeons, American Medical Association

Disclosure: Nothing to disclose.

Gaurav Gupta, MD, FAANS, FACS Associate Professor of Neurosurgery, System Co-Director, Cerebrovascular and Endovascular Neurosurgery, Fellowship Director, Endovascular Neurosurgery Fellowship (Site), Department of Surgery, Division of Neurosurgery, Rutgers RWJ Barnabas Healthcare, Rutgers Robert Wood Johnson Medical School

Gaurav Gupta, MD, FAANS, FACS is a member of the following medical societies: American Academy of Neurology, American Association for the Advancement of Science, American Association of Neurological Surgeons, American College of Surgeons, American Heart Association, American Medical Association, Congress of Neurological Surgeons, Facial Pain Association, Society for Neuroscience, Society of NeuroInterventional Surgery

Disclosure: Nothing to disclose.

Jonathan P Miller, MD Director, Functional and Restorative Neurosurgery, Director of Epilepsy Surgery, Attending Neurosurgeon, University Hospitals Cleveland Medical Center; Director, Functional and Restorative Neurosurgery Center, UH Cleveland Medical Center Neurological Institute; Associate Professor of Neurosurgery, Fellowship Director, Functional and Stereotactic Neurosurgery, Associate Residency Program Director, Department of Neurosurgery, Surgical Director, Neuromodulation Center, Case Western Reserve University School of Medicine

Jonathan P Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Association of Neurological Surgeons, American College of Surgeons, American Epilepsy Society, American Society for Stereotactic and Functional Neurosurgery, Congress of Neurological Surgeons, International Neuromodulation Society, North American Neuromodulation Society, Ohio State Neurosurgical Society, Society of Neurological Surgeons

Disclosure: Nothing to disclose.

Ahmed Meleis, MD Resident Physician, Department of Neurosurgery, Rutgers New Jersey Medical School

Disclosure: Nothing to disclose.

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