Peripheral Nerve Stimulation for the Treatment of Occipital Neuralgia and Transformed Migraine Using a C1-2-3 Subcutaneous Paddle Style Electrode: A Technical Report

Oh, Michael; Ortega, Juan Carlos Barrera; Bellotte, J. Bradley; Whiting, Donald; Alò, Kenneth M.

doi:10.1111/j.1094-7159.2004.04014.x

Cited by 186 publications

(162 citation statements)

References 31 publications

(84 reference statements)

Supporting

Mentioning

154

Contrasting

Unclassified

Order By: Relevance

“…21 Hammer and Doleys 3 presented a report on a patient with occipital neuralgia who underwent implantation with an obliquely placed eightcontact electrode; she maintained 90% improvement in pain intensity as well as improvement in most psychological indicators. 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: 95%

“…All 10 patients with severe chronic migraine who were evaluated using positron emission tomography studies by Matharu et al 7 achieved excellent pain relief with suboccipital stimulators (although one patient also required bilateral supraorbital stimulation). Whereas percutaneous, wire-type electrodes were used in these two studies, Oh et al 9 reported on 10 patients with transformed migraines who underwent implantation of paddle-type electrodes (seven of them initially had received percutaneous electrodes that migrated and were replaced with surgical leads); all 10 had more than 75% pain relief at both 1 and 6 months after the implantation.…”

Section: Treatment Resultsmentioning

confidence: 99%

“…Implantation of such electrodes can be preceded by a trial with wire-type electrodes, 5 or the trial can be done with a plate-type electrode connected to a temporary extension. 9 In all cases the electrodes are placed over the path of the peripheral nerve that supplies the painful area and may be involved in the generation of pain.…”

Section: Surgical Proceduresmentioning

confidence: 99%

See 2 more Smart Citations

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

177

120

View full text Add to dashboard Cite

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.

show abstract

Section: Treatment Resultsmentioning

confidence: 95%

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

FOC

177

120

View full text Add to dashboard Cite

show abstract

“…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

182

View full text Add to dashboard Cite

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.

show abstract

“…15,21,28 Both PNS and peripheral nerve field stimulation (PNfS) have been shown to be effective treatment modalities for conditions associated with truncal pain, intractable abdominal pain, and fibromyalgia. 3,21,22 Peripheral nerve stimulation has also been successfully applied toward the treatment of a variety of chronic headache etiologies, including occipital neuralgia, 20,29 transformed migraine, 20,24 chronic refractory migraines, 10 craniofacial neuropathic pain, 13 cervical headaches, chronic cluster headaches, 14,17 and chronic refractory headaches. 12 Promising advantages of PNS versus DBS and SCS are less invasive lead placement, greater target accessibility through minimally invasive techniques, lower morbidity, and potentially lower costs.…”

mentioning

confidence: 99%

Novel technique for trialing peripheral nerve stimulation: ultrasonography-guided StimuCath trial

Reddy¹,

Flouty²,

Holland³

et al. 2017

FOC

View full text Add to dashboard Cite

OBJECTIVE Peripheral nerve stimulation (PNS) has been used for the treatment of neuropathic pain for many decades. Despite the specific indications for PNS, clinicians often have difficulty screening for candidates likely to have a good or fair outcome. Given the expense of a permanent implant, most insurance companies will not pay for the implant without a successful PNS trial. And since PNS has only recently been approved by the US Food and Drug Administration, many insurance companies will not pay for a conventional trial of PNS. The objective of this study is to describe a short low-cost method for trialing and screening patients for peripheral nerve stimulator implantation. Additionally, this study demonstrates the long-term efficacy of PNS in the treatment of chronic neuropathic pain and the relative effectiveness of this novel screening method. METHODS The records of all patients who had undergone trialing and implantation of a PNS system for chronic refractory pain at the authors' institution over a 1-year period (August 1, 2012–July 31, 2013) were examined in this retrospective case series. The search revealed 17 patients, 13 who had undergone a novel in-office ultrasonography-guided StimuCath screening technique and 4 who had undergone a traditional week-long screening procedure. All 17 patients experienced a successful PNS trial and proceeded to permanent PNS system implantation. Patients were followed up for a mean duration of 3.0 years. Visual analog scale (VAS) pain scores were used to assess pain relief in the short-term (< 6 weeks), at 1 year, and at the last follow-up. Final outcome was also characterized as good, fair, poor, or bad. RESULTS Of these 17 patients, 10 were still using their stimulator at the last follow-up, with 8 of them obtaining good relief (classified as ≥ 50% pain relief, with an average 81% reduction in the VAS score) and 2 patients attaining fair relief (< 50% relief but still using stimulation therapy). Among the remaining 7 patients, the stimulator had been explanted in 4 and there had been no relief in 3. Excluding explanted cases, follow-up ranged from 14 to 46 months, with an average of 36 months. Patients with good or fair relief had experienced pain prior to implantation for an average of 5.1 years (range 1.8–15.2 years). A longer duration of pain trended toward a poorer outcome (bad outcome 7.6 years vs good outcome 4.1 years, p = 0.03). Seven (54%) of the 13 patients with the shorter trial experienced a good or fair outcome with an average 79% reduction in the VAS score; however, all 4 of the bad outcome cases came from this group. Three (75%) of the 4 patients with the longer trial experienced a good or fair outcome at the last follow-up, with an average 54% reduction in the VAS score. There was no difference between the trialing methods and the proportion of favorable (good or fair) outcomes (p = 0.71). CONCLUSIONS Short, ultrasonography-guided StimuCath trials were feasible in screening patients for permanent implantation of PNS, with efficacy similar to the traditional week-long screening noted at the 3-year follow-up.

show abstract

Peripheral Nerve Stimulation for the Treatment of Occipital Neuralgia and Transformed Migraine Using a C1-2-3 Subcutaneous Paddle Style Electrode: A Technical Report

Cited by 186 publications

References 31 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

Peripheral Nerve Stimulation for Neuropathic Pain

Novel technique for trialing peripheral nerve stimulation: ultrasonography-guided StimuCath trial

Contact Info

Product

Resources

About