Peripheral Neurostimulation for the Treatment of Chronic, Disabling Transformed Migraine

Popeney, Charles A.; Alò, Kenneth M.

doi:10.1046/j.1526-4610.2003.03072.x

Cited by 227 publications

(197 citation statements)

References 11 publications

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“…Recently, pain specialists started linking occipital neuralgia with "spinally transformed migraine," sometimes using these terms interchangeably. 1 Popeney and Aló 10 reported results of occipital PNS in 25 patients with chronic disabling transformed migraine; at a mean follow-up interval of 18 months, improvement in the migraine disability assessment score was almost 90%. 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).…”

Section: Treatment Resultsmentioning

confidence: 99%

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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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177

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%

“…1,10 Standard fouror eight-contact electrodes were used (Fig. 1); the electrodes were passed in the epifascial plane under the skin but above the muscles.…”

Section: Surgical Techniquementioning

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

177

120

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“…In keeping with other reported case series, problems included a high rate of electrode migrations, wound infections, and hardware-induced discomfort, necessitating several reoperations. 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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“…Возможно про-ведение невролиза затылочного нерва или декомпрессии корешков С2-3. В последние годы получены данные об эф-фективности стимуляции БЗН [68].…”

Section: к л и н и ч е с к и е х а р а к т е р и с т и к и ц г бunclassified

Cervicogenic headache: pathophysiology, clinical picture, approaches to therapy

Tabeeva

Сергеев

2010

Neurology, Neuropsychiatry, Psychosomatics

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Peripheral Neurostimulation for the Treatment of Chronic, Disabling Transformed Migraine

Abstract: These results raise the possibility that C1 through C3 peripheral nerve stimulation can help improve transformed migraine symptoms and disability. A controlled study is required to confirm these results.

Cited by 227 publications

References 11 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

Cervicogenic headache: pathophysiology, clinical picture, approaches to therapy

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