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Expert Column

Nerve Stimulators for Headaches

Q: My son suffers from terrible cluster headaches. I read about a rechargeable battery-powered electrode device that is the size of a matchstick and is being called the latest headache cure. When implanted in the back of the neck, it sends signals that reduce the pain by as much as 95% for patients with chronic headaches. Can this device be used to treat people who suffer from cluster headaches?

A: Occipital nerve stimulators have been studied for the treatment of occipital neuralgia and chronic daily headache (chronic migraine, chronic cluster headache and hemicrania continua). They are primarily implanted in patients who have headaches in the back of the head (in the occipital region) and who have failed multiple preventive drug therapies, or in those who experience significant side effects from common migraine preventive medications. Deep brain stimulation has been analyzed in a few smaller studies in patients with chronic cluster headaches, and 50% to 70% of the patients showed significant clinical response. Continued research in larger patient populations will be needed to further determine whether nerve stimulation (occipital nerve or deep brain stimulation) will show clinical promise in patients with chronic cluster headache or chronic migraine.

George R. Nissan, DO, Co-Director, Diamond Headache Clinic, Chicago, IL



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