Occipital Nerve Stimulation Helps Cluster Headache

But symptoms return when stimulation is lost

FRIDAY, March 9 (HealthDay News) -- Occipital nerve stimulation is an effective treatment for intractable cluster headache, although symptoms return within days if stimulation ceases, according to two pilot studies published online March 8 in The Lancet and The Lancet Neurology.

In the study in The Lancet, Peter J. Goadsby, M.D., and colleagues from the National Hospital for Neurology and Neurosurgery in London, United Kingdom, implanted electrodes in the suboccipital region to bilaterally stimulate the occipital nerve in eight patients with cluster headache that did not respond to drug treatment. After a median follow-up of 20 months, the researchers found that six patients reported at least 25 percent improvement in their attacks. However, symptoms returned soon after when the device stopped working due to battery depletion.

In the study in The Lancet Neurology, Jean Schoenen, M.D., from Liege University in Belgium, and colleagues implanted a suboccipital neurostimulator on the side of the headache to stimulate the occipital nerve in eight patients with drug-resistant chronic cluster headache. After a mean follow-up of 15.1 months, the researchers found that seven patients reported at least 40 percent improvement, of whom two were pain-free. As observed in the other study, loss of stimulation caused symptoms to return within days.

"The clinical effect of occipital nerve stimulation in intractable chronic cluster headache, as shown in these two studies, is slightly inferior and slower than that obtained with hypothalamic deep-brain stimulation," Anna Ambrosini, M.D., from INM Neuromed in Pozzilli, Italy, writes in an accompanying editorial. "But the side-effect and safety profile seems to be better with occipital nerve stimulation."

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