Clinical utility of implantable neurostimulation devices in the treatment of chronic migraine

John A. Freeman, Terrance L. Trentman

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations

Abstract

Chronic migraine is a disabling disorder that is costly to individuals and society. Occipital nerve stimulation has been used to treat refractory cases of primary headache disorders including drug-resistant chronic cluster headaches and chronic migraine. The Food and Drug Administration (FDA) off-labeled application of equipment used for peripheral nerve (occipital) stimulation is borrowed from FDA-labeled spinal cord stimulation. Manufacturer-sponsored randomized trials include a feasibility study (ONSTIM-Medtronic) and a safety and efficacy study (St Jude). A non-industry sponsored prospective, randomized crossover study by Serra and Marchiotretto suggests improved quality of life and a significant reduction in medication use. Though preliminary studies suggest occipital nerve stimulation is safe and efficacious in treating chronic migraine headache, complication rates, including lead migration, lead fracture, and surgical site infections remain high. Further studies are needed to demonstrate long-term outcomes, while improved surgical techniques and site-specific equipment are needed to minimize complications.

Original languageEnglish (US)
Pages (from-to)195-201
Number of pages7
JournalMedical Devices: Evidence and Research
Volume6
Issue number1
DOIs
StatePublished - Nov 20 2013

Keywords

  • Electrical stimulation therapy
  • Headache
  • Neuromodulation
  • Occipital nerve stimulation
  • Peripheral nerve stimulation

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Biomedical Engineering

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