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Neurostimulation for Neck Pain and Headache

Authors

  • Jennifer Hong MD,

    1. Division of Neurosurgery, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
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  • Perry A. Ball MD,

    1. Division of Neurosurgery, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
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  • Gilbert J. Fanciullo MD

    Corresponding author
    1. Division of Pain Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
    • Address all correspondence to G.J. Fanciullo, Division of Pain Medicine, Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03765, USA.

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  • Conflict of Interest: None.

Abstract

Patients with medically refractory headache disorders are a rare and challenging-to-treat group. The introduction of peripheral neurostimulation (PNS) has offered a new avenue of treatment for patients who are appropriate surgical candidates. The utility of PNS for headache management is actively debated. Preliminary reports suggested that 60-80% of patients with chronic headache who have failed maximum medical therapy respond to PNS. However, complications rates for PNS are high. Recent publication of 2 large randomized clinical trials with conflicting results has underscored the need for further research and careful patient counseling. In this review, we summarize the current evidence for PNS in treatment of chronic migraine, trigeminal autonomic cephalagias and occipital neuralgia, and other secondary headache disorders.

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