Occipital Nerve Stimulation for Headache: Mechanisms and Efficacy

Authors

  • Peter J. Goadsby MD, PhD,

    1. From Headache Group, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK (P.J. Goadsby); Department of Neurology, University of California, San Francisco, CA, USA (P.J. Goadsby); Department of Neurology, University of Kiel, Kiel, Germany (T. Bartsch); Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA (D.W. Dodick).
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  • Thorsten Bartsch MD,

    1. From Headache Group, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK (P.J. Goadsby); Department of Neurology, University of California, San Francisco, CA, USA (P.J. Goadsby); Department of Neurology, University of Kiel, Kiel, Germany (T. Bartsch); Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA (D.W. Dodick).
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  • David W. Dodick MD

    1. From Headache Group, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK (P.J. Goadsby); Department of Neurology, University of California, San Francisco, CA, USA (P.J. Goadsby); Department of Neurology, University of Kiel, Kiel, Germany (T. Bartsch); Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA (D.W. Dodick).
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  • Conflict of Interest: Dr. Goadsby has consulted for and done research projects with Advanced Bionics and Medtronic.

Peter J. Goadsby, University of California, San Francisco, Department of Neurology, 505 Parnassus Avenue, San Francisco, CA 94143, USA.

Abstract

Headache disorders are common problems in medicine and it is this commonness that often provides an air of the simple or obvious. Patients expect doctors understand headache; indeed doctors expect they may understand headache, and in turn since simple treatments exist and can be purchased from a supermarket, the very concept of the difficult headache problem has a pejorative connotation. A decade ago none of the authors were using device-based therapies to any substantial extent, and now hardly a week goes by when we will not see a patient who has considerable potential to benefit from such approaches. Here we cover the most promising of the device-based approaches, neurostimulation therapy using occipital nerve stimulation. Far from proven and with much work to be done, this is an exciting potential development for patients and doctors. Other device-based therapies, such as deep brain stimulation for cluster headache and patent foramen ovale closure, are covered elsewhere.

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