scholarly journals An unusual case of lead migration in occipital nerve stimulation: A case report and literature review

2021 ◽  
Vol 12 ◽  
pp. 189
Author(s):  
Rafael Caiado Vencio ◽  
Paulo Eduardo Albuquerque Zito Raffa ◽  
André Costa Corral Ponce ◽  
Bruno Pricoli Malamud ◽  
César Cozar Pacheco ◽  
...  
Keyword(s):  
Nerve Stimulation ◽  
Unusual Case ◽  
Stress Relief ◽  
Sudden Onset ◽  
Occipital Neuralgia ◽  
Occipital Nerve Stimulation ◽  
Neck Movement ◽  
Occipital Nerve ◽  
Skull Radiography ◽  
History Of

Background: Lead migration is a complication associated with occipital nerve stimulation (ONS). We present a rare case in which fibrosis in the stress relief loop caused lead migration in the treatment of occipital neuralgia. Case Description: A 30-year-old woman with a 5-year history of refractory occipital neuralgia, who had been under ONS therapy for 2 months, presented with a sudden onset of typical occipital neuralgia pain associated with cervical muscles spasms and myoclonus. A skull radiography showed lead migration. The patient underwent surgery for lead repositioning. During surgery, we identified extensive fibrosis throughout the stress relief loop that produced several constriction points. The fibrosis in the stress relief loop increased tension on the lead during head-and-neck movement, causing progressive migration of the lead. Conclusion: Although lead migration is a common complication of ONS, its association with fibrosis in the stress relief loop has not, to the best of our knowledge, been reported before. Lead migration can directly affect treatment outcome and it is, therefore, important to fully understand the possible mechanisms that can cause it and how to promptly manage them.

scholarly journals Neurostimulation for the Treatment of Chronic Head and Facial Pain: A Literature Review

2019 ◽  
Vol 5 (22;5) ◽  
pp. 447-477
Author(s):  
Ajay Antony
Keyword(s):  
Peripheral Nerve ◽  
Cluster Headache ◽  
Nerve Stimulation ◽  
Facial Pain ◽  
Current Evidence ◽  
Occipital Neuralgia ◽  
Occipital Nerve Stimulation ◽  
Peripheral Nerve Stimulator ◽  
Occipital Nerve ◽  
Craniofacial Pain

Background: Head and facial pain is a common and often difficult to treat disorder. Routine treatments sometimes fail to provide acceptable relief, leaving the patient searching for something else, including narcotics and surgery. Recently, neuromodulation has been expanding to provide another option. Secondary to its potentially temporary nature and relatively manageable risk profile, several reviews have suggested trialing neuromodulation prior to starting narcotics or invasive permanent surgeries. There is evidence that neuromodulation can make a difference in those patients with intractable severe craniofacial pain. Objectives: To provide a basic overview of the anatomy, epidemiology, pathophysiology and common treatments of several common head and facial disorders. Furthermore, to demonstrate the suggested mechanisms of neuromodulation and the evidence currently existing for the use of neuromodulation. Methods: A comprehensive review was performed regarding the available literature through targeting articles reporting on the use of neuromodulation to treat pain of the head and face. Results: We compiled and discuss the current evidence available in treating head and facial pain. The strongest evidence currently for neuromodulation is for occipital nerve stimulation for migraine, transcutaneous vagal nerve stimulation for migraine and cluster headache, sphenopalatine ganglion microstimulation for cluster headache, and transcutaneous supraorbital and supratrochlear nerve stimulation for migraine. In addition, there is moderate evidence for occipital nerve stimulation in treating occipital neuralgia. Limitations: Neuromodulation has been trialed and is promising in several craniofacial pain disorders; however, there remains a need for large-scale, randomized, placebo-controlled clinical trials to further evaluate the efficacy and safety of most treatments. Much of the current data relies on case reports without randomization or placebo controls. Conclusions: With advancing techniques and technology, neuromodulation can be promising in treating intractable pain of the head and face. Although more randomized controlled trials are warranted, the current literature supports the use of neuromodulation in intractable craniofacial pain. Key words: Neuromodulation, headache, facial pain, craniofacial pain, migraine, cluster headache, trigeminal neuralgia, occipital neuralgia, peripheral nerve stimulator, high cervical spinal cord stimulator, peripheral nerve field stimulator

Occipital Nerve Stimulation for Intractable Occipital Neuralgia

Neurosurgery ◽  
2008 ◽  
Vol 62 (6) ◽  
pp. 1426
Author(s):  
Philippe Magown ◽  
Rene Garcia ◽  
Ian Beauprie ◽  
Ivar Mendez
Keyword(s):  
Nerve Stimulation ◽  
Occipital Neuralgia ◽  
Occipital Nerve Stimulation ◽  
Occipital Nerve

scholarly journals Occipital Nerve Stimulation for the Treatment of Patients With Medically Refractory Occipital Neuralgia

Neurosurgery ◽  
2015 ◽  
Vol 77 (3) ◽  
pp. 332-341 ◽  
Author(s):  
Jennifer A. Sweet ◽  
Laura S. Mitchell ◽  
Samer Narouze ◽  
Ashwini D. Sharan ◽  
Steven M. Falowski ◽  
...  
Keyword(s):  
Nerve Stimulation ◽  
Occipital Neuralgia ◽  
Occipital Nerve Stimulation ◽  
Occipital Nerve

scholarly journals Implanted Occipital Nerve Stimulators

2008 ◽  
Vol 2;11 (3;2) ◽  
pp. 187-200
Author(s):  
Joseph F. Jasper
Keyword(s):  
Systematic Review ◽  
Cluster Headache ◽  
Nerve Stimulation ◽  
Chronic Headache ◽  
Cervicogenic Headache ◽  
Occipital Neuralgia ◽  
Occipital Nerve Stimulation ◽  
Occipital Nerve ◽  
Transformed Migraine ◽  
Daily Headache

Background: Chronic headache represents a very significant public health and economic issue. One treatment modality for chronic refractory headache involves the use of subcutaneous implanted neurostimulator leads in the occipital region. Varied types of headache etiologies including migraine, transformed migraine, chronic daily headache, cluster headache, hemicrania continua, occipital neuralgia, and cervicogenic headache have been studied with peripheral nerve field stimulation and found responsive to stimulation of the suboccipital region, known commonly as occipital nerve stimulation (ONS). Objective: To evaluate the strength of evidence that occipital nerve stimulation is an effective treatment of benign headache. Study Design: A systematic review of occipital nerve stimulation for the treatment of chronic headache. Methods: A systematic review of the literature through EMBASE and PubMed/Medline for clinical studies was performed. The Agency for Healthcare Research and Quality (AHRQ) criteria was utilized to assess the evidence regarding occipital nerve stimulators and arrives at conclusions as to their efficacy in the treatment of headache. Studies were also graded using AHRQ criteria. The overall body of evidence was then graded on a 5 level scale from Level I (conclusive), Level II (strong), Level III (moderate), Level IV (limited) to Level V (indeterminate). Results: Ten observational studies, of which 4 were prospective, and a number of case series, case reports, and reviews were identified. No randomized controlled trials (RCT) were identified. All of the articles reported positive outcomes including improved pain relief, reduced frequency, intensity, and duration of headaches with reduced medication consumption. ONS was reportedly successful for 70 – 100% of patients. Reduction of pain in patients with occipital headaches and transformed migraine is significant and rapid; for cluster patients the improvement may be less dramatic and it may take several months of occipital stimulation to achieve relief. No long-term adverse events occurred. Several short-term incidents occurred including infection, lead displacement, and battery depletion. The body of evidence as a whole is a level of strength of IV, limited. Conclusion: ONS is a useful tool in the treatment of chronic severe headaches with at least Level IV (limited) evidence based on multiple positive studies. Key Words: headache, chronic daily headache, occipital neuralgia, cervicogenic headache, migraine, transformed migraine, cluster headache, neuromodulation, neurostimulation, stimulator, peripheral nerve stimulation.

Occipital Nerve Stimulation for the Treatment of Refractory Occipital Neuralgia: A Case Series

2017 ◽  
Vol 105 ◽  
pp. 599-604 ◽  
Author(s):  
Orion P. Keifer ◽  
Ashley Diaz ◽  
Melissa Campbell ◽  
Yarema B. Bezchlibnyk ◽  
Nicholas M. Boulis
Keyword(s):  
Nerve Stimulation ◽  
Case Series ◽  
Occipital Neuralgia ◽  
Occipital Nerve Stimulation ◽  
Occipital Nerve

scholarly journals Central modulation in cluster headache patients treated with occipital nerve stimulation: an FDG-PET study

BMC Neurology ◽  
2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Delphine Magis ◽  
Marie-Aurélie Bruno ◽  
Arnaud Fumal ◽  
Pierre-Yves Gérardy ◽  
Roland Hustinx ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Nerve Stimulation ◽  
Fdg Pet ◽  
Occipital Nerve Stimulation ◽  
Occipital Nerve ◽  
Headache Patients
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