Occipital nerve stimulation: Effective migraine treatment?

I've had chronic migraines since age 20. I'm now 49. I've tried numerous medications with varying degrees of success. Would occipital nerve stimulation offer any hope?

- Karen / California

Answer

Occipital nerve stimulation is a relatively new procedure used to treat chronic headache disorders, including chronic migraines. In occipital nerve stimulation, a surgeon implants a small device at the base of the skull — near the occipital nerve. Special wires tunneled under the skin connect the device to a pacemaker that's also implanted under the skin, generally under the collar bone (clavicle), under the skin in the lower back, or in the lower abdomen. The pacemaker sends electrical impulses to the occipital nerve, either on a steady or as-needed basis.

Research indicates that occipital nerve stimulation may improve headaches for 70 percent or more of people who try the therapy. However, studies on occipital nerve stimulation thus far have included only a small number of participants — and long-term results aren't yet available. After occipital nerve stimulation, the need for surgical revision of wire placement is common. Infection also is a risk.

The bottom line? Although there's some evidence that occipital nerve stimulation can be effective in the treatment of chronic headache disorders, more studies are needed before the approach can be considered a routine headache treatment.

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