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Year : 2020  |  Volume : 68  |  Issue : 8  |  Page : 231--234

Occipital Nerve Stimulation and Sphenopalatine Ganglion Stimulation for Treatment of Intractable Headache Syndromes

Department of Neurology, The Ohio State University Wexner Medical Center, The Ohio State University, Columbus, USA

Correspondence Address:
Dr. Kiran F Rajneesh
Department of Neurology, The Ohio State University Wexner Medical Center, The Ohio State University, 410 W 12th Ave, Columbus, OH – 43210
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.302477

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Headaches are an increasing cause of disability in the world. Intractable headache syndromes affect all age groups but predominantly the middle-aged, working population. Occipital neuralgia is a frequent comorbidity with intractable migraine headaches. Occipital nerve stimulation at the level of nuchal ridge is a reasonable option for these refractory patients. Ultrasound guidance of occipital nerve stimulation can optimize depth placement of leads. Revision surgeries of occipital nerve stimulation are usually performed using surgical leads. Cluster headaches and trigeminal autonomic cephalagias (TACs) are refractory headache conditions that are mediated by sphenopalatine ganglion. Sphenopalatine ganglion stimulation with infrazygomatic approach and fluoroscopic guidance of percutaneous leads can help alleviate pain from cluster headaches and TACs. Innovation in neurostimulation technologies have brought new optimism to these refractory conditions. Efficient and optimal delivery of neurostimulation for intractable headache syndromes requires a multidisciplinary team-based approach for long term compliance and efficacy.


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Online since 20th March '04
Published by Wolters Kluwer - Medknow