%0 Journal Article
%T Four Decades of Occipital Nerve Stimulation for Headache Disorders: A Systematic Review.
%A Kollenburg L
%A Kurt E
%A Mulleners W
%A Abd-Elsayed A
%A Yazdi C
%A Schatman ME
%A Yong RJ
%A Cerda IH
%A Pappy A
%A Ashina S
%A Robinson CL
%A Dominguez M
%J Curr Pain Headache Rep
%V 0
%N 0
%D 2024 Jun 22
%M 38907793
%F 3.904
%R 10.1007/s11916-024-01271-1
%X OBJECTIVE: Chronic headaches are a significant source of disability worldwide. Despite the development of conventional strategies, a subset of patients remain refractory and/or experience side effects following these treatments. Hence, occipital nerve stimulation (ONS) should be considered as an alternative strategy for intractable chronic headaches. This review aims to provide a comprehensive overview of the effectiveness, safety, mechanisms and practical application of ONS for the treatment of headache disorders.
RESULTS: Overall response rate of ONS is 35.7-100%, 17-100%, and 63-100% in patients with cluster headache, chronic migraine and occipital neuralgia respectively. Regarding the long-term effectivity in all groups, 41.6-88.0% of patients remain responders after ≥ 18.3 months. The most frequently reported adverse events include lead migration/fracture (13%) and local pain (7.3%). Based on our results, ONS can be considered a safe and effective treatment for chronic intractable headache disorders. To support more widespread application of ONS, additional research with larger sample sizes should be conducted.