Burst occipital nerve stimulation, which does now not produce the scalp paraesthesia related to tonic occipital nerve stimulation, produces right first-rate analgesia for sufferers with persistent migraine and persistent cluster headache, in step with a look at posted in Neuromodulation. Larger studies are needed to decide if there are variations in efficacy among the stimulation modes.
Although tonic occipital nerve stimulation is extensively used for continual migraine and chronic cluster headache remedy, the associated scalp paraesthesia may be bothersome and bounds remedy.
It has been proven that effective analgesia in occipital neuralgia is possible using paraesthesia-loose waveforms in spinal twine stimulation, and the present day have a look at became designed to decide if the same is viable the usage of burst occipital nerve stimulation for persistent migraine or chronic cluster headache.
The have a look at included 12 sufferers with continual migraines and five patients with persistent cluster headaches who were handled with bilateral burst-sample occipital nerve stimulation, 4 of whom (1 chronic migraine and 3 persistent cluster headache) had formerly had tonic occipital nerve stimulation but required revision surgical operation because of contamination or lead displacement.
In continual migraine (suggest headache days per month, 26.5), burst occipital nerve stimulation produced a sizeable suggest reduction of headache days in step with month through 10.2 (P =.002, one-tailed sign check), but the responses have been dichotomous, with four sufferers displaying no reduction and the opposite 8 displaying a median reduction of 15 days.
In continual cluster headache (suggest cluster attack frequency, 7.6 in line with day), a 92% discount became visible in headache attack frequency (P =.013, one-tailed sign check) and a 42% discount become visible in depth of residual headaches (P =.023, one-tailed signal check).
Study boundaries consist of the retrospective design, lack of a manipulate group, and patients who were not systematically trialed with both stimulation models.
Study investigators finish, “Paraesthesia isn’t necessary for [occipital nerve stimulation] to be powerful in [chronic migraine] and [chronic cluster headache]. The consequences in this have a look at advise that paraesthesia-free burst [occipital nerve stimulation] can perform as well as tonic [occipital nerve stimulation] or possibly better, but larger research can be required to provide a extra correct evaluation of efﬁcacy. Paraesthesia-free stimulation offers the possibility to perform double-blind trials of [occipital nerve stimulation].”