Occipital Stimulation For Headaches
Recent research in the field of cluster headache and migraine headache has indicated that occipital stimulation or occipital stim may have benefit for some headache sufferers.
The biggest benefit seems to be for cluster headache. In a study presented at the American Headache Society, 67% of patients with severe cluster headaches had their pain relieved.
These are patients who have not responded to medications or even IV infusions of steroids to stop their headaches.
Similar good results were seen with occipital stim in patients with severe migraine. Again those patients chosen for the research study were ones who had failed on many medications.
Researchers both in the United Stated and from Europe were present at the meeting and agreed the procedure is generally simple from the surgical point of view.
Although not covered by all insurances at the present time like any other method, as the research results continue to be promising, this then will lead to more insurance coverage. Dr. Robert Lipton says..
There is still a lot of unmet need, Dr. Lipton said. So the idea of having stimulatory devices that can be used to prevent headaches or to treat them acutely is very attractive to me, and I think very attractive to patients as well. (NY Times online)
At the present time, as mentioned, the procedure is in clinical trials but the trials are now close. However, new ones always start up. The company who makes the stimulator is made by Medtronics and current trials are at the Mayo clinic in Arizona and at Michigan Head and Pain Institute.
The procedure itself involves putting small electrodes just under the skin at the back of the head. The electrodes are placed just over the occipital nerves that run in that area. When I say small..I mean small. The wires attached to the electrodes are slim and very flexible. A small battery pack is placed just under the skin and the batteries last for several years.
This procedure does NOT involve opening the skull or direct brain surgery of any sort.
As the nerves are stimulated by the electrodes they feedback messages through the upper part of the spine to the brains center for registering headache pain. Specifically, the hypothalamus.
This results in a lessening in the perception of pain from the trigeminal nerve along the side of the head..usually the pounding of a migraine.
For a cluster headache the theory is that it affects that area of the hypothalamus responsible for clusters.
The most common side effect after surgery is numbness at the back of the head which most patients did not find objectionable.
As of June 2008 the trials closed, but there are options. Additional research presented at the American Headache Society meeting indicated that many patients responded to occiptal nerve blocks even if they didn't have pain at the back of the head.
If your neurologist can do this for you, it is a simple 10 minute procedure of an injection around the nerve. A small of amount of an anesthetic like lidocaine is mixed with a steroid and injected into the area. This could provide justification to your insurance company for you to get occipital stimulation for headache prevention. I have had patients do this and then see the neurosurgeon or the pain specialist and get the stimulator put in..and it works!
Keep checking with Clinicaltrials.gov for up to date information about new clinical trials in the treatment of migraine and other headaches.
Don't forget to read more about different types of headaches.