Using peripheral stimulation to reduce the pain of C2-mediated occipital headaches: a preliminary report.

BACKGROUND Peripheral nerve stimulation (PNS) is an accepted treatment for neuropathic pain. Recent studies have focused on its potential for relieving headache pain. OBJECTIVES To investigate the effectiveness of PNS in reducing occipital headache pain. DESIGN A prospective, 12-week pilot study involving 11 patients evaluated before and after implantation of PNS systems to treat C2-mediated occipital headaches. METHODS Prior to and at 4 and 12 weeks after implantation, patients completed the Short-Form McGill Pain Questionnaire (SF-MPQ), Visual Analog Scale (VAS), and Present Pain Index (PPI). Patients also answered questionnaires and kept diaries to record stimulator use, medication consumption, and numbers of headaches. RESULTS A comparison of pre- and post-implantation evaluations showed statistically significant declines in scores on the SF-MPQ (64%; p = 0.0013), VAS (67%; p < 0.0001), and PPI (68%; p = 0.0009). Most patients (91% and 64% respectively) reported reductions in medication use and numbers of headaches. Patients also reported a reduction in headache symptoms and the impact of headaches on activities. Two adverse events were encountered, one due to a loose connection and, the other caused by lead migration. CONCLUSIONS PNS reduced headache pain, headache frequency and medication use.