Focus of the Report: This report focuses on occipital nerve stimulation (ONS) for treatment of chronic cluster headache (CH) that has failed to respond to available drug treatments.
Technology Description: ONS involves electrical stimulation of the greater and/or lesser occipital nerves at the back of the head. It is performed with electrodes that are implanted subcutaneously over the nerves and connected to a battery-powered internal pulse generator that is subcutaneously implanted in a pocket in the chest, abdomen, or lower back. ONS is generally performed in an outpatient setting.
Controversy: ONS is an invasive technique that requires surgical implantation of a stimulator. Some patients obtain limited or no relief from this treatment, and it is difficult to predict which patients with chronic CH will benefit.
Key Questions:
Does ONS improve CH outcomes in patients whose symptoms have not responded to standard therapies?
How does ONS compare with alternative technologies (e.g., deep brain stimulation)?
Is ONS safe for treatment of CH?
Have definitive patient selection criteria been identified for ONS for the treatment of CH?
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