Occipital Nerve Field Stimulation for Medically Intractable Occipital Neuralgia ; A Case Report

Park, Ji Hoon; Park, Young Seok; Jhang, In Bok; Song, Joon Ho

Case report

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2013;9(1):29-32.
Published online June 30, 2013.

Occipital Nerve Field Stimulation for Medically Intractable Occipital Neuralgia ; A Case Report

Ji Hoon Park, Young Seok Park, In Bok Jhang, Joon Ho Song

Department of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea

Abstract

Neuromodulation is an arising field of chronic pain management including refractory and pharmacological management. Occipital nerve stimulation (ONS) is a kind of peripheral nerve stimulation used to release refractory cluster headache, postsurgical pain and occipital neuralgia by blocking the lesser, greater occipital nerve, third occipital nerve and great auricular nerve. Medically intractable occipital neuralgic pain can be controlled with peripheral nerve stimulation. ONS may serve as a good alternative to destructive surgical manipulations for the patients. A 60-year-old male patient presented with a 5-year history of occipital headache and posterior neck pain. After failing consecutive pain medication and pain block procedure, we implanted subcutaneous occipital peripheral nerve stimulation systems with surgical leads (4volts, 200width , 130Hz). This resulted in more than 50% pain relief without the use of medication at 1 year after the implantation. In summary, the feasibility of occipital nerve field stimulation (ONfS) to treat occipital neuralgia was presented in this study. With ONfS, we achieved optimal pain control during the follow-up period of 12 months. No complications or adverse events were noted. Severity of headache decreased by more than 50%, the symptoms which accompanied his migraines ceased.

Key Words: Occipital nerve field stimulation, Suboccipital neuralgia.