Occipital nerve stimulation for medically intractable headache

There is an unmet need, and thus a continued search, for effective treatments for patients with chronic daily headache who do not respond to or tolerate conventional therapies. Recent interest has focused on the use of occipital nerve stimulation (ONS) to treat patients with chronic, disabling headaches who are not adequately controlled by usual therapies. A small but growing body of evidence supports the use of ONS for the treatment of intractable headache. Electrical stimulation of the occipital nerve has both peripheral and central nervous system effects that modulate nociception. The exact role for ONS will evolve as our understandings of its physiologic effects, efficacy, and safety grow.