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Updated: Jul 5, 2026

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Neurostimulation in chronic cluster headache.

Delphine Magis, Jean Schoenen

    Current Pain and Headache Reports
    |May 14, 2008
    PubMed
    Summary
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    Occipital nerve stimulation (ONS) offers a safe and effective first-line invasive treatment for intractable chronic cluster headache (iCCH) patients. This reversible neurostimulation method provides satisfactory relief, unlike less safe or ineffective alternatives.

    Area of Science:

    • Neurology
    • Neurosurgery

    Background:

    • Intractable chronic cluster headache (iCCH) affects about 1% of patients, proving refractory to standard drug therapies.
    • Previous lesional interventions for iCCH have lacked lasting efficacy.
    • Nondestructive neurostimulation presents a promising alternative for managing iCCH.

    Purpose of the Study:

    • To evaluate the efficacy and safety of occipital nerve stimulation (ONS) as a treatment for intractable chronic cluster headache (iCCH).

    Main Methods:

    • A review of two trials involving 17 iCCH patients treated with occipital nerve stimulation (ONS).
    • Comparison of ONS with hypothalamic deep brain stimulation (hDBS) and other emerging neurostimulation techniques.

    Main Results:

    • Occipital nerve stimulation (ONS) demonstrated very satisfactory clinical efficacy in most iCCH patients and investigators.

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  • ONS is considered harmless and reversible, though slightly less efficacious than hypothalamic deep brain stimulation (hDBS).
  • Emerging case reports suggest potential roles for supraorbital and vagus nerve stimulation in iCCH management.

    • Conclusions:

    • Occipital nerve stimulation (ONS) is recommended as the preferred first-line invasive therapy for intractable chronic cluster headache (iCCH) due to its safety and efficacy.
    • Further research is needed to determine the definitive role of other neurostimulation methods, such as supraorbital and vagus nerve stimulation, in iCCH treatment.