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Updated: May 26, 2026
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Stimulation ranges, usage ranges, and paresthesia mapping during occipital nerve stimulation
Terrence L Trentman1, Richard S Zimmerman, Nikesh Seth
1Departments of Anesthesiology, Neurosurgery, Biostatistics, and Neurology, Mayo Clinic, Scottsdale, AZ, USA; and Department of Anesthesiology, University of Texas, Houston, TX, USA.
Occipital nerve stimulation shows promise for refractory headaches. In a study of 10 patients, half reported significant headache reduction, with stimulation primarily felt in the occipital region.
Area of Science:
- Neurology
- Neurosurgery
- Pain Management
Background:
- Refractory headache disorders significantly impact quality of life.
- Occipital nerve stimulation (ONS) is an emerging treatment for these conditions.
Purpose of the Study:
- To characterize occipital stimulation parameters in patients with ONS implants.
- To assess patient response to ONS for headache management.
Main Methods:
- Evaluated 10 patients post-ONS implantation.
- Tested all electrode combinations to determine sensory and discomfort thresholds.
- Mapped paresthesia distribution for each patient.
Main Results:
- Mean perception threshold was 1.07 V; mean discomfort threshold was 3.63 V.
- Paresthesia maps confirmed occipital stimulation in most patients; trigeminal distribution was less common.
- 50% of patients achieved ≥50% reduction in headache frequency or severity.
Conclusions:
- Stimulation characteristics provide insights for clinical decision-making and device manufacturing.
- Larger prospective studies are necessary to confirm the safety and efficacy of ONS for headache disorders.
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