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Peripheral neuromodulation in chronic migraine.

F Perini¹, A De Boni

¹Headache Center, St Bortolo Hospital, Vicenza, Italy. francesco.perini@ulssvicenza.it

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

|May 31, 2012

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For chronic migraines unresponsive to medication, electric neurostimulation (ENS) offers alternative pain management. Peripheral ENS, particularly targeting occipital nerves, is reviewed for treating chronic migraine.

Area of Science:

Neurology
Pain Management
Neurosurgery

Background:

Chronic migraines frequently resist conventional medical treatments, necessitating alternative pain modulation strategies.
Neuromodulation encompasses various techniques, including meditation, biofeedback, physical therapy, pharmacotherapy, and electric neurostimulation (ENS).
Electric neurostimulation (ENS) can target the central nervous system (invasively or non-invasively) or the peripheral nervous system.

Purpose of the Study:

To review the indications for utilizing peripheral electric neurostimulation (ENS) applied to the occipital nerves.
To explore alternative pain management strategies for chronic migraine patients refractory to medical treatment.

Main Methods:

Review of existing literature on electric neurostimulation (ENS) modalities.

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Focus on peripheral ENS applications, specifically at the occipital nerve sites.

Examination of ENS use in treating chronic primary headaches, including cluster headaches and chronic migraines.

Main Results:

Central nervous system neuromodulation (deep brain or occipital nerve stimulation) is common for severe conditions like cluster headaches.
Peripheral ENS, using modalities like transcutaneous electrical nerve stimulation and pulsed radiofrequency, has been applied to various peripheral nerve sites.
The review specifically examines the application of peripheral ENS at the occipital nerves for chronic migraine management.

Conclusions:

Peripheral electric neurostimulation (ENS) presents a viable option for managing chronic migraine.
Occipital nerve stimulation, a form of peripheral ENS, is indicated for chronic migraine treatment.
Further research into peripheral ENS modalities for chronic migraine is warranted.