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Peripheral Nerve Stimulation for Occipital Neuralgia: A Parallel Approach
Steven Kim1, Maryam Hosseini2, Hesham Elsharkawy3
1Department of Physical Medicine and Rehabilitation, MetroHealth/Case Western Reserve University, Cleveland, OH.
Pain Medicine Case Reports
|June 30, 2025
Summary
Peripheral nerve stimulation (PNS) offers a novel treatment for occipital neuralgia (ON). A parallel lead placement technique resulted in significant, long-term pain relief for a patient with severe ON.
Area of Science:
- Neurology
- Pain Management
- Neurosurgery
Background:
- Occipital neuralgia (ON) causes severe head pain impacting quality of life.
- Standard treatments often fail to provide adequate relief for ON patients.
- Peripheral nerve stimulation (PNS) is an emerging option for refractory ON.
Observation:
- A patient with persistent ON post-surgery underwent a trial PNS implantation.
- An 8-lead stimulator was placed parallel to the occipital nerve using ultrasound and fluoroscopy.
- The patient reported substantial pain reduction after the trial implantation.
Findings:
- A permanent PNS system with 4-tined leads was implanted parallel to the nerve.
- The patient experienced near-complete pain absence at 3, 6, and 12 months post-implantation.
- This parallel technique demonstrated superior outcomes compared to conventional methods.
Implications:
- A parallel lead placement technique for PNS in ON may offer improved efficacy.
- This approach presents a viable alternative for managing debilitating occipital neuralgia.
- Further research into parallel PNS techniques could advance treatment options for nerve pain.
