What is an occipital nerve stimulation procedure?

Occipital nerve stimulation is a therapeutic procedure to implant an electrical device that diminishes the function of the occipital nerve. The device consists of electrodes connected with insulated leads to a pulse generator that delivers small electrical impulses to the occipital nerve. The electrical impulses produce a tingling sensation and block the transmission of pain signals to the brain.
Occipital nerve stimulation is a minimally invasive procedure developed in the early 1990s, for management of certain intractable pain syndromes that do not respond to treatments with medication. The stimulation can be tailored to suit individual needs and is reversible.
What does the occipital nerve control?
The occipital nerves provide sensation to the entire back of the head and the ears.
The occipital nerves are a group of nerves that arise from the top of the spine and pass under the neck muscle, up the scalp. to the top of the head. Three sets of nerves with several branches emerge out of the spinal nerve, on each side of the back of the head:
- Greater occipital nerves: two great nerves that are on either side of the back of the head, covering most of the scalp right up to the top of the head.
- Lesser occipital nerves: two nerves on the side of the neck running behind each ear.
- Third occipital nerves: two short nerves located centrally just above the neck.
Why is occipital nerve stimulation performed?
Occipital nerve stimulation is performed to provide pain relief from chronic, intractable daily headaches that do not respond to treatment with medication. Headaches that occur 15 days or more in a month are considered chronic.
Occipital nerve stimulation is used treat
- Headaches that lack a clear underlying cause (chronic, intractable primary headache disorder)
- Headaches that result due to underlying causes (chronic, intractable secondary headache disorders) such as:
- Medication overuse
- Opioid overuse
- Post-trauma
- Inflammation
- Sinus infection
- Brain infection
- Systemic illnesses
- Idiopathic intracranial hypertension (Pressure buildup in the cranium)
- Spontaneous intracranial hypotension (Drop in pressure in the cranium)
- Temporal arteritis (inflammation of artery in the head)
- Neuropathic pain (neuralgia) in the occipital area
Occipital nerve stimulation has been found to be beneficial in reducing pain for conditions that include
- Intractable occipital neuralgia
- Occipital headaches
- Intractable migraine
- Postherpetic neuralgia (persistent neuralgia after shingles)
- Cervicogenic headache (originating from the neck)
- Tension headaches
- Cluster headaches
- Posttraumatic headache
- Chronic daily headaches (transformed migraine)
- Chronic headache due to whiplash injury
- Newly developed persistent headache with no history (new daily persistent headache)
- Hemicrania continua (persistent one-sided headache)

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