Stimulating Occipital Nerve Eases Cluster Headaches

But the pain returns once the experimental therapy is stopped, studies find

By Amanda Gardner
HealthDay Reporter

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THURSDAY, March 8 (HealthDay News) -- Two pilot studies found that electrical stimulation of the occipital nerve helped ease the agony of cluster headaches, which some have likened to getting stuck in the eye with a hot poker.

The studies, which involved eight patients each, were published in this week's The Lancet and The Lancet Neurology.

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"These studies concord to indicate that ONS (occipital nerve stimulation) is a clinically useful treatment in drug-resistant chronic cluster headache, and that it should receive a trial before hypothalamic deep brain stimulation which is also effective but not risk-less," said Dr. Jean Schoenen, author of the Lancet Neurology study and professor of neurology at Liege University in Liege, Belgium.

Previous trials of hypothalamic deep brain stimulation, which involves stimulating the hypothalamus region of the brain, showed a small risk of fatal hemorrhage.

Other experts urged caution when interpreting the new findings.

"You cannot generalize from two studies of eight people to the whole universe, but one would certainly call it very encouraging," said Dr. Jay Selman, a neurologist with Northern Westchester Hospital Center in Mount Kisco, N.Y., and clinical associate professor of neurology at Columbia University in New York City. "There were no significant side effects, no unintended consequences," Selman added.

Cluster headaches are much less common than migraines, affecting about one in 1,000 people. They typically strike in clusters once or twice a year, causing attacks one or two times a day for two to three months. The debilitating attacks last for about two hours and affect one side of the head.

"In the world of headaches, cluster headaches are much less common than tension-type headaches or migraines but are very severe and can be incredibly debilitating to patients," Selman explained. "Within the world of cluster headaches, there is a small group who have chronic cluster headaches, meaning they don't go more than about a month or so without attack. This subgroup is very difficult to manage. The problem is that they have ended up being on a variety of medications, often multiple medications, which don't tend to work well."

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