title: Peripheral nerve field stimulation for chronic headache: 60 cases and long-term follow-up.
abstract: OBJECTIVE
  The objective of this study is to evaluate the efficacy of peripheral nerve field stimulation (PNFS) for the treatment of chronic headache conditions.
  
  
  METHODS
  For more than a four-year period, 83 patients underwent a trial of a PNFS system targeting the nerve regions including occipital and supraorbital and infraorbital nerves, which best corresponded with their area of head pain. Sixty patients reported a successful trial and underwent a subsequent implant of the PNFS system. Questionnaires, along with patients' charts, were used to assess outcomes as follows: pain (11-point numerical pain rating scale), analgesic use, depression (Zung Depression Scale), disability (Neck Disability Index), patient satisfaction, and surgical complications. Patients were followed up for an average of 12.9 ± 9.4 months (range 3-42 months).
  
  
  RESULTS
  An average pain reduction of 4.8 ± 2.3 pain scale points was observed (preimplant 7.4 ± 1.6; follow-up 2.6 ± 2.1 [p ≤ 0.001]). Of the 60 patients implanted, 41 reported >50% pain relief. Medication use was reduced in 83% of patients who were previously taking analgesics or prophylactic medications. Similarly, reductions in degree of disability and depression also were observed. Of the 60 cases, ten surgical revisions were required; however, no long-term complications were reported.
  
  
  CONCLUSIONS
  PNFS for chronic headache is an evolving therapy. This study demonstrates that this reversible and effective treatment can be a promising pain relief strategy for this often intractable condition.
authors.affiliation: Metro Spinal Clinic, Caulfield South, Vic., Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Verrills
authors.forename: Rebecca
authors.initials: R
authors.lastname: Rose
authors.forename: Bruce
authors.initials: B
authors.lastname: Mitchell
authors.forename: David
authors.initials: D
authors.lastname: Vivian
authors.forename: Adele
authors.initials: A
authors.lastname: Barnard
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D020773:Headache Disorders / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010525:Peripheral Nerves / Q000503:physiopathology*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000700:Analgesics
keywords: chronic pain; headache; migraine; neuromodulation; occipital nerve stimulation; outcome measure; peripheral nerve field stimulation