Occipital nerve stimulation for managing chronic migraines remains incompletely understood. A previously reported multicenter, randomized, double-blind trial of bilateral occipital nerve stimulation for chronic migraine in 157 patients revealed significant and clinically meaningful reductions in the active stimulation group for pain intensity, headache days, and migraine-related disability, but no significant difference in primary endpoint (proportion of patients achieving a 50% reduction in pain intensity) was observed. Now a 40-week open label extension of the above trial showed nearly 50% of patients reporting 50% reduction in headache days, and approximately 7 fewer headache days per month. Moreover, good or excellent headache relief was reported in 65-70% of patients. Still, 70% of patients experienced an adverse event, 9% of adverse events required hospitalization, and 41% of device-related adverse events required surgical intervention. While occipital nerve stimulation is promising for migraine headaches, further study is required with attention to reducing device-related complications.
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