Neuromodulation Interventions for Headache
Headache is one of the leading causes of disability worldwide. The prevalence of acute migraine ranges between 2.6% to 21.7% depending on the studied population, whereas chronic migraine refractory to traditional first-line agents may afflict approximately 2% of the general population. It is well-known that headaches impose a significant economic burden including a reduction in productivity, an increase in sick days, and an increase in disability costs. Recently, neuromodulation interventions have been increasingly utilized to treat various headache disorders refractory to conservative management, first-line pharmacological agents, and injection therapy (e.g. occipital/supraorbital steroid injections, botulinum toxin injections, etc.). Most studies assessing neuromodulation interventions for the treatment of headache have focused on peripheral nerve stimulation and peripheral field stimulation, although observational studies have also recently emerged on the utility of high-cervical dorsal column spinal cord stimulation for the treatment of headache.
Learning Objectives
Upon completion of this educational activity, participants should be able to:
- Describe various manifestations of headaches, epidemiology, and traditional management (conservative therapy, first-line pharmacologic therapy, and injection therapy).
- Disuss clinical outcomes (pain intensity, physical function, satisfaction, mental health, adverse events) of peripheral nerve stimulation for various headache disorders (migraines, occipital neuralgia, supraorbital neuralgia, trigeminal autonomic cephalgia).
- Identify clinical outcomes (pain intensity, physical function, satisfaction, mental health, adverse events) of peripheral field stimulation and non-invasive neuromodulation for various headache disorders (migraines, occipital neuralgia, supraorbital neuralgia, trigeminal autonomic cephalgia).
- Explain clinical outcomes (pain intensity, physical function, satisfaction, mental health, adverse events) of high-cervical dorsal column spinal cord stimulation for various headache disorders (migraines, occipital neuralgia, supraorbital neuralgia, trigeminal autonomic cephalgia).
Peripheral Nerve Stimulation for Headache: Occipital and Supraorbital Neuralgia
Narayan Kissoon, MD
Peripheral Field Stimulation and Non-invasive Neuromodulation for Trigeminal Autonomic Cephalgias
Nathaniel M. Schuster, MD
High-Cervical Dorsal Column Spinal Cord Stimulation for Migraine and Other Headache Disorders
Ryan S. D'Souza, MD
Faculty subject to change.