Response to occipital nerve block is not useful in predicting efficacy of occipital nerve stimulation

T. J. Schwedt, D. W. Dodick, T. L. Trentman, R. S. Zimmerman

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Occipital nerve stimulation (ONS) may be effective for the treatment of headaches that are recalcitrant to medical therapy. The objective of this study was to determine if response to occipital nerve block (ONB) predicts response to ONS in patients with chronic, medically intractable headaches. We evaluated 15 patients who underwent placement of occipital nerve stimulators for the treatment of chronic headaches. Data were collected regarding analgesic response to ONB and to ONS. Nine of 15 patients were ONS responders (≥50% reduction in headache frequency or severity). Thirteen patients had ONB prior to stimulator implantation. Ten of 13 who had ONB had significant relief of head pain lasting at least 24 h, and three were ONB non-responders. Of the three ONB non-responders, two were ONS responders. Of the two patients who did not have ONB prior to ONS, one was an ONS responder and one was an ONS non-responder. In conclusion, analgesic response to ONB may not be predictive of the therapeutic effect from ONS in patients with medically refractory chronic headaches.

Original languageEnglish (US)
Pages (from-to)271-274
Number of pages4
Issue number3
StatePublished - Mar 2007


  • Chronic cluster headache
  • Chronic migraine
  • Hemicrania continua
  • Occipital nerve block
  • Occipital nerve stimulation
  • Post-traumatic headache

ASJC Scopus subject areas

  • Clinical Neurology


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