Stimulation ranges, usage ranges, and paresthesia mapping during occipital nerve stimulation

Terrence L. Trentman, Richard S. Zimmerman, Nikesh Seth, Joseph G. Hentz, David W. Dodick

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Introduction. Subcutaneous, occipital nerve stimulation has emerged as a potentially effective treatment modality for patients with refractory headache disorders. The purpose of this study was to document occipital stimulation characteristics in 10 patients status post implantation of an occipital nerve stimulator. Methods. All possible electrode combinations were tested in each patient, and sensory threshold, discomfort threshold, and associated paresthesia maps were noted. Results. Mean perception threshold was 1.07 V and mean discomfort threshold was 3.63 V. The associated paresthesia maps demonstrated that most patients felt stimulation as expected in the occipital regions; trigeminal distribution stimulation occurred but only in a minority of patients. Half of the patients experienced ≥ 50% reduction in headache frequency or severity. Conclusions. These results should aid in clinical decision-making and manufacturing requirements for this modality; larger, prospective studies will be needed to determine the safety and efficacy of stimulation techniques for headache disorders.

Original languageEnglish (US)
Pages (from-to)56-61
Number of pages6
Issue number1
StatePublished - Jan 2008


  • Headache disorder
  • Migraine headache
  • Occipital nerve stimulation
  • Paresthesia
  • Peripheral nerve stimulation

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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