Response rates reported in neurostimulation studies do not seem superior to those of the most effective prophylactic medications. Selection criteria for neurostimulation in headache patients are not uniform, and with few exceptions follow-up is too short to provide firm conclusions on long-term efficacy and safety, as well as costs. Notwithstanding these limitations, occipital nerve stimulation does seem to produce satisfactory improvement in chronic drug-resistant cluster headache and when it does not produce benefit, hypothalamic stimulation can be considered. Occipital nerve stimulation has been extensively investigated as a treatment of chronic migraine, but there is still some skepticism about its efficacy.
Future Neurology. 2013;8(4):457-467. © 2013 Future Medicine Ltd.