Peripheral Neurostimulation for Headache and Facial Pain

Peripheral neurostimulation (PNS) is a surgical procedure used to treat patients suffering from headaches or facial pain. The PNS procedure involves placing electrodes under the skin in the region of the pain, which are then connected to a pacemaker-like device implanted beneath the collarbone. The result is an improvement in headache or facial pain severity and frequency. PNS has been proven to be a highly effective treatment for these types of chronic pain in multiple studies throughout the United States and abroad.

The conditions that we treat using PNS include the following:

Migraine Headaches

Migraine is a neurological disorder marked by pulsating headaches on one side of the head, often accompanied by nausea, vomiting, and increased sensitivity to light. While the causes of migraine headaches are unclear, there’s growing evidence that they may be caused by abnormalities in blood vessels or an imbalance in brain chemistry. Patients who don’t experience sufficient relief from the range of available migraine medications may be candidates for PNS.

Cluster Headaches

Cluster headaches involve periodic episodes of intense headaches on one side of the head. Their cause is unknown, but a part of the brain called the hypothalamus may be involved. Management of cluster headaches includes medicines similarly used for migraine headaches. PNS is an option for patients with this syndrome who do not experience significant relief from these medications.

Occipital Neuralgia

Occipital neuralgia is a condition characterized by chronic pain in the upper neck, back of the head, and behind the eyes. It is caused by damage to the occipital nerves in the back of the head due to trauma or repetitive motions of the neck. Medical management includes nerve blocks, steroids, phenol injections, and antidepressants. Patients with occipital neuralgia who remain impaired despite proactive medical treatment may be candidates for PNS.

Supraorbital Neuralgia

Supraorbital neuralgia is a headache syndrome resulting from damage to the supraorbital nerve above the eye. Treatment involves nerve blocks and steroids. Patients with supraorbital neuralgia who do not respond sufficiently to treatment may be candidates for PNS.

Infraorbital Neuralgia

Infraorbital neuralgia is a facial pain syndrome caused by damage of the infraorbital nerve below the eye. Treatment involves nerve blocks and steroids. Patients with infraorbital neuralgia who remain significant disabled despite proactive medical treatment may be candidates for PNS.

Other Potential Uses

NYU Langone’s Center for Neuromodulation has the nation’s largest experience in the use of peripheral neurostimulation in patients with headache associated with Chiari malformation (a condition in which the brain protrudes into the spinal canal). We are currently involved in FDA-sponsored studies of this application for PNS.

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