Evaluation of Occipital Nerve Stimulation in Intractable Occipital Neuralgias

Inclusion Criteria

• •Patients between 18 and 85 years old
• •Chronic occipital neuralgias as defined by International Headache Society (IHS) more than 6 months with permanent pain associated or not with paroxysm
• •Secondary occipital neuralgias (post-traumatic, post-surgery, major arthrosis, compression or lesion of the occipital nerve …)
• •Chronic neuropathic pain according to the Neuropathic Pain Diagnostic Questionnaire (DN4 ≥ 4)
• •Maximum pain on VAS ≥ 50/100
• •Failure of medical treatment (association of neuropathic medication like antiepileptic and/or antidepressant and/or antalgic treatment like paracetamol, tramadol or morphine) and pain management in a pain Unit including multidisciplinary approach, physiotherapy, block test in C1-C2, radiofrequency rhizolysis, and/or corticosteroid infiltration of C2 according to the criteria defined by Health Authorities for spinal cord stimulation.
• •Reduction of pain with Transcutaneous Electrical Nerve Stimulation (TENS) in occipital area
• •Neurological examen has to be completed and must be normal except for the occipital neuralgia territory
• •A negative pregnancy test for women with childbearing potential
• •Women of childbearing potential must use appropriate method(s) of contraception during the clinical trial
• •Patients must be capable of giving informed consent and must have signed informed consent
• •Affiliation to an appropriate health insurance