• Pyung B Lee, Christian Horazeck, Francis S Nahm, and Billy K Huh.
• Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
• Pain Physician. 2015 Sep 1; 18 (5): 505-16.

BackgroundDespite the various modalities available for treating headaches, typical therapy does not provide adequate pain relief for some patients.ObjectivesThis study explored the efficacy and safety of long-term peripheral nerve stimulation (PNS) for intractable chronic headaches.Study DesignRetrospective study of refractory headache patients at academic pain center.MethodsThe medical records of all patients (N = 46) permanently implanted with PNS between January 2005 and January 2012 were reviewed retrospectively. Patient records and phone interviews were used to quantify the levels of pain intensity, headache days per month, and overall patient satisfaction with treatment. The correlation between headache duration and effectiveness of PNS was also assessed.ResultsPain intensity on the 11-point Numeric Rating Scale decreased from 7.60 ± 1.73 before implantation to 3.78 ± 2.41, 3.32 ± 2.67, 3.42 ± 2.74, and 2.04 ± 2.27 at one, 6, 12, and > 12 (19-98) months after implantation, respectively (P < .001). The mean number of headache days per month decreased by about 14 days from the base line. No correlation (r = -.33) was found between the number of years the patients had suffered from headaches and the efficacy of treatment.LimitationsDue to the limitation of a retrospective study, the data collected via chart reviews and phone interviews are susceptible to selection and information biases.ConclusionsPNS is an effective modality in the long-term management of intractable chronic headaches. Despite long histories of chronic headaches, the majority of patients had significant reductions in pain scores and the number of headache days per month. The outcomes were not dependent on the number of years the patients had suffered from headaches before PNS treatment.

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