• Antonios Mammis, Mark Gudesblatt, and Alon Y Mogilner.
• Department of Neurosurgery, Cushing Neuroscience Institutes, Hofstra University School of Medicine and North Shore University Hospital, Manhasset, New York, USA.
• Neuromodulation. 2011 Sep 1;14(5):432-5; discussion 435.

Introduction  Cluster headache is a headache syndrome characterized by periodic episodes of intense headache with spontaneous remission. There are recent reports utilizing occipital nerve stimulation for the successful management of medically refractory cases of cluster headache.Methods  The case of an 18-year-old boy with chronic, refractory, recurrent cluster headaches is presented. He was treated surgically with combined occipital, supraorbital, and infraorbital nerve stimulation.Results  Prior to operation, the patient suffered three to four episodes of cluster headache per day, for four years. After implantation of occipital, supraorbital, and infraorbital nerve stimulators, the patient averages at most three to four headaches per month, at 36-month follow-up.Conclusion  Peripheral neurostimulation is safe and efficacious in the management of chronic, medically refractory cluster headache syndrome. The efficacy of treatment was found to be persistent after three years.© 2011 International Neuromodulation Society.

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