%0 Journal Article
%T Occipital peripheral nerve stimulation in the management of chronic intractable occipital neuralgia in a patient with neurofibromatosis type 1: a case report
%A Ioannis Skaribas
%A Octavio Calvillo
%A Evangelia Delikanaki-Skaribas
%J Journal of Medical Case Reports
%D 2011
%I BioMed Central
%R 10.1186/1752-1947-5-174
%X A 42-year-old Caucasian woman presented with bilateral occipital neuralgia refractory to various conventional treatments, and she was referred for possible treatment with occipital peripheral nerve stimulation. She was found to be a suitable candidate for the procedure, and she underwent implantation of two octapolar stimulating leads and a rechargeable, programmable, implantable generator. The intensity, severity, and frequency of her symptoms resolved by more than 80%, but an infection developed at the implantation site two months after the procedure that required explantation and reimplantation of new stimulating leads three months later. To date she continues to experience symptom resolution of more than 60%.These results demonstrate the significance of peripheral nerve stimulation in the management of refractory occipital neuralgias in patients with neurofibromatosis type 1 and the possible role of neurofibromata in the development of occipital neuralgia in these patients.Chronic daily headache (CDH) syndromes represent a major health issue worldwide in terms of lost workdays and revenue [1-3]. Diagnoses include migraine, atypical migraine, cluster headaches, transformed migraines, cervicogenic headaches, occipital and facial hemicranias, or any combination of these diagnoses. Many of the patients who experience these syndromes become totally disabled after conservative and pharmacological treatments fail to relieve their symptoms [4,5].Occipital neuralgia is described by the National Institute of Neurological Diseases and Stroke as a "distinct type of headache characterized by piercing, throbbing, or electric-shock-like chronic pain in the upper neck, back of the head, and behind the ears, usually on one side" [6]. Typically, the pain of occipital neuralgia begins at the base of the head and spreads upward within the distribution of the greater and lesser occipital nerves. Characteristically, it is neuropathic, with paroxysmal episodes of shooting electric sho
%U http://www.jmedicalcasereports.com/content/5/1/174