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Licensed Unlicensed Requires Authentication Published by De Gruyter January 6, 2021

Updated management of occipital nerve stimulator lead migration: case report of a technical challenge

  • Jose De Andres ORCID logo , Giuseppe Luca Formicola , Ruben Rubio-Haro and Carmen De Andres-Serrano


Electrode migration is a challenge, even with adequate anchoring techniques, due to the high mechanical stress on components of occipital nerve stimulation (ONS) for headache disorders. When a lead displacement of an ONS implant is diagnosed, there are currently different approaches described for its management. Nevertheless current neuromodulation devices are designed like a continuum of components without any intermediate connector, and if a lead displacement is diagnosed, the solution is the complete removal of the electrode from its placement, and its repositioning through an ex-novo procedure. The described technique can allow ONS leads to be revised while minimizing the need to reopen incisions over the IPG, thus improving patients’ intraoperative and postoperative discomfort, shortening surgical time and medical costs, reasonably reducing the incidence of infective postoperative complications.

Corresponding author: Prof. Dr. Jose De Andres, Anesthesia Unit, Surgical Specialties Department, School of Medicine, University of Valencia, Valencia, Spain; and Anesthesia, Critical Care and Multidisciplinary Pain Management Department, Valencia University General Hospital, Avda. Tres Cruces, s/n 46014, Valencia, Spain, Phone: (+34) 963 18 75 54, Fax: (+34) 961 97 21 82, E-mail:

  1. Research funding: None.

  2. Author contributions: All authors contributed in some part to the design, and drafting of the manuscript. Jose De Andres and Giuseppe Luca Formicola drafted and initiated the article, and prepared the manuscript draft with important intellectual contributions by Ruben Rubio-Haro and Carmen De Andres-Serrano. All authors contributed to the revision and approved the submitted version of the manuscript.

  3. Competing interests: None.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The local Institutional Review Board deemed the study exempt from review.


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Received: 2020-08-19
Accepted: 2020-12-01
Published Online: 2021-01-06
Published in Print: 2021-04-27

© 2020 Walter de Gruyter GmbH, Berlin/Boston

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