Peripheral nerve stimulation for refractory headache after whiplash injury: a case report.
Faria Nisar, Jessica Suratkal, Nicolas Mas D' Alessandro et al.
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Case in brief
A 64-year-old patient developed severe, persistent headache after a whiplash injury and had not obtained lasting relief from conservative treatment. Ultrasound- and fluoroscopy-guided percutaneous peripheral nerve stimulation targeting the greater occipital nerve was delivered for 8 weeks, after which the device was removed. Pain decreased from 10/10 to 1/10, with improvements in sleep, physical function, and quality of life at 3 months and 80–90% satisfaction. At 1 year, neuropathic pain scores had worsened beyond baseline and physical function had partially rebounded, leaving long-term benefit uncertain.
What made this case unusual
The case illustrates a marked short-term response to temporary greater occipital nerve stimulation, followed by worsening neuropathic pain scores beyond baseline at 1 year despite the initial improvement.
Diagnostic / clinical pearl
For refractory post-whiplash headache, temporary peripheral nerve stimulation targeting the greater occipital nerve may provide short-term relief, but improvement should not be assumed to persist after device removal.