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Peripheral nerve field stimulation to the preauricular area for intractable chronic migraine: a case report

Authors Li YF, Mao P, Zhu Q, Liu BT, Fan BF

Received 28 November 2018

Accepted for publication 15 March 2019

Published 24 May 2019 Volume 2019:12 Pages 1665—1671

DOI https://doi.org/10.2147/JPR.S196214

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Michael A Überall


Yi-Fan Li,1,2 Peng Mao,2 Qian Zhu,2 Bo-Tao Liu,2 Bi-Fa Fan2

1Department of Graduate School, Beijing University of Chinese Medicine, Beijing 100029, People’s Republic of China; 2Department of Pain, China-Japan Friendship Hospital, Beijing 100029, People’s Republic of China

Objective: To report a successful attempt of peripheral nerve field stimulation (PNFS) in preauricular area to treat refractory chronic migraine (CM). This article focuses on novel utilization of PNFS and discusses its existing issues.
Case report: A 35-year-old woman diagnosed with CM complained about a 2-year history of severe pain at the occipitocervical and left auriculotemporal area, sometimes bilaterally, which did not benefit from conventional medical therapy. After failed attempts of occipital nerve stimulation and PNFS at the retroauricular area, we used exploratory PNFS at the preauricular area, which to our knowledge is the first reported case in literature, to such an area in refractory CM. The patient experienced satisfactory pain relief and obvious improvement in quality of life. And the amelioration on the severity of pain was validated by reduced scores (from 9 to 2) on the numerical rating scale. The clinical effects continued in the next 2-year follow-up after the implantation, without adverse events.
Conclusion: PNFS is a promising and safe neuromodulation therapy for refractory CM. Facial areas like preauricular region are applicable for lead implantation. Nevertheless, the underlying mechanisms are still unverified, and there is still a lack of standardized operation guides of PNFS. Large-scale randomized clinical trials should be conducted to further validate these findings.

Keywords: chronic migraine, neuromodulation, peripheral nerve field stimulation, occipital nerve stimulation, preauricular pain, case report

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