Post programming neuromodulation (ons)

Programming the ONS neuromodulation device for chronic migraine

At the Migraine and Headache Center of the Kiel Pain Clinic, we have established a specialized consultation service for the care of patients with severe, therapy-resistant forms of migraine and other chronic pain conditions, for whom occipital nerve stimulation (ONS) or other neuromodulation procedures have become necessary for treatment. Depending on individual needs, reprogramming of an implanted neurostimulator for peripheral nerve stimulation can be performed on an outpatient or inpatient basis. Experts at the Kiel Pain Clinic have special certification for the operation and reprogramming of neurostimulation systems. The goal is to ensure optimal individual effectiveness of the neurostimulation system. Patients receive a series of different parameter combinations individually programmed by a physician. The position of the electrodes, as well as the patient's individual anatomical characteristics, are taken into account. The individual sensory aspects of the stimulation must be determined and individually adjusted and recorded for optimal stimulation effect. Experience has shown that, in some cases, reprogramming is necessary during the postoperative period following the implantation of a new neurostimulation system to adapt the parameters to the course of treatment. To arrange for reprogramming, an appointment can be made directly by calling the specialist consultation hour for neuromodulation on 0431-20099400.

Neuromodulation

For patients suffering from severe chronic migraines and other serious chronic pain, there are few effective treatment options. Standard therapies are generally not effective in the long term. Recently, peripheral nerve stimulation (PNS) has come into focus as a treatment possibility. Peripheral nerve stimulation is a specific application of neuromodulation. It can be successfully used for headaches, back pain, neck pain, and arm and leg pain. Thanks to advances in microelectronics, it is now possible to implant a pacemaker-like device under the skin, enabling continuous neuromodulation. The device is about the size of a matchbox. The neurostimulator is implanted in cooperation with the neurosurgery departments of the University Hospital Schleswig-Holstein. The indication, pre- and post-operative care, programming, and monitoring of progress and success are carried out by experts from the Kiel Pain Clinic.

A special rechargeable system can be implanted to treat chronic migraines, eliminating the need for battery changes. The stimulator sends electrical signals to the occipital nerve (ON), located directly under the skin at the back of the neck. Due to this specific location, this treatment option is also called occipital nerve stimulation (ONS). The mechanism of action of occipital nerve stimulation is explained by changes in electrical regulation in the brainstem. The pattern of pain signals is modulated and masked by the continuous stimulation. The constant hypersensitivity in the nervous system is balanced and reduced. The function of the neurostimulator system and the peripheral nerve stimulation are comparable to those of a cardiac pacemaker. It is believed that neuromodulation activates and stabilizes the body's own pain defense mechanisms, thus naturally reducing sensitivity to pain signals. The individual steps of the system implantation and further details can be found here .