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Other Alternative Treatment

Rarely, doctors may recommend surgery for people with chronic cluster headaches who don't find relief with aggressive treatment or who can't tolerate the medications or their side effects.

Sphenopalatine ganglion stimulation involves surgery to implant a neurostimulator that's operated by a hand-held remote controller. Some research showed quick pain relief and a lower frequency of headaches, but more studies are needed.

Noninvasive vagus nerve stimulation (VNS) is another surgical option. It also uses a hand-held controller to deliver electrical stimulation to the vagus nerve through the skin. While more research is needed, some studies found that VNS helped reduce the frequency of cluster headaches.

Several small studies found that occipital nerve stimulation on one or both sides may be beneficial. This involves implanting an electrode next to one or both occipital nerves.

Some surgical procedures for cluster headache attempt to damage the nerve pathways thought to be responsible for pain, most commonly the trigeminal nerve that serves the area behind and around your eye.

However, the long-term benefits of destructive procedures are disputed. Also, because of the possible complications — including muscle weakness in your jaw or sensory loss in certain areas of your face and head — it's rarely considered.

Potential future treatments
Researchers are studying several potential treatments for cluster headache.

Occipital nerve stimulation. In this procedure, your surgeon implants electrodes in the back of your head and connects them to a small pacemaker-like device (generator). The electrodes send impulses to stimulate the area of the occipital nerve, which may block or relieve your pain signals.

Several small studies of occipital nerve stimulation found that the procedure reduced pain and frequency of headaches in some people with chronic cluster headaches.

Deep brain stimulation. Deep brain stimulation is a promising but as yet unproven treatment for cluster headaches that don't respond to other treatments.

In this procedure, doctors implant an electrode in the hypothalamus, the area of your brain associated with the timing of cluster periods. Your surgeon connects the electrode to a generator that changes your brain's electrical impulses and may help relieve your pain.

Because this involves placing an electrode deep in the brain, there are significant risks, such as an infection or hemorrhage.

Deep brain stimulation of the hypothalamus may provide relief for people with severe, chronic cluster headaches that haven't been successfully treated with medications.