Evidence-based recommendations on occipital nerve stimulation for intractable chronic migraine. This involves using implanted electrodes to deliver electrical impulses to the occipital nerve to mask migraine pain.

January 2020: The devices in the evidence base considered by the committee no longer have current CE marks for this indication. The CE mark is necessary for medical devices to be marketed in the European Union. A non-CE marked device can only be used in the context of clinical investigations with MHRA and research ethical approval.

Guidance development process

How we develop NICE interventional procedures guidance

Coding recommendations

Stage 1

A70.4 Insertion of neurostimulator electrodes into peripheral nerve

Y70.5 Temporary operations

Y70.3 First stage of staged operations NOC

Y53.4   Approach to organ under fluoroscopic control (if fluoroscopic control has been used)

Z92. 1 Head  NEC

Stage 2

A70.1 Implantation of neurostimulator into peripheral nerve

Y71.1 Subsequent stage of staged operations NOC

Y53.4   Approach to organ under fluoroscopic control (if fluoroscopic control has been used)

Z92.1 HeadNEC

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. 

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)