Refractory migraines may respond to occipital nerve stimulation, according to Dr. Joel Saper who led a multicenter trial of this treatment.  An electrode was surgically implanted in the back of the head, where the occipital nerve is located, and a pacemaker-size device was implanted under the skin.  The trial looked at 110 patients who had more than 15 days with migraines each month and who did not respond to a variety of medications.  66 patients completed the diary information for three months following the start of treatment.  The results were encouraging – 39% of patients improved, compared with 6% in the control group.  None of the patients had any adverse events.