Contraindications of occipital nerve stimulation are as follows: • The procedure is not recommended if there is no improvement in pain during trial stimulation • Local infections • Bleeding abnormalities • Pregnancy • Arnold-chiari malformation • A pre-existing implanted electrical device such as pacemaker that may interfere with this therapy • If the headache is due to misuse of opioids, then the patient is disqualified from the stimulation even if it is improving pain with the trail stimulation