Clinical Trial of Wireless CranioFacial Nerve Stimulation (CFNS) for the Treatment of CranioFacial Neuropathic Pain

Subjects will be randomized at enrollment into either a delayed or immediate continuation
group. The immediate continuation group will immediately continue with the stimulation after
a 30-day trial period and will be monitored for a total of 12 months. The delayed activation
group will have their device turned off after the 30-day trial period for the next 3-months.
At the 3-month visit, both groups be evaluated and the delayed activation group will have
their devices reactivated.

Subjects will have neuropathic pain of various etiologies, including trauma, surgery or
post-herpetic infections. Stimulators will be placed at the site target of the painful area,
including the epifascial plane under the skin but above the muscles in the vicinity of the
targeted branches of; A. Branches of Trigeminal Nerves in the Ophthalmic, Maxillary, or
Mandibular B. Sensory branches of Facial Nerves C. Branches of the Occipital Nerves (Greater
and/or Lesser) D. Branches of the Cervical Plexus (Superficial and/or Deep)

Inclusion Criteria:

- Subject is ≥ 18 years of age at time of informed consent

- Subjects have been diagnosed with Cranial-facial pain with an average VAS > 5 (on a
0-10 scale) over the course of the last month based on baseline pain diary.

- Subject diagnosis with neuropathic cranial-facial pain refractory to conventional
medical management for at least 12 months prior to enrollment;

- Based on the medical opinion of the Principal Investigator, subject has a stable pain
medication regimen for 3 months prior to study entry.

- Based on the medical opinion of the Principal Investigator, subject has a stable
Tricyclic regimen for 3 months prior to study entry

- No medication overuse and not attributed to another causative disorder

- Based on the medical opinion of the Principal Investigator, there is no evidence of
anatomic abnormalities that could jeopardize the placement of the device or pose a
hazard to the subject;

- Based on the opinion of the Principal Investigator, subject is willing and able to
operate the patient programmer, recharging equipment, diary and has the ability to
undergo study assessments and provide accurate responses;

- Based on the opinion of the implanter, subject is a good surgical subject for the
implant procedure;

- Subject is willing to undergo surgical implant procedure, attend visits as scheduled,
and comply with the study requirements;

- Subject is male or non-pregnant female as determined with a negative pregnancy test at
baseline visit, and if sexually active, must be using a medically acceptable method of
contraception for the duration of their study participation;

- Subject is deemed to be neuro-psycho-socially appropriate for implantation therapies
based of the assessment of a Clinical Psychologist, using face-to-face encounters and
the psychological testing described in the measures;

- Patient is capable of giving informed consent

Exclusion Criteria:

- A. Subject has undergone botulinum toxin (BOTOX) injections of the head and/or neck in
the last 3 months.

- Unresolved Malignancies in last six months;

- Subject has a history of migraine, headaches of central origin or trigeminal autonomic
cephalalgias;

- Subject has postherpetic neuralgia (shingles);

- Complete deafferentation of all branches of the trigeminal, facial, occipital nerves
and cervical plexus;

- Subject has an active systemic infection or is immune-compromised;

- Based on the medical opinion of the Principal Investigator, Psychologist and/or
Psychiatrist, the subject has other psychological conditions (e.g., psychosis,
suicidal ideation, borderline personality disorder, somatization, narcissism), other
health conditions (e.g., substance abuse, another chronic condition requiring the
regular use of opioid medication), or other legal concerns that would preclude his/her
enrollment in the study or potentially confound the results of the study;

- Subject is currently enrolled in or plans to enroll in any concurrent drug and/or
device study while participating in this study;

- Insulin-dependent diabetic who is not controlled through diet and/or medication
(determined by the physician) or non-insulin dependent diabetic who is not well
controlled through diet and/or medication;

- Bleeding complications or coagulopathy issues;

- Pregnant/lactating or not using adequate birth control;

- A life expectancy of less than one year;

- Any active implanted device whether turned off or on;

- A previous peripheral nerve stimulator (PNS) experience for the treatment of facial
pain including a failed trial or explanted device;

- Conditions requiring Magnetic Resonance Imaging (MRI) evaluation or diathermy
procedures;

- Subject is currently involved in litigation regarding injury, or is receiving worker's
compensation benefits.