Türk Nöroloji Dergisi (Mar 2022)

Comparison of the Effectiveness of Greater Occipital Nerve Block in Patients Receiving and not Receiving Medical Prophylactic Treatment in Chronic Migraine

  • Meltem Karacan Gölen,
  • Dilek Yılmaz Okuyan

DOI
https://doi.org/10.4274/tnd.2021.29660
Journal volume & issue
Vol. 28, no. 1
pp. 19 – 23

Abstract

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Objective: Chronic migraine (CM) refers to an increasing frequency of attacks and number of days with pain, and disease progression in patients with migraine. Recently, many studies have shown that peripheral nerve blockade is particularly effective in migraine, and greater occipital nerve (GON) blockade has been used in patients with treatment-resistant migraine. In our study, we aimed to investigate the effectiveness of the blockade performed in patients who were followed up with a diagnosis of migraine and underwent GON blockade due to persistent pain while receiving regular medical prophylaxis, and patients who only underwent GON blockade. Materials and Methods: Sixty patients with CM aged 18-65 years who underwent medical treatment and GON blockade and 74 patients with CM who only underwent GON blockade were included in the study. The patients' visual analogue scale (VAS) and migraine disability assessment scale (MIDAS) scores, attack frequency, duration of attack, and need for analgesic use were recorded before the procedure, and in the first and third months. Then, the data in the pre-treatment period were compared with the data in the first and third months. Results: In our both groups who received and did not receive prophylaxis and in whom recurrent GON blockades were applied, the duration of attacks, frequency of attacks and analgesic use significantly decreased, and a significant improvement was found in VAS and MIDAS scores in the 1st and 3rd months compared to the pre-treatment period (p<0.001). There was no statistically significant difference between the two groups in terms of pain duration, pain frequency, analgesic intake, and VAS and MIDAS scores. Conclusion: The GON blockade is effective in patients with CM who cannot receive medical treatment or who have received medical treatment for a long time but have not had benefit. This method, which is easy to apply, has few adverse effects and has a high contribution to reducing treatment costs, can be considered as a treatment option for suitable patients.

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