Purpose: The aim of this study to examine the in changes inhibitory interneurons of the brainstem, which are likely to be involved in pathophysiology of cervical dystonia, using the cutaneous silent period(SP) method which is an inhibitor reflex. Materials and Methods: SP latency and interval values were obtained from bilateral sternocleidomastoid (SCM) muscles of individuals in 20 patients with cervical dystonia and 25 healthy volunteers using superficial electrodes. SP parameters obtained were compared within and between groups. Furthermore, intra-individual correlation analysis was performed for SP parameters from bilateral SCMs of the individuals in both groups. Results: The mean age of the patients participating in the study was 49.3 ± 14.7, and the control group was 48.0 ± 13.7. There was no statistically significant difference between the two groups in terms of age and gender. No significant difference was found in the comparison of SP parameters both within and between groups. There was a strong intra-individual correlation between SP latencies of bilateral SCMs of both patient and control groups. It was determined that the strongly positive intra-individual correlation between SP intervals also continued in the control group, whereas at patient group disappeared. Conclusion: The loss of correlation between bilateral SCM SP durations in the dystonia group indicates that the abnormality in interneuron connections, which is thought to be present in dystonia, may actually be a loss of order. This “disorganization” may explain the discrepancies in the results of cutaneous SP studies in dystonia patients.

Purpose: Peripheral nerve blocks have long been used in headache treatment and greater occipital nerve (GON) blocks are the most frequently preferred peripheral nerve blocks in patients with headaches in the past years. In this study, the efficacy of GON blocks in patients with primary headache disorders was evaluated. Materials and Methods: This retrospective cohort study was undertaken in April 2021 and April 2022. One hundred twenty-one patients with primary headache disorders were included. Changes in the duration and frequency of headache attacks, pain severity, and type of oral medication before and after the injection treatment during the first and third months of follow-up were evaluated. Results: The number of headache attacks decreased from 13 to 5 and the visual analogue scale(VAS) score decreased from 9 to 5 at the end of the third month in the migraine group. Similarly, the number of headache attacks decreased from 17 to 7 and the VAS score decreased from 8 to 4 in tension-type headache (TTH) group. Improvements in all parameters were found to be statistically significant in both groups. Conclusion: GON block is a low-cost, rapid and minimally invasive treatment, and our data support that this method can be an effective treatment option in patients with migraine and TTH who are resistant to oral medication by reducing the number, frequency and severity of headache attacks. In conclusion, GON blockade should be considered by clinicians as a primary treatment option in patients with migraine and TTH resistant to oral medication.