F723 Pulsed Radiofrequency Therapy Versus Greater Occipital Nerve Block in the Management of Refractory Cervicogenic Headache – A Pilot Study

Gabrhelík, Tomáš; Michálek, Pavel; Pieran, M.

doi:10.1016/s1754-3207(11)70669-1

Cited by 26 publications

(46 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For ON, several uncontrolled studies have reported benefit, 12,31,51,55,56 with one study suggesting that pulsed RF might provide longer term benefit than steroid injections. 22 In a single-blind randomized study conducted in 30 patients with cervicogenic headache, Gabrhelik et al 22 found that steroid injections and PRF of the greater occipital nerve provided comparable relief at 3 months, but that the analgesic effect of PRF was greater at 9 months. The objective of this study was to evaluate the effectiveness of PRF and steroid injections for ON in a double-blind, comparative-effectiveness study.…”

Section: Introductionmentioning

confidence: 99%

Randomized, double-blind, comparative-effectiveness study comparing pulsed radiofrequency to steroid injections for occipital neuralgia or migraine with occipital nerve tenderness

Cohen

Peterlin

Fulton

et al. 2015

Pain

View full text Add to dashboard Cite

Occipital neuralgia (ON) is characterized by lancinating pain and tenderness overlying the occipital nerves. Both steroid injections and pulsed radiofrequency (PRF) are used to treat ON, but few clinical trials have evaluated efficacy, and no study has compared treatments. We performed a multicenter, randomized, double-blind, comparative-effectiveness study in 81 participants with ON or migraine with occipital nerve tenderness whose aim was to determine which treatment is superior. Forty-two participants were randomized to receive local anesthetic and saline, and three 120 second cycles of PRF per targeted nerve, and 39 were randomized to receive local anesthetic mixed with deposteroid and 3 rounds of sham PRF. Patients, treating physicians, and evaluators were blinded to interventions. The PRF group experienced a greater reduction in the primary outcome measure, average occipital pain at 6 weeks (mean change from baseline −2.743 ± 2.487 vs −1.377 ± 1.970; P <0.001), than the steroid group, which persisted through the 6-month follow-up. Comparable benefits favoring PRF were obtained for worst occipital pain through 3 months (mean change from baseline−1.925 ± 3.204 vs−0.541 ± 2.644; P = 0.043), and average overall headache pain through 6 weeks (mean change from baseline −2.738 ± 2.753 vs −1.120 ± 2.1; P = 0.037). Adverse events were similar between groups, and few significant differences were noted for nonpain outcomes. We conclude that although PRF can provide greater pain relief for ON and migraine with occipital nerve tenderness than steroid injections, the superior analgesia may not be accompanied by comparable improvement on other outcome measures.

show abstract

Section: Introductionmentioning

confidence: 99%

Randomized, double-blind, comparative-effectiveness study comparing pulsed radiofrequency to steroid injections for occipital neuralgia or migraine with occipital nerve tenderness

Cohen

Peterlin

Fulton

et al. 2015

Pain

View full text Add to dashboard Cite

show abstract

“…These symptoms could be used by the novice and experienced clinician to establish a diagnosis and differentiate ON from MWA. This assumption and observations are echoed by other investigations 2,6,18,22 indicating that ON is a true neuropathic pain described in the sub-occipital, frontal, temporal, and orbital areas of the head. MWA and ON are headache pains described as very intense, with the presence of many autonomic symptoms.…”

Section: Symptoms That Differentiate On From Mwamentioning

confidence: 68%

Differentiating occipital neuralgia from migraine and tension-type headache

Molina¹,

Santos²,

Martins³

et al. 2014

RNC

View full text Add to dashboard Cite

Objective. To establish differential diagnosis in patients presenting occipital neuralgia, tension-type headache, and migraine with aura. Method. We analyzed 32 patients with Occipital neuralgia (mean age=38.0; females=75%), 102 with tension-type headache (mean age=33.0; females=92.2%), and 16 with migraine without aura (mean age=37.0; females=56.3%). The specific symptoms of headaches were used in according to International Classification of Headache Disorders (ICHD) in patients with for craniomandibular disorders and bruxing behavior. Results. Occipital neuralgia group presented more nausea (78.1%; p=0.0001), vomiting (62.5%; p=0.0001), photophobia (71.8%; p=0.0001), throbbing (53.1%; p=0.0001), stabbing pain (78.1%; p=0.0001), severe pain (93.7%; p=0.0001), burning (68.8%; p=0.0001), and occipital nerve tenderness (100%; p=0.0001) than tension-type headache group. Occipital neuralgia group showed more stabbing (78.1%; p=0.0001), burning (68.8%; p=0.0005), and occipital nerve tenderness (100%; p=0.0001) than migraine without aura group. Migraine without aura group showed more vomiting (94%; p=0.03) and photophobia (100%; p=0.02) than occipital neuralgia group. Conclusions. Nausea, vomiting, photophobia, throbbing, stabbing, severer pain, a burning description and occipital nerve tenderness, better differentiated occipital neuralgia from tension-type headache. Stabbing pain, burning and occipital nerve tenderness, better differentiated occipital neuralgia from migraine without aura.

show abstract

“…At the 3 and 9-month follow-up examinations, a significant reduction in pain scores was determined in both groups [7].…”

Section: Discussionmentioning

confidence: 94%

“…On the cervical lateral radiograph, there was severe narrowing and osteodegenerative findings in the intervertebral foramen, especially at the levels of C 5-6 and C [6][7] .…”

Section: Casementioning

confidence: 99%

Occipital Nerve Blockage in Cervicogenic Headache: A case Report and Brief Review of Literature

Koca¹

2015

Med-Science

View full text Add to dashboard Cite

show abstract

F723 Pulsed Radiofrequency Therapy Versus Greater Occipital Nerve Block in the Management of Refractory Cervicogenic Headache – A Pilot Study

Cited by 26 publications

References 0 publications

Randomized, double-blind, comparative-effectiveness study comparing pulsed radiofrequency to steroid injections for occipital neuralgia or migraine with occipital nerve tenderness

Randomized, double-blind, comparative-effectiveness study comparing pulsed radiofrequency to steroid injections for occipital neuralgia or migraine with occipital nerve tenderness

Differentiating occipital neuralgia from migraine and tension-type headache

Occipital Nerve Blockage in Cervicogenic Headache: A case Report and Brief Review of Literature

Contact Info

Product

Resources

About