Greater occipital nerve blockade in migraine, tension-type headache and cervicogenic headache

Terzi, Tansel; Karakurum, Başak; Üçler, Serap; İnan, Levent Ertuğrul; Tulunay, Cankat

doi:10.1007/s101940200031

Cited by 36 publications

(30 citation statements)

References 14 publications

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“…The migraine attacks improved after this time and this improvement was maintained for more than 60 days. Studies that used prilocaine hydrochloride 2% over the GON [55] and bupivacaine 0.5% over the GON and supraorbital nerve [56] showed reduced intensity during attacks. In an isolated study with a limited number of patients, GON blockage did not reduce the intensity of acute migraine attacks [52].…”

Section: Clinical Studiesmentioning

confidence: 98%

Convergence of cervical and trigeminal sensory afferents

Piovesan¹,

Kowacs²,

Oshinsky³

2003

Current Science Inc

140

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Cranial nociceptive perception shows a distinct topographic distribution, with the trigeminal nerve receiving sensory information from the anterior portions of the head, the greater occipital nerve, and branches of the upper cervical roots in the posterior regions. However, this distribution is not respected during headache attacks, even if the etiology of the headache is specific for only one nerve. Nociceptive information from the trigeminal and cervical territories activates the neurons in the trigeminal nucleus caudalis that extend to the C2 spinal segment and lateral cervical nucleus in the dorsolateral cervical area. These neurons are classified as multimodal because they receive sensory information from more than one afferent type. Clinically, trigeminal activation produces symptoms in the trigeminal and cervical territory and cervical activation produces symptoms in the cervical and trigeminal territory. The overlap between the trigeminal nerve and cervical is known as a convergence mechanism. For some time, convergence mechanisms were thought to be secondary to clinical observations. However, animal studies and clinical evidence have expanded our knowledge of convergence mechanisms. In this paper, the role of convergence mechanisms in nociceptive physiology, physiopathology of the headaches, clinical diagnosis, and therapeutic conduct are reviewed.

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Section: Clinical Studiesmentioning

confidence: 98%

Convergence of cervical and trigeminal sensory afferents

Piovesan¹,

Kowacs²,

Oshinsky³

2003

Current Science Inc

140

View full text Add to dashboard Cite

show abstract

“…Local anesthetic alone injected into the GON was used as early as 1940 for headache relief (2). A study of Bovim and another study of Terzi examined the efficacy of lidocaine alone for immediate pain relief and reported that it was significantly more effective for cervicogenic headache than for migraine and tension-type headache (3,4). Caputi reported that there was variable level of response to bupivacaine injected into both the GON and supraorbital nerves on alternate days (5-10 injections in total) in 11 migraine patients (5).…”

Section: Introductionmentioning

confidence: 97%

Greater occipital nerve blockade for the treatment of chronic migraine: a randomized, multicenter, double-blind, and placebo-controlled study

İnan

Karadaş³

et al. 2015

Acta Neurol Scand

132

134

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“…We found four of the 12 trials had a low risk of bias [28-30,35,36,41] and 8 trials had high risk of bias [31-34,37-40]. See Fig.…”

Section: Resultsmentioning

confidence: 83%

“…We found low quality evidence (1 trial [36]; 20 participants) that there was a statistically significant improvement immediately post treatment for pain (SMD -3.60 (95% CI -5.12 to -2.07)) in a patient population with cervicogenic headache between those receiving greater occipital nerve blockade with prilocaine vs those receiving greater occipital nerve blockade with normal saline injection.…”

Section: Resultsmentioning

confidence: 99%

Physician-Delivered Injection Therapies for Mechanical Neck Disorders: A Systematic Review Update (Non-Oral, Non-Intravenous Pharmacological Interventions for Neck Pain)

Gross

Peloso²,

Galway³

et al. 2013

TOORTHJ

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Background: Controversy persists regarding medicinal injections for mechanical neck disorders (MNDs).Objectives: To determine the effectiveness of physician-delivered injections on pain, function/disability, quality of life, global perceived effect and patient satisfaction for adults with MNDs.Search Methods: We updated our previous searches of CENTRAL, MEDLINE and EMBASE from December 2006 through to March 2012.Selection Criteria: We included randomized controlled trials of adults with neck disorders treated by physician-delivered injection therapies.Data Collection and Analysis: Two authors independently selected articles, abstracted data and assessed methodological quality. When clinical heterogeneity was absent, we combined studies using random-effects models.Results: We included 12 trials (667 participants). No high or moderate quality studies were found with evidence of benefit over control. Moderate quality evidence suggests little or no difference in pain or function/disability between nerve block injection of steroid and bupivacaine vs bupivacaine alone at short, intermediate and long-term for chronic neck pain. We found limited very low quality evidence of an effect on pain with intramuscular lidocaine vs control for chronic myofascial neck pain. Two low quality studies showed an effect on pain with anaesthetic nerve block vs saline immediately post treatment and in the short-term. All other studies were of low or very low quality with no evidence of benefit over controls.Authors' Conclusions: Current evidence does not confirm the effectiveness of IM-lidocaine injection for chronic mechanical neck pain nor anaesthetic nerve block for cervicogenic headache. There is moderate evidence of no benefit for steroid blocks vs controls for mechanical neck pain.

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Greater occipital nerve blockade in migraine, tension-type headache and cervicogenic headache

Cited by 36 publications

References 14 publications

Convergence of cervical and trigeminal sensory afferents

Convergence of cervical and trigeminal sensory afferents

Greater occipital nerve blockade for the treatment of chronic migraine: a randomized, multicenter, double-blind, and placebo-controlled study

Physician-Delivered Injection Therapies for Mechanical Neck Disorders: A Systematic Review Update (Non-Oral, Non-Intravenous Pharmacological Interventions for Neck Pain)

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