Interventional Procedures in Episodic Migraine

Plato, Brian M.; Whitt, Mandy

doi:10.1007/s11916-020-00909-0

Cited by 5 publications

(5 citation statements)

References 28 publications

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“…PTNB, TPI, and GONB are often used because they are safe, well-tolerated, and effective in treating migraines, allodynia, and photophobia. [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ] In general, 48 to 100% of adult migraineurs receive full or partial relief from migraine prevention that lasts a few days to several months. [ 6 ] The combination of GONB and TPI has been found to reduce allodynia in previous studies, with 85% improvement between 5 and 20 min and 1 week after therapy.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the lack of evidence regarding its efficacy, steroids have been linked to several specific adverse effects, including alopecia, hypopigmentation, and cutaneous atrophy, especially when repeated blocks are administered. [ 6 , 7 , 8 ] Therefore, steroids were not administered.…”

Section: Discussionmentioning

confidence: 99%

“…[ 5 ] Trigger point injections (TPIs), supraorbital and supratrochlear nerve blocks (SONB, STNB), and greater occipital nerve block (GONB), which are all effective migraine treatments, can be used when medical therapy fails. [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ] Myofascial discomfort can cause or contribute to headache syndromes by generating trigger points, which are areas of concentrated allodynia. The trapezius muscle, the most typical headache trigger point location, can induce pain in the temporal, jaw, occiput, and upper neck regions.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound-Guided Combined Greater Occipital Nerve Block at the C2 Level with Trapezius Trigger Point Injection and Supraorbital-Supratrochlear Nerve Block: More Effective on Allodynia and Disability in Chronic Migraine

Turan,

Aydın,

Gözükara

et al. 2023

Annals of Indian Academy of Neurology

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Background: Chronic migraine (CM) patients with cutaneous allodynia (CA) show a poor response to treatment. Long-term studies have yet to be conducted to demonstrate the efficacy of blocks on CA. This study evaluated the improvement in allodynia and disability in CM treated with ultrasound (US)-guided blocks. Methods: In this prospective, non-randomized comparative study, 60 CM patients with CA were evaluated for the clinical effectiveness of the therapy using the numeric rating scale (NRS), headache impact test-6 (HIT-6), brush allodynia test, and allodynia symptom checklist (ASC-12). At the first visit, tenderness in the nerve or trapezius muscle was confirmed in the intervention group. US-guided greater occipital nerve block (GONB), GONB, and trapezius muscle injection (TPI), or GONB, TPI, and peripheral trigeminal nerve block (PTNB), respectively, were performed four times once a week for a month. Initial and third-month assessments were performed. Results: The ASC-12 scores decreased in the GONB+TPI+PTNB and GONB groups more than the GONB+TPI group (mean rank, respectively, 26.86, 27.40, 38.39; P = 0.018). The decrease in HIT-6 scores was greater in the GONB+TPI+PTNB group than in the GONB group (mean rank, respectively, 21.98, 39.95, P < 0.017) in the first month. In the third month, the GONB+TPI+PTNB group scored HIT-6 significantly lower than GONB and GONB+TPI (mean rank: 18.84, 38.73, 35.61; P < 0.001). Conclusions: GONB+TPI+PTNB was more successful in alleviating allodynia and disability.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ultrasound-Guided Combined Greater Occipital Nerve Block at the C2 Level with Trapezius Trigger Point Injection and Supraorbital-Supratrochlear Nerve Block: More Effective on Allodynia and Disability in Chronic Migraine

Turan,

Aydın,

Gözükara

et al. 2023

Annals of Indian Academy of Neurology

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“…Episodic migraine was diagnosed in cases where the diagnosis of chronic migraine was excluded according to the International Classification of Headache Disorders, third edition (ICHD-3) criteria published in 2018. Patients experiencing headache days fewer than 15 times a month were classified as having episodic migraine [ 7 ]. All of the participants were informed about the study and provided written informed consent for their participation.…”

Section: Methodsmentioning

confidence: 99%

“…Prophylactic treatments for migraine mainly include antidepressants, antiepileptics, beta-blockers, and calcium channel blockers [ 4 , 5 , 6 ]. However daily medication use may be hindered in cases with cardiovascular/cerebrovascular comorbid diseases, or by drug–drug interactions and renal/hepatic impairment [ 7 ]. Due to these conditions, only 23.8% of patients with episodic migraine undergo prophylactic medical treatment [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Greater Occipital Nerve Blockade and Sphenopalatine Ganglion Blockade in Patients with Episodic Migraine

Unal,

Basarı,

Celiker

et al. 2024

JCM

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Objectives: Compare the effects of greater occipital nerve (GON) and sphenopalatine ganglion (SPG) blocks on headache intensity and duration, number of headache days, and disability in patients with episodic migraine. Methods: In this prospective single-blind randomized study, patients with episodic migraine were randomly divided into two groups: GON and SPG block groups. Patients received blocks once a week for 4 weeks, and once a month for 2 months. The number of headache days, the headache duration, numeric rating scale (NRS) scores, and number of acute medical treatments were assessed before the procedures and 1 month, 2 months, and 3 months after the procedures. Disability was evaluated using the migraine disability assessment (MIDAS) questionnaire at baseline and 3 months after treatment. This study protocol is registered at ClinicalTrials.gov (NCT06243874.). Results: 19 patients in the GON block group and 18 patients in the SPG block group were evaluated. Significant improvements in pain severity, headache duration, number of headache days, and the need for acute medical treatment were observed in the 1st, 2nd, and 3rd months compared to baseline in the two groups (p < 0.001). There were significant improvements in the MIDAS scores in the third month (p < 0.001). The GON block group showed a greater reduction in headache intensity, duration, number of headache days, and MIDAS scores compared to the SPG block group in the 3rd month (p < 0.001). Conclusions: GON block reduces headache duration, intensity, the number of headache days, and the need for acute medical treatment much more than SPG block in patients with episodic migraine.

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