Nerve Blocks in the Treatment of Headache

Abstract

Summary: Nerve blocks and neurostimulation are reasonable therapeutic options in patients with head and neck neuralgias. In addition, these peripheral nerve procedures can also be effective in primary headache disorders, such as migraine and cluster headaches. Nerve blocks for headaches are generally accomplished by using small subcutaneous injections of amide-type local anesthetics, such as lidocaine and bupivicaine. Targets include the greater occipital nerve, lesser occipital nerve, auriculotemporal nerve, supratrochlear and supraorbital nerves, sphenopalatine ganglion, cervical spinal roots, and facet joints of the upper cervical spine. Although definitive studies examining the usefulness of nerve blocks are lacking, reports suggest that this area deserves further attention in the hope of acquiring evidence of effectiveness.

Postoperative Intractable Headache Resolving after Occipital Nerve Block

“…Not all observations can be accounted for by this mechanism. There are three phenomena associated with responses to nerve blocks described in the literature: pain relief may outlast the conduction blockade; block distal to the site of the pain inducing lesion may stop or alleviate the pain and blocking a peripheral nerve supplying a large part, but not the whole of the region of pain, may provide pain relief in the entire region [10,11].…”

Bloqueo anestésico de nervios pericraneales como tratamiento preventivo de migraña: experiencia en una serie de 60 pacientes

“…Nuestro grupo realizó bloqueo anestésico con una mezcla de bupivacaína y mepivacaína a 10 pacientes con diagnóstico de NO, obteniendo una respuesta completa en todos ellos durante un periodo de entre 2 y 6 meses 20 . También la cefalea cervicogénica, la cefalea postraumá-tica, los diferentes tipos de cefaleas antes agrupados como «cefalea crónica diaria», y otras neuralgias, como la supraorbitaria o auriculotemporal, han mostrado beneficiarse de los bloqueos anestésicos 9,12,21 .…”

Ultrasound guided chronic pain interventions (Part I)

“…GON blockade is used in various type of headaches like migraine, occipital neuralgia, servicogenic headache, postdural puncture headache (PDPH) with generally favorable clinical outcomes. [19,20] For a long time, GON blockade has been performed by classical approach using anatomical landmarks (Figure 1). In one related study, 10 patients who received GON pulsed radiofrequency (PRF) by classical landmark technique due to occipital neuralgia were followed up for 7.5 months on average, and their pain scores decreased to 0.8 after PRF from 6.9.…”