Prolongation of greater occipital neural blockade with 10% lidocaine neurolysis: a case series of a new technique

Kim, David Daewhan; Sibai, Nabil

doi:10.2147/jpr.s112947

Cited by 7 publications

(10 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…82 Concentrations of lidocaine above 2% have been discouraged because of possible greater adverse events although, in a retrospective small series of 13 patients of migraine and occipital neuralgia, 10% lidocaine produced prolonged relief in headaches lasting months. 83 Only one open-label study reviewed here used a combination of lidocaine and bupivacaine possibly to augment quicker onset and longer duration of action. However, the benefit of such a combination is questionable.…”

Section: Discussionmentioning

confidence: 99%

Role of greater occipital nerve block for preventive treatment of chronic migraine: A critical review

Chowdhury

Mundra

2020

Cephalalgia Reports

View full text Add to dashboard Cite

Objective: The aim of this study is to critically analyze the evidence of the efficacy and safety of greater occipital nerve (GON) block for the preventive treatment of chronic migraine (CM). Background: A rigorous scientific assessment of efficacy and safety of the GON block for preventive treatment in CM is not available. This critical review was undertaken for this purpose. Methods: References for this review were identified by searches of articles published in the English language in PubMed between 1969 and April 15, 2020 using “greater occipital nerve block,” “chronic migraine,” “migraine,” “headache,” and “treatment” as keywords. Results: Out of potential 532 articles, 9 open-label and 4 placebo-controlled trials that studied the role of GON block for prevention of CM were identified and reviewed. Open-label trials reported a reduction of headache severity and frequency in 35–68% of patients. The beneficial effect of a single block lasted up to 4 weeks. Randomized controlled trials (RCTs) used varied methodology and techniques of GON block and the outcomes were reported at different time points. A single RCT showed a beneficial effect of the GON block at 1 week. However, the GON block was found to be safe and well tolerated. Conclusion: Long-term efficacy of GON block in CM shall need further well-designed RCTs using standardized methodology. This study, in addition, reviewed the limitations and uncertainties regarding the technique and methods of use of GON block in CM.

show abstract

Section: Discussionmentioning

confidence: 99%

Role of greater occipital nerve block for preventive treatment of chronic migraine: A critical review

Chowdhury

Mundra

2020

Cephalalgia Reports

View full text Add to dashboard Cite

show abstract

“…The other alternative was chemical neurolysis with phenol and alcohol, which was ruled out given the possibility of soft tissue necrosis and cosmetic disfigurement of 10% Lidocaine Neurolysis for Supraorbital Neuralgia the tissues surrounding the supraorbital nerve. Kim et al (11) in their retrospective review of 13 patients with migraine and occipital neuralgia that received greater occipital nerve block with 10% lidocaine, reported a significant reduction in visual analogue pain score for a mean duration of 148.05 days (standard deviation of 98.87) as compared to 6.33 days with 0.5% bupivacaine. Kim et al (11) concluded that 10% lidocaine, with comparable results and no reported side effects, can be used as a safe and effective alternative to radiofrequency ablation for neurolysis as far as symptom control for chronic neuropathic pain is concerned .…”

Section: Discussionmentioning

confidence: 99%

“…Kim et al (11) in their retrospective review of 13 patients with migraine and occipital neuralgia that received greater occipital nerve block with 10% lidocaine, reported a significant reduction in visual analogue pain score for a mean duration of 148.05 days (standard deviation of 98.87) as compared to 6.33 days with 0.5% bupivacaine. Kim et al (11) concluded that 10% lidocaine, with comparable results and no reported side effects, can be used as a safe and effective alternative to radiofrequency ablation for neurolysis as far as symptom control for chronic neuropathic pain is concerned . Han et al (12) reported the clinical outcomes of trigeminal nerve block using 10% lidocaine and concluded that besides a relative simplicity inherent to the procedure, it is safe to perform and associated with complete reversibility of induced sensory deficits along with providing long duration of…”

Section: Discussionmentioning

confidence: 99%

A Report on Use of 10% Lidocaine Neurolysis for Chronic Refractory Supraorbital Neuralgia

Chauhan¹

2018

PMCR

View full text Add to dashboard Cite

We present a case report of a 50-year-old female with a past medical history of chronic headaches diagnosed as supraorbital neuralgia. Her headaches had been refractory to conventional analgesic medications and she had received multiple supraorbital nerve blocks which gave her temporary relief of the headaches lasting up to 2 weeks. The patient also received chemical neurolysis of the supraorbital nerve bilaterally with 10% Lidocaine bilaterally, under fluoroscopic guidance in the pain clinic. The patient reported positive outcome following the block with significant pain control for up to 6-7 months postprocedure. The authors conclude that in a patient with a refractory headache due to supraorbital neuralgia, a 10% lidocaine,injection can be an efficacious alternative to radiofrequency ablation as it yields optimum symptom control for up to 6 - 7 months and is a relatively easy procedure to perform. Furthermore, the procedure is not associated with significant side effects and with reversibility of induced sensory functional deficits, offering an advantage over radiofrequency ablation. Key words: Lidocaine, supraorbital neuralgia, neurolysis, nerve blocks, flouroscopy

show abstract

“…Series that describe benefit of GON blockade for occipital neuralgia frequently involve a mixed cohort of patients including cervicogenic headache, migraine, or other craniofacial pain with occipital tenderness and pain. 35,[67][68][69][70][71][72] A few studies suggest that in patients with occipital neuralgia, guided proximal GON blockade may provide additional benefit over the GON block at the nuchal line. 35,73 A retrospective review examined the response of 33 patients with severe refractory occipital neuralgia to computed tomography-guided GON blocks given at the first bend of GON between the inferior obliquus capitis and semispinalis capitis muscles, and found that 32 of 37 GON blocks resulted in >50% pain reduction with a mean relief duration of 9.15 months (range 3-24 months).…”

Section: Occipital Neuralgiamentioning

confidence: 99%

Narrative review of peripheral nerve blocks for the management of headache

et al. 2022

View full text Add to dashboard Cite

Objective: To provide an overview of the current available literature on peripheral nerve blocks for the management of migraine and other headache disorders in adults.Background: Peripheral nerve blocks have been commonly performed in the headache practice for migraine, cluster headache, occipital neuralgia, and other headache disorders, despite a paucity of evidence supporting their use historically. In the past decade, there has been an effort to explore the efficacy and safety of peripheral nerve blocks for the management of headache, with the greatest interest centered around greater occipital blocks. Design:We performed a search in PubMed using key words including "occipital nerve blocks," "peripheral nerve blocks," "occipital nerve," "migraine," "cluster headache," and "neuralgia." We reviewed the randomized controlled trials (RCTs), observational studies, and case series, and summarized the anatomy, techniques, and the evidence for the use of peripheral nerve blocks in different headache disorders, with particular focus on available RCTs. Case reports were included for a detail review of adverse events.Results: Of 12 RCTs examining the use of greater occipital nerve blocks for migraine, all but one demonstrate efficacy with reduction in headache frequency, intensity, and/or duration compared to placebo. Studies have not demonstrated a difference in clinical outcomes with the use of corticosteroids for nerve blocks compared to blocks with local anesthetic in the treatment of migraine. There are two RCTs supporting the use of greater occipital blockade for cluster headache, both showing benefit of suboccipitally injected corticosteroid. One RCT suggests benefit of greater occipital nerve blocks for cervicogenic headache. Observational studies and case series/reports show that greater occipital nerve block may be effective in prolonged migraine aura, status migrainosus, post-dural puncture headache, and occipital neuralgia. Overall, peripheral nerve blocks are well tolerated. Serious side effects are rare but have been reported, including acute cerebellar syndrome and infection.Conclusions: Peripheral nerve blocks, especially occipital nerve blocks, are a viable treatment option for migraine and may be helpful in cluster headache as a transitional therapy or rescue therapy.

show abstract

Prolongation of greater occipital neural blockade with 10% lidocaine neurolysis: a case series of a new technique

Cited by 7 publications

References 34 publications

Role of greater occipital nerve block for preventive treatment of chronic migraine: A critical review

Role of greater occipital nerve block for preventive treatment of chronic migraine: A critical review

A Report on Use of 10% Lidocaine Neurolysis for Chronic Refractory Supraorbital Neuralgia

Narrative review of peripheral nerve blocks for the management of headache

Contact Info

Product

Resources

About