Effects of cranial nerve blockage in patients with chronic migraine resistant to first-line treatment

Gökhan Evcili; Ahmet Yabalak

doi:10.28982/josam.1000962

Research Article

Effects of cranial nerve blockage in patients with chronic migraine resistant to first-line treatment

Year 2021, Volume: 5 Issue: 11, 1131 - 1134, 01.11.2021

Gökhan Evcili Ahmet Yabalak

https://doi.org/10.28982/josam.1000962

Abstract

Background/Aim: Migraine is a common, disabling neurological disorder and cranial nerve blocks (CNB) are used in the treatment of headaches. This study aimed to compare the effectiveness of a CNB with conventional medical treatment in patients with chronic migraine resistant to first-line treatment.
Methods: This retrospective cohort study included 102 patients with chronic migraine resistant to first-line treatment who were treated in our outpatient clinic. The patients were divided into two groups as those who underwent CNB (n=67) and the control group, who were only treated with conventional drugs (n=35). Bilateral CNB was performed on the patients at baseline and in the second week. The patients’ Visual Analogue Scale (VAS) scores, number of days in pain, and the number of analgesics taken were recorded at baseline and the second month.
Results: The second-month VAS scores and the number of days in pain were significantly lower than baseline in both the CNB and control groups (P<0.01, and P<0.05, respectively). However, while the number of analgesics taken in the 2nd month was lower in the CNB group, it was similar in the control group. (P<0.01, P=0.33). No significant difference was found between the groups in terms of the number of days in pain in the second month (P=0.09). The second month's VAS scores and the number of analgesics taken were significantly lower in the CNB group compared to the control group (P=0.01, P<0.01).
Conclusion: Our findings indicated that the CNB was more effective than conventional treatment in patients with chronic migraine resistant to first-line treatment.

Keywords

Chronic migraine, Nerve block, Great occipital nerve, GON, SON

References

1. Stewart WF, Shechter A, Rasmussen B. Migraine prevalence. A review of population-based studies. Neurology. 1994;44(6 Suppl 4):S17-23.
2. Ertas M, Baykan B, Orhan EK, Zarifoglu M, Karli N, Saip S, et al. One-year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults. J Headache Pain. 2012;13(2):147-57. doi: 10.1007/s10194-011-0414-5
3. Ha H, Gonzalez A. Migraine Headache Prophylaxis. American family physician. 2019;99(1):17-24.
4. Blumenfeld AM, Bloudek LM, Becker WJ, Buse DC, Varon SF, Maglinte GA, et al. Patterns of use and reasons for discontinuation of prophylactic medications for episodic migraine and chronic migraine: Results from the second International Burden of Migraine Study (IBMS‐II). Headache: The Journal of Head and Face Pain. 2013;53(4):644-55. doi: 10.1111/head.12055
5. Blumenfeld A, Ashkenazi A, Napchan U, Bender SD, Klein BC, Berliner R, et al. Expert Consensus Recommendations for the Performance of Peripheral Nerve Blocks for Headaches – A Narrative Review. Headache: The Journal of Head and Face Pain. 2013;53(3):437-46. doi: 10.1111/head.12053
6. Terzi T, Karakurum B, Üçler S, İnan LE, Tulunay C. Greater occipital nerve blockade in migraine, tension-type headache and cervicogenic headache. J Headache Pain. 2002;3(3):137-41. doi: 10.1007/s101940200031
7. Ashkenazi A, Young WB. The Effects of Greater Occipital Nerve Block and Trigger Point Injection on Brush Allodynia and Pain in Migraine. Headache: The Journal of Head and Face Pain. 2005;45(4):350-4. doi: 10.1111/j.1526-4610.2005.05073.x
8. Inan N, Inan LE, Coşkun Ö, Tunç T, Ilhan M. Effectiveness of Greater Occipital Nerve Blocks in Migraine Prophylaxis. Noro Psikiyatr Ars. 2016;53(1):45-8. doi: 10.5152/npa.2015.10003
9. Tang Y, Kang J, Zhang Y, Zhang X. Influence of greater occipital nerve block on pain severity in migraine patients: A systematic review and meta-analysis. The American Journal of Emergency Medicine. 2017;35(11):1750-4. doi: 10.1016/j.ajem.2017.08.027
10. Zhang H, Yang X, Lin Y, Chen L, Ye H. The efficacy of greater occipital nerve block for the treatment of migraine: A systematic review and meta-analysis. Clinical Neurology and Neurosurgery. 2018;165:129-33. doi: 10.1016/j.clineuro.2017.12.026
11. Caputi CA, Firetto V. Therapeutic Blockade of Greater Occipital and Supraorbital Nerves in Migraine Patients. Headache: The Journal of Head and Face Pain. 1997;37(3):174-9. doi: 10.1046/j.1526-4610.1997.3703174.x
12. Gul HL, Ozon AO, Karadas O, Koc G, Inan LE. The efficacy of greater occipital nerve blockade in chronic migraine: A placebo-controlled study. Acta Neurologica Scandinavica. 2017;136(2):138-44. doi: 10.1111/ane.12716
13. Inan LE, Inan N, Karadaş Ö, Gül HL, Erdemoğlu AK, Türkel Y, et al. Greater occipital nerve blockade for the treatment of chronic migraine: a randomized, multicenter, double-blind, and placebo-controlled study. Acta Neurologica Scandinavica. 2015;132(4):270-7. doi: 10.1111/ane.12393
14. Okmen K, Dagistan Y, Dagistan E, Kaplan N, Cancan E. Efficacy of the greater occipital nerve block in recurrent migraine type headaches. Neurologia i Neurochirurgia Polska. 2016;50(3):151-4. doi: 10.1016/j.pjnns.2016.01.015
15. Ashkenazi A, Matro R, Shaw JW, Abbas MA, Silberstein SD. Greater occipital nerve block using local anaesthetics alone or with triamcinolone for transformed migraine: a randomised comparative study. Journal of Neurology, Neurosurgery &amp; Psychiatry. 2008;79(4):415. doi: 10.1136/jnnp.2007.124420
16. Tobin J, Flitman S. Treatment of migraine with occipital nerve blocks using only corticosteroids. Headache. 2011;51(1):155-9. doi: 10.1111/j.1526-4610.2010.01801.x
17. Ünal-Artık HA, İnan LE, Ataç-Uçar C, Yoldaş TK. Do bilateral and unilateral greater occipital nerve block effectiveness differ in chronic migraine patients? Neurological Sciences. 2017;38(6):949-54. doi: 10.1007/s10072-017-2861-5
18. Deniz Palamar M, Derya Uluduz M, Sabahattin Saip M, Gul Erden M. Ultrasound-guided greater occipital nerve block: an efficient technique in chronic refractory migraine without aura? Pain Physician. 2015;18:153-62. doi: 10.36076/ppj/2015.18.153
19. Kashipazha D, Nakhostin-Mortazavi A, Mohammadianinejad SE, Bahadoram M, Zandifar S, Tarahomi S. Preventive effect of greater occipital nerve block on severity and frequency of migraine headache. Global journal of health science. 2014;6(6):209. doi: 10.5539/gjhs.v6n6p209
20. Dilli E, Halker R, Vargas B, Hentz J, Radam T, Rogers R, et al. Occipital nerve block for the short-term preventive treatment of migraine: A randomized, double-blinded, placebo-controlled study. Cephalalgia. 2014;35(11):959-68. doi: 10.1177/0333102414561872
21. Takmaz SA, İnan N, Uçler S, Yazar MA, İnan L, Başar H. Greater occipital nerve block in migraine headache: preliminary results of 10 patients. The journal of the Turkish Society of Algology. 2008;20(1):47-50.
22. Piñero MR, Carrillo PM, Hueso MP, de la Cruz Rodríguez C, Mesonero LL, Peral AG. Pericranial nerve blockade as a preventive treatment for migraine: experience in 60 patients. Neurología (English Edition). 2016;31(7):445-51. doi: 10.1016/j.nrl.2014.10.001

Year 2021, Volume: 5 Issue: 11, 1131 - 1134, 01.11.2021

Gökhan Evcili Ahmet Yabalak

https://doi.org/10.28982/josam.1000962

Abstract

References

1. Stewart WF, Shechter A, Rasmussen B. Migraine prevalence. A review of population-based studies. Neurology. 1994;44(6 Suppl 4):S17-23.
2. Ertas M, Baykan B, Orhan EK, Zarifoglu M, Karli N, Saip S, et al. One-year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults. J Headache Pain. 2012;13(2):147-57. doi: 10.1007/s10194-011-0414-5
3. Ha H, Gonzalez A. Migraine Headache Prophylaxis. American family physician. 2019;99(1):17-24.
4. Blumenfeld AM, Bloudek LM, Becker WJ, Buse DC, Varon SF, Maglinte GA, et al. Patterns of use and reasons for discontinuation of prophylactic medications for episodic migraine and chronic migraine: Results from the second International Burden of Migraine Study (IBMS‐II). Headache: The Journal of Head and Face Pain. 2013;53(4):644-55. doi: 10.1111/head.12055
5. Blumenfeld A, Ashkenazi A, Napchan U, Bender SD, Klein BC, Berliner R, et al. Expert Consensus Recommendations for the Performance of Peripheral Nerve Blocks for Headaches – A Narrative Review. Headache: The Journal of Head and Face Pain. 2013;53(3):437-46. doi: 10.1111/head.12053
6. Terzi T, Karakurum B, Üçler S, İnan LE, Tulunay C. Greater occipital nerve blockade in migraine, tension-type headache and cervicogenic headache. J Headache Pain. 2002;3(3):137-41. doi: 10.1007/s101940200031
7. Ashkenazi A, Young WB. The Effects of Greater Occipital Nerve Block and Trigger Point Injection on Brush Allodynia and Pain in Migraine. Headache: The Journal of Head and Face Pain. 2005;45(4):350-4. doi: 10.1111/j.1526-4610.2005.05073.x
8. Inan N, Inan LE, Coşkun Ö, Tunç T, Ilhan M. Effectiveness of Greater Occipital Nerve Blocks in Migraine Prophylaxis. Noro Psikiyatr Ars. 2016;53(1):45-8. doi: 10.5152/npa.2015.10003
9. Tang Y, Kang J, Zhang Y, Zhang X. Influence of greater occipital nerve block on pain severity in migraine patients: A systematic review and meta-analysis. The American Journal of Emergency Medicine. 2017;35(11):1750-4. doi: 10.1016/j.ajem.2017.08.027
10. Zhang H, Yang X, Lin Y, Chen L, Ye H. The efficacy of greater occipital nerve block for the treatment of migraine: A systematic review and meta-analysis. Clinical Neurology and Neurosurgery. 2018;165:129-33. doi: 10.1016/j.clineuro.2017.12.026
11. Caputi CA, Firetto V. Therapeutic Blockade of Greater Occipital and Supraorbital Nerves in Migraine Patients. Headache: The Journal of Head and Face Pain. 1997;37(3):174-9. doi: 10.1046/j.1526-4610.1997.3703174.x
12. Gul HL, Ozon AO, Karadas O, Koc G, Inan LE. The efficacy of greater occipital nerve blockade in chronic migraine: A placebo-controlled study. Acta Neurologica Scandinavica. 2017;136(2):138-44. doi: 10.1111/ane.12716
13. Inan LE, Inan N, Karadaş Ö, Gül HL, Erdemoğlu AK, Türkel Y, et al. Greater occipital nerve blockade for the treatment of chronic migraine: a randomized, multicenter, double-blind, and placebo-controlled study. Acta Neurologica Scandinavica. 2015;132(4):270-7. doi: 10.1111/ane.12393
14. Okmen K, Dagistan Y, Dagistan E, Kaplan N, Cancan E. Efficacy of the greater occipital nerve block in recurrent migraine type headaches. Neurologia i Neurochirurgia Polska. 2016;50(3):151-4. doi: 10.1016/j.pjnns.2016.01.015
15. Ashkenazi A, Matro R, Shaw JW, Abbas MA, Silberstein SD. Greater occipital nerve block using local anaesthetics alone or with triamcinolone for transformed migraine: a randomised comparative study. Journal of Neurology, Neurosurgery &amp; Psychiatry. 2008;79(4):415. doi: 10.1136/jnnp.2007.124420
16. Tobin J, Flitman S. Treatment of migraine with occipital nerve blocks using only corticosteroids. Headache. 2011;51(1):155-9. doi: 10.1111/j.1526-4610.2010.01801.x
17. Ünal-Artık HA, İnan LE, Ataç-Uçar C, Yoldaş TK. Do bilateral and unilateral greater occipital nerve block effectiveness differ in chronic migraine patients? Neurological Sciences. 2017;38(6):949-54. doi: 10.1007/s10072-017-2861-5
18. Deniz Palamar M, Derya Uluduz M, Sabahattin Saip M, Gul Erden M. Ultrasound-guided greater occipital nerve block: an efficient technique in chronic refractory migraine without aura? Pain Physician. 2015;18:153-62. doi: 10.36076/ppj/2015.18.153
19. Kashipazha D, Nakhostin-Mortazavi A, Mohammadianinejad SE, Bahadoram M, Zandifar S, Tarahomi S. Preventive effect of greater occipital nerve block on severity and frequency of migraine headache. Global journal of health science. 2014;6(6):209. doi: 10.5539/gjhs.v6n6p209
20. Dilli E, Halker R, Vargas B, Hentz J, Radam T, Rogers R, et al. Occipital nerve block for the short-term preventive treatment of migraine: A randomized, double-blinded, placebo-controlled study. Cephalalgia. 2014;35(11):959-68. doi: 10.1177/0333102414561872
21. Takmaz SA, İnan N, Uçler S, Yazar MA, İnan L, Başar H. Greater occipital nerve block in migraine headache: preliminary results of 10 patients. The journal of the Turkish Society of Algology. 2008;20(1):47-50.
22. Piñero MR, Carrillo PM, Hueso MP, de la Cruz Rodríguez C, Mesonero LL, Peral AG. Pericranial nerve blockade as a preventive treatment for migraine: experience in 60 patients. Neurología (English Edition). 2016;31(7):445-51. doi: 10.1016/j.nrl.2014.10.001

There are 22 citations in total.

Details

Primary Language	English
Subjects	Neurology and Neuromuscular Diseases
Journal Section	Research article
Authors	Gökhan Evcili 0000-0003-2965-9936 Ahmet Yabalak 0000-0002-3317-9567
Publication Date	November 1, 2021
Published in Issue	Year 2021 Volume: 5 Issue: 11

Cite

APA	Evcili, G., & Yabalak, A. (2021). Effects of cranial nerve blockage in patients with chronic migraine resistant to first-line treatment. Journal of Surgery and Medicine, 5(11), 1131-1134. https://doi.org/10.28982/josam.1000962
AMA	Evcili G, Yabalak A. Effects of cranial nerve blockage in patients with chronic migraine resistant to first-line treatment. J Surg Med. November 2021;5(11):1131-1134. doi:10.28982/josam.1000962
Chicago	Evcili, Gökhan, and Ahmet Yabalak. “Effects of Cranial Nerve Blockage in Patients With Chronic Migraine Resistant to First-Line Treatment”. Journal of Surgery and Medicine 5, no. 11 (November 2021): 1131-34. https://doi.org/10.28982/josam.1000962.
EndNote	Evcili G, Yabalak A (November 1, 2021) Effects of cranial nerve blockage in patients with chronic migraine resistant to first-line treatment. Journal of Surgery and Medicine 5 11 1131–1134.
IEEE	G. Evcili and A. Yabalak, “Effects of cranial nerve blockage in patients with chronic migraine resistant to first-line treatment”, J Surg Med, vol. 5, no. 11, pp. 1131–1134, 2021, doi: 10.28982/josam.1000962.
ISNAD	Evcili, Gökhan - Yabalak, Ahmet. “Effects of Cranial Nerve Blockage in Patients With Chronic Migraine Resistant to First-Line Treatment”. Journal of Surgery and Medicine 5/11 (November 2021), 1131-1134. https://doi.org/10.28982/josam.1000962.
JAMA	Evcili G, Yabalak A. Effects of cranial nerve blockage in patients with chronic migraine resistant to first-line treatment. J Surg Med. 2021;5:1131–1134.
MLA	Evcili, Gökhan and Ahmet Yabalak. “Effects of Cranial Nerve Blockage in Patients With Chronic Migraine Resistant to First-Line Treatment”. Journal of Surgery and Medicine, vol. 5, no. 11, 2021, pp. 1131-4, doi:10.28982/josam.1000962.
Vancouver	Evcili G, Yabalak A. Effects of cranial nerve blockage in patients with chronic migraine resistant to first-line treatment. J Surg Med. 2021;5(11):1131-4.

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