F723 PULSED RADIOFREQUENCY THERAPY VERSUS GREATER OCCIPITAL NERVE BLOCK IN THE MANAGEMENT OF REFRACTORY CERVICOGENIC HEADACHE – A PILOT STUDY

2011 ◽  
Vol 5 (1) ◽  
pp. 194 ◽  
Author(s):  
T. Gabrhelík ◽  
P. Michálek ◽  
M. Pieran
Author(s):  
Zenat Eldadamony Mohamed ◽  
Carmen Ali Zarad ◽  
Mohamed E. Flifel ◽  
Ali A. Abou Elmaaty

Abstract Introduction Traditionally, non-invasive and invasive techniques were used for the treatment of cervicogenic headache (CH). Greater occipital nerve block is the most frequent peripheral nerve block invasive technique used for the management of cervicogenic headache. The purpose of this prospective, double-blinded study was to compare the efficacy of two different techniques: multifidus cervicis plane block and greater occipital nerve block in the treatment of refractory cervicogenic headache by using ultrasound. Methods Sixty patients with cervicogenic headache were recruited and diagnosed according to the ICHD-III beta version. The patients were divided into two groups, one group was for greater occipital nerve block and the other group was for multifidus cervicis plane block with ultrasound-guided. Results Visual analog scale (VAS) was 2.09% in the multifidus cervicis plane block (MCPB) group and was 2.22% in the greater occipital nerve block (GONB) group with a median reduction of − 4.33 and − 3.048, respectively, at 2-week visits with a statistically significant difference better in the MCPB group (P < 0.001). At 4 weeks visits, VAS scale was better in the MCPB group than in the GONB group (3.79 and 4.44, respectively) with a median reduction in VAS scale (− 3.27 and − 3.095, respectively) and statistically significant differences between both groups (P = 0.020). Conclusion Both the ultrasound-guided multifidus cervicis plane block and greater occipital nerve block are effective as intervention techniques in the treatment of refractory cervicogenic headache. These techniques are simple, safe, more reliable with less side effects, and often reduce the requirements of analgesic drugs.


2021 ◽  
pp. jnnp-2021-326433
Author(s):  
Jan Hoffmann ◽  
Jan Mehnert ◽  
Elena M Koo ◽  
Arne May

IntroductionThe pharmacological block of the greater occipital nerve has been proven effective in numerous headache and facial pain syndromes. This clinical effect supports the hypothesis of a strong functional interaction between the occipital and trigeminal nerves which has been proposed in neurophysiological in vivo experiments in rodents. Although it is likely that the interaction has to occur in the central nervous system, the exact site and the mechanisms of the interaction remain largely unknown.MethodsFocusing on these questions we investigated in a double-blind, placebo-controlled, randomised study the influence of an occipital nerve block with lidocaine 1% on neuronal activation in the trigeminocervical complex using high-resolution functional magnetic resonance on a 3T scanner. In order to investigate potential clinical effects on the trigeminal nerve, we further performed quantitative sensory testing and analysed a potential shift in thermal detection and pain thresholds.ResultsThe pharmacological block of the greater occipital nerve induced an occipital anaesthesia ipsilateral to the block. Functional imaging revealed that the occipital injection of lidocaine but not placebo significantly reduced nociceptive trigeminal activation.ConclusionsThese data suggest that the functional inhibition of the occipital nerve block on trigeminal nociceptive activity is likely to occur at the C2 level where the occipital nerve enters the trigeminocervical complex and converges on the same central nuclei before the signal crosses the midline at that level and is then transmitted to higher processing centres.


2016 ◽  
Vol 50 (3) ◽  
pp. 151-154 ◽  
Author(s):  
Korgun Okmen ◽  
Yasar Dagistan ◽  
Emine Dagistan ◽  
Necati Kaplan ◽  
Emre Cancan

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