scholarly journals Modulation of pain areas by greater occipital nerve block in chronic daily headache

2020 ◽  
Vol 37 (3) ◽  
pp. 248-251
Author(s):  
Douglas Baughman ◽  
Shellie A. Boudreau ◽  
Elisabeth B. Powelson ◽  
Diego Molina Ochoa ◽  
Lars Arendt-Nielsen ◽  
...  
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

Cephalalgia ◽  
2019 ◽  
Vol 39 (7) ◽  
pp. 908-920 ◽  
Author(s):  
Levent Ertugrul Inan ◽  
Nurten Inan ◽  
Hanzade Aybuke Unal-Artık ◽  
Ceyla Atac ◽  
Gulcin Babaoglu

Objectives The importance and popularity of peripheral nerve block procedures have increased in the treatment of migraine. Greater occipital nerve (GON) block is a commonly used peripheral nerve block method, and there are numerous researches on its use in migraine treatment. Materials and methods A search of PubMed for English-language randomized controlled trials (RCT) and open studies on greater occipital nerve block between 1995 and 2018 was performed using greater occipital nerve, headache, and migraine as keywords. Results In total, 242 potentially relevant PubMed studies were found. A sum of 228 of them which were non-English articles and reviews, case reports, letters and meta-analyses were excluded. The remaining articles were reviewed, and 14 clinical trials, seven of which were randomized-controlled on greater occipital nerve block in migraine patients, were identified and reviewed. Conclusions Although clinicians commonly use greater occipital nerve block in migraine patients, the procedure has yet to be standardized. The present study reviewed the techniques, drugs and dosages, the frequency of administration, side effects, and efficacy of greater occipital nerve block in migraine patients.


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