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Randomized Controlled Trial
Greater occipital and supraorbital nerve blockade for the preventive treatment of migraine: a single-blind, randomized, placebo-controlled study.
- Duygu Özer, Cem Bölük, Ülkü Türk Börü, Deniz Altun, Mustafa Taşdemir, and Cansu Köseoğlu Toksoy.
- a Department of Neurology , University of Health Sciences Dr. Lütfi Kırdar Kartal Training and Research Hospital , Istanbul , Turkey.
- Curr Med Res Opin. 2019 May 1; 35 (5): 909-915.
ObjectiveNerve injections have been used for the acute and preventive treatment of migraine in recent decades. Most of these injections focused on greater occipital nerve (GON) blockade. However, few studies were placebo controlled, and only a few of them investigated GON and supraorbital nerve (SON) blockade together. This study aimed to evaluate the efficacy of GON and SON blockade with local anesthetics for the preventive treatment of migraine without aura.MethodsEighty-seven patients diagnosed with migraine without aura were included in the study. Patients were divided randomly. One group was injected with 1% lidocaine, the other group was injected with 0.9% saline. GON and SON injections were done bilaterally. The injections were repeated weekly for 3 weeks. Patients were followed up for 2 months to assess clinical response.ResultsSeventy-one patients completed the study. After 2 months, the number of headache days decreased significantly from 12.8 ± 10.9 to 5.3 ± 7.4, and VAS decreased from 8.3 ± 1.0 to 5.5 ± 1.9 in the blockade group. The number of headache days decreased from 12.4 ± 10.3 to 7.5 ± 7.2 and VAS decreased from 8.2 ± 1.1 to 7.4 ± 1.3 in the placebo group. Response was seen in 65.1% of the patients in the blockade group (65.4% for episodic migraine, 64.7% for chronic migraine) and 28.6% of the patients in the placebo group. The difference was significant.ConclusionsThe results suggest that GON and SON blockade with lidocaine was more effective than the placebo in the prophylactic treatment of both episodic and chronic migraine.
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