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Acta Neurol Scand. 2017 Apr;135(4):426-433. doi: 10.1111/ane.12692. Epub 2016 Sep 26.

Greater occipital nerve block in the treatment of triptan-overuse headache: A randomized comparative study.

Author information

1
Department of Neurology, Ankara Mevki Military Hospital, Ankara, Turkey.
2
Department of Neurology, Liv Hospital, Ankara, Turkey.
3
Department of Medical Biochemistry, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
4
Department of Neurology, Mersin University School of Medicine, Mersin, Turkey.

Abstract

OBJECTIVES:

This study aims to investigate the efficiency of a single and repeated greater occipital nerve (GON) block using lidocaine in the treatment of triptan-overuse headache (TOH), whose importance has increased lately.

MATERIALS AND METHODS:

In the study, 105 consecutive subjects diagnosed with TOH were evaluated. The subjects were randomized into three groups. In Group 1 (n=35), only triptan was abruptly withdrawn. In Group 2 (n=35), triptan was abruptly withdrawn and single GON block was performed. In Group 3 (n=35), triptan was abruptly withdrawn and three-stage GON block was performed. All patients were injected bilaterally with a total amount of 5 cc 1% lidocaine in each stage. During follow-up, the number of headache days per month, the severity of pain (VAS), the number of triptans used, and hsCRP and IL-6 levels were recorded three times; in the pretreatment period, in the second month post-treatment, and in the fourth month post-treatment. They were then compared.

RESULTS:

There was a statistically significant difference in the post-treatment fourth month in comparison with the pretreatment period in Group 3 (P<.05). Compared to Group 1, the number of headache days, VAS, and decrease in triptan need in Group 3 was statistically significant compared to Group 2 (P<.05). Compared to pretreatment, in the fourth month post-treatment, both hsCRP and IL-6 levels were lower only in Group 3 (P<.05).

CONCLUSIONS:

We are of the opinion that repeated GON block in addition to the discontinuation of medication has significant efficacy for TOH cases.

KEYWORDS:

greater occipital nerve; medication overuse headache; migraine; occipital nerve block; triptan-overuse headache

PMID:
27666722
DOI:
10.1111/ane.12692
[Indexed for MEDLINE]

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