Inan Nurten, Inan Levent E, Coşkun Özlem, Tunç Tuğba, Ilhan Mustafa
Department of Anaesthesiology and Algology, Gazi University School of Medicine, Ankara, Turkey.
Neurology and Algology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey.
Noro Psikiyatr Ars. 2016 Mar;53(1):45-48. doi: 10.5152/npa.2015.10003. Epub 2016 Mar 1.
Peripheral nerve blocks have been used in primary headache treatment since a long time. In this study, we aimed to examine the efficiency of greater occipital nerve (GON) block in migraine prophylaxis.
Data from migraine without aura patients who had GON block were collected and divided into two groups: Group PGON (n=25), which included patients who were under medical prophylaxis and had GON block, and Group GON (n=53), which included patients who had only GON blocks. Migraine was diagnosed using International Headache Society (IHS) classification. Data of 78 patients were analyzed. Headache attack frequency, headache duration, and severity were compared between and within groups in a 3-month follow-up period.
The decrease in headache parameters after GON block in both groups was significantly similar. Headache attack frequency decreased from 15.73±7.21 (pretreatment) to 4.52±3.61 (3rd month) in Group GON and from 13.76±8.07 to 3.28±2.15 in Group PGON (p<0.05). Headache duration decreased from 18.51±9.43 to 8.02±5.58 at 3rd month in Group GON and from 15.20±9.16 to 7.20±4.16 in Group PGON (p<0.05). Headache severity decreased from 8.26±1.32 to 5.16±2.64 in Group GON and from 8.08±0.90 to 5.96±1.20 in Group PGON (p<0.05). There was no statistically significant difference between the groups in 3rd month after treatment (p>0.05).
This study showed significant decreases in headache parameters in both groups. As GON blocks were performed in patients unresponsive to medical prophylaxis, a decrease in the headache parameters in Group PGON similar to that in Group GON can be attributed to GON blocks. Consequently, these results show that repeated GON blocks with local anesthetic can be an effective alternative treatment in migraine patients who are unresponsive to medical prophylaxis or who do not prefer to use medical prophylaxis.
周围神经阻滞用于原发性头痛治疗已有很长时间。在本研究中,我们旨在探讨枕大神经(GON)阻滞预防偏头痛的疗效。
收集接受GON阻滞的无先兆偏头痛患者的数据,并分为两组:PGON组(n = 25),包括正在接受药物预防且接受GON阻滞的患者;GON组(n = 53),包括仅接受GON阻滞的患者。偏头痛的诊断采用国际头痛协会(IHS)分类标准。对78例患者的数据进行分析。在3个月的随访期内,比较组间和组内的头痛发作频率、头痛持续时间和严重程度。
两组GON阻滞后头痛参数的下降显著相似。GON组头痛发作频率从15.73±7.21(治疗前)降至4.52±3.61(第3个月),PGON组从13.76±8.07降至3.28±2.15(p<0.05)。GON组头痛持续时间在第3个月从18.51±9.43降至8.02±5.58,PGON组从15.20±9.16降至7.20±4.16(p<0.05)。GON组头痛严重程度从8.26±1.32降至5.16±2.64,PGON组从8.08±0.90降至5.96±1.20(p<0.05)。治疗后第3个月,两组间无统计学显著差异(p>0.05)。
本研究显示两组头痛参数均显著下降。由于GON阻滞是在对药物预防无反应的患者中进行的,PGON组头痛参数的下降与GON组相似可归因于GON阻滞。因此,这些结果表明,对药物预防无反应或不倾向于使用药物预防的偏头痛患者,重复使用局部麻醉剂进行GON阻滞可能是一种有效的替代治疗方法。