Taha Nourhan Abdelmohsen, Fathy Mai, Elsadek Ahmed, Emara Tamer Hussein, Farag Sherien Mohamed, Moustafa Ramez Reda, Abdulghani Mohamad Osama
Department of Neurology, Faculty of Medicine, Ain Shams University, 38 Abbasia, PO 11591, Cairo, Egypt.
J Headache Pain. 2025 Apr 16;26(1):80. doi: 10.1186/s10194-025-02013-3.
Migraine is a common primary headache disorder with different treatment modalities emerging as ultrasound guided peripheral nerve blocks. We compared the efficacy and safety of ultrasound guided bilateral sphenopalatine ganglion (SPG) block versus bilateral greater occipital nerve (GON) block, in chronic resistant migraine patients and controls.
This study was an interventional randomized controlled trial, including 53 patients, 22 in sphenopalatine ganglion arm, 21 greater occipital nerve arm and 10 in sham group. All patients were assessed initially by headache diary (for 3 months), HIT-6 and MIDAS scales. The patients (blindly allocated) underwent nerve block ultrasound guided, then followed up after one month by headache diary and HIT- 6 scale and three months by MIDAS. Results were analysed on SPSS, using mixed AVOVA and Tukey's Post-Hoc analysis, Fisher's exact and paired t-test.
The two groups were matched as regards the gender, age, type of migraine, frequency and years lived with headache. The study revealed that GON and SPG block, were equally effective (p < 0.05) as regards reducing the headache diary parameters, as well as the total pain index and the functional impact on HIT-6 and MIDAS scale. SPG block was more effective in patients with autonomic manifestations and temporal location of pain.
Ultrasound guided SPG is as effective as GON as a treatment modality for chronic resistant migraine and may be more useful in the presence of autonomic manifestations and temporal location of pain.
偏头痛是一种常见的原发性头痛疾病，超声引导下的周围神经阻滞成为不同的治疗方式。我们比较了超声引导下双侧蝶腭神经节（SPG）阻滞与双侧枕大神经（GON）阻滞在慢性难治性偏头痛患者和对照组中的疗效和安全性。
本研究为一项干预性随机对照试验，包括53例患者，22例在蝶腭神经节组，21例在枕大神经组，10例在假手术组。所有患者最初通过头痛日记（为期3个月）、HIT-6和MIDAS量表进行评估。患者（随机分配）接受超声引导下的神经阻滞，然后在1个月后通过头痛日记和HIT-6量表进行随访，在3个月后通过MIDAS量表进行随访。使用SPSS软件，采用混合方差分析、Tukey事后分析、Fisher精确检验和配对t检验对结果进行分析。
两组在性别、年龄、偏头痛类型、发作频率和头痛持续年限方面相匹配。研究表明，GON阻滞和SPG阻滞在降低头痛日记参数、总疼痛指数以及对HIT-6和MIDAS量表的功能影响方面同样有效（p < 0.05）。SPG阻滞在有自主神经症状和疼痛位于颞部的患者中更有效。
超声引导下的SPG阻滞作为慢性难治性偏头痛的一种治疗方式与GON阻滞同样有效，并且在存在自主神经症状和疼痛位于颞部的情况下可能更有用。
