Comparison of the efficacy of repeated greater occipital nerve block and pulsed radiofrequency therapy in chronic migraine patients: a randomized controlled study

Abstract

The aim of this study was to compare the effectiveness of greater occipital nerve (GON) block and pulsed radiofrequency (PRF) treatment in chronic migraine patients. Seventy patients admitted to the Neurology and Algology outpatient clinic between September 2023 and December 2023 and diagnosed with chronic migraine according to The International Classification of Headache Disorders 3rd Edition (ICHD-3) criteria were included in the study. Patients were randomized into 2 groups to receive ultrasound-guided repeated GON block and PRF. Visual Analog Scale (VAS) scores for pain relief and Migraine Disability Assessment (MIDAS) scores for disability were recorded before the procedure and at 1st and 6th months after the procedure. In both groups, 35 patients with greater occipital nerve (GON) block, 32 patients with GON PRF, the pain scores at 1st and 6th months post-procedure were significantly lower compared to before the procedure (p < 0.001, p < 0.001, respectively). VAS scores were significantly lower in the PRF group than in the GON block group at 6th month (p = 0.009). In both groups, post-procedural MIDAS scores at 1st and 6th months were significantly lower compared to before the procedure (p < 0.001, p < 0.001, respectively). In the GON PRF group, MIDAS scores at 6th month were significantly lower than MIDAS scores at 1st month (p < 0.001). MIDAS scores were significantly lower in the PRF group compared to the GON block group at 6th months (p < 0.001).Interventional procedures such as GON block and PRF are safe and effective methods in chronic migraine. PRF is a better alternative to GON block in chronic migraine with longer effectiveness.