Effectiveness of Bilateral Greater and Lesser Occipital Nerve Blocks in the Prophylaxis of Episodic Migraine

Abstract

Aim: In recent years, many studies have been conducted on the effectiveness of occipital nerve block (ONB) especially in the prophylaxis of chronic migraine. In this study, it was aimed to investigate the effectiveness of bilateral greater and lesser ONBs in the prophylaxis of episodic migraine without aura. Material and Methods: This retrospective study included patients with episodic migraine without aura who underwent bilateral greater and lesser ONBs between January 2018 and December 2019. Information about headache frequency, attack duration, and pain severity (VAS score) of the patients in the last month before nerve block and 1 month after nerve block was retrieved from the database and recorded for statistical analysis. Results: A total of 17 patients aged 26-57 years were included in this study. None of the patients developed any drug side effects or complications associated with ONB. With ONB, the median value of headache attack frequency dropped from 5 (range, 4-14) to 2 (range, 0-6) per month (p=0.001), the median value of pain duration dropped from 12 (range, 6-14) to 4 (range, 0-9) days (p<0.001), and the median value of VAS pain severity score dropped from 9 (range, 7-10) to 5 (range, 0-10) for the patients (p=0.001), compared with the pretreatment values. Conclusion: Bilateral greater and lesser ONBs are effective in the prophylaxis of episodic migraine without aura. ONB can be considered as a treatment option in patients with episodic migraine without aura who do not respond to conventional treatments (oral drugs) or do not accept conventional therapy.