A comparison of the effects of greater occipital nerve blockade and combined greater occipital–supraorbital nerve blockade on headache in chronic migraine
摘要
To evaluate and compare the effects of isolated greater occipital nerve (GON) blockade versus combined GON–supraorbital nerve (SON) blockade on headache severity, frequency, duration, and quality of life in patients with chronic migraine.
MethodsThis retrospective study included 80 patients with CM who had not responded to adequate medical prophylaxis. Forty patients received isolated GON blockade, while the remaining 40 received combined GON–SON blockade. Nerve blockades were administered weekly during the first month and monthly for the subsequent two months. Headache frequency, duration, severity, analgesic use, and scores on the Migraine Disability Assessment Scale (MIDAS) and Headache Impact Test-6 (HIT-6) were recorded at baseline (month 0) and after treatment (month 3). Outcomes were analyzed both within and between groups.
ResultsBoth groups showed significant improvements from baseline to post-treatment (weeks 1–3, month 1, and month 3) in attack frequency, duration, VAS pain scores, analgesic use, and MIDAS and HIT-6 scores (p < 0.05). Between-group comparisons revealed significantly greater improvements in attack frequency, pain severity, and analgesic use in the combined blockade group, excluding attack duration. This group also demonstrated superior improvements in MIDAS and HIT-6 scores at 3 months (p < 0.05).
ConclusionBoth blockade treatment approaches resulted in clinical improvement in patients with chronic migraine. However, the combined GON and SON blockade demonstrated more favorable outcomes than GON blockade in terms of headache burden and quality of life during specific follow-up periods. this is the first study to directly compare these two treatment modalities in patients with CM.