Greater occipital nerve blockage in patients with chronic migraine complicated by medication overuse

Abstract

Objective: To examine the effects of Greater Occipital Nerve (GON) blockade on attack treatment and emergency department visits in patients with chronic migraine (CM) complicated by medication overuse headache (MOH).

Method: A total of 103 patients aged 18-55 years who presented to our neurology outpatient clinic were prospectively included in our study. Bilateral GON blockade (10 mg 0.5% bupivacaine per session) was administered for 4 sessions at 2-4 week intervals, followed by continued treatment for all patients at 1-2 month intervals for 9 months. A pain diary, Visual Analog Scale (VAS), and Migraine Disability Assessment Scale (MIDAS) scores were assessed at 9-month follow-up.

Results: The mean age of the 103 patients was 37.0 ± 9.8 years, and 79.6% were female. A reduction in monthly headache days to fewer than 5 days was observed in 64.1% of cases. Furthermore, a significant reduction was recorded in analgesic use. Similarly, emergency admission and intramuscular treatment rates, as well as VAS/MIDAS scores, showed a significant decrease (p<0.05).

Conclusion: GON blockade appears to be a promising supportive option for patients with CM complicated by MOH.