Greater occipital nerve injection in primary headache syndromes--prolonged effects from a single injection

Pain
S K AfridiP J Goadsby

Abstract

Most patients with primary headache syndromes who have frequent attacks of pain have tenderness in the sub-occipital region. Injection of the greater occipital nerve (GON) with local anesthetic and corticosteroids has been widely used in clinical practice for many years, yet there is no clear understanding of its mechanisms of action. Moreover, there is no current gold-standard of practice regarding GON injections in the management of headache. We audited of our practice to generate hypotheses about the range of primary headaches that might benefit, to determine response rates to power future studies, and to assess whether we should continue to do this procedure. Twenty-six of fifty-seven injections in 54 migraineurs yielded a complete or partial response that lasted for the partial response a median of 30 days. For cluster headache 13 of 22 injections yielded a complete or partial response lasting for a median of 21 days for the partial response. Tenderness over the GON was strongly predictive of outcome, although local anesthesia after the injection was not. The presence or absence of medication overuse did not predict outcome. Apart from two patients with a small patch of alopecia the injection was well tolerated. GON inject...Continue Reading

References

Jan 1, 1992·Clinical Neurology and Neurosurgery·M Anthony
Jun 5, 2002·Current Opinion in Neurology·K Michael A Welch, Peter J Goadsby
Jun 22, 2002·Brain : a Journal of Neurology·Thorsten Bartsch, Peter J Goadsby
Sep 17, 2002·Cephalalgia : an International Journal of Headache·M F P PeresS D Silberstein
Aug 9, 2003·Drugs·Manjit S MatharuPeter J Goadsby

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Citations

Nov 17, 2007·Journal of Neurology·C Cianchetti, Y Hmaidan
Mar 16, 2007·Current Neurology and Neuroscience Reports·Peter J GoadsbyManjit S Matharu
Feb 23, 2013·Current Neurology and Neuroscience Reports·Neil Cherian
Mar 21, 2007·Current Pain and Headache Reports·Elizabeth LoderHerbert Markley
May 17, 2007·Current Pain and Headache Reports·Avi Ashkenazi, Morris Levin
Apr 18, 2008·Current Pain and Headache Reports·Miles J LevyPeter J Goadsby
Jan 8, 2009·Current Pain and Headache Reports·Bert B Vargas
Apr 29, 2010·Current Pain and Headache Reports·Anne H Calhoun, B Lee Peterlin
Jul 28, 2010·Current Pain and Headache Reports·William B Young
Nov 17, 2010·Current Pain and Headache Reports·Elisabetta Cittadini, Peter J Goadsby
Feb 28, 2013·Current Pain and Headache Reports·Elizabeth Leroux, Anne Ducros
Mar 8, 2008·Current Treatment Options in Neurology·Marc E Lenaerts
Nov 15, 2012·Current Treatment Options in Neurology·Elliott Schulman, Brian E McGeeney
May 1, 2010·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Koen Paemeleire, Thorsten Bartsch
May 1, 2010·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Morris Levin
Sep 15, 2009·Lancet Neurology·Peter J Goadsby
Sep 10, 2011·Lancet Neurology·David W Dodick
Jun 17, 2011·The Clinical Journal of Pain·Andrea E Bialocerkowski, Anne Daly
Sep 22, 2006·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·A MayUNKNOWN EFNS Task Force
Sep 18, 2007·Cephalalgia : an International Journal of Headache·P IrimiaE Martinez-Vila
Jan 19, 2008·Cephalalgia : an International Journal of Headache·J A ParejaJ Porta-Etessam
Apr 4, 2008·Cephalalgia : an International Journal of Headache·M W Weatherall
Jun 14, 2008·Cephalalgia : an International Journal of Headache·P J Goadsby, T Bartsch
Jun 14, 2008·Cephalalgia : an International Journal of Headache·M LeoneG Bussone
Mar 18, 2009·Cephalalgia : an International Journal of Headache·M SeleklerA Almaç
Mar 14, 2009·Cephalalgia : an International Journal of Headache·P IrimiaE Martínez-Vila
May 15, 2009·Cephalalgia : an International Journal of Headache·N MorelliD Guidetti
Sep 24, 2010·Cephalalgia : an International Journal of Headache·Joel R SaperUNKNOWN ONSTIM Investigators
Jul 25, 2008·Orphanet Journal of Rare Diseases·Elizabeth Leroux, Anne Ducros
Aug 8, 2012·Continuum : Lifelong Learning in Neurology·Peter J Goadsby
Feb 14, 2014·Current Pain and Headache Reports·Sanjay Prakash, Rushad Patell
Oct 2, 2012·Annals of Indian Academy of Neurology·Fayyaz AhmedModar Khalil
Oct 2, 2012·Annals of Indian Academy of Neurology·Giorgio Lambru, Manjit S Matharu
Apr 17, 2014·Current Pain and Headache Reports·Carrie Dougherty
Dec 3, 2014·Journal of Bodywork and Movement Therapies·Danit TaliLeonid Kalichman
Jun 6, 2014·Current Pain and Headache Reports·Amy A Gelfand, Peter J Goadsby
May 3, 2008·Current Opinion in Neurology·Peter J GoadsbyAnna S Cohen
May 8, 2016·Neurologia i neurochirurgia polska·Korgun OkmenEmre Cancan
Nov 3, 2006·Expert Review of Neurotherapeutics·Arne May, Tim P Jurgens
Nov 12, 2009·Expert Review of Neurotherapeutics·Vinod Kumar Gupta
Aug 9, 2011·Expert Opinion on Investigational Drugs·Svein I Bekkelund, Karl B Alstadhaug
Feb 20, 2016·Current Pain and Headache Reports·María Luz CuadradoJuan A Pareja

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