Occipital nerve blocks: effect of symptomatic medication: overuse and headache type on failure rate

Headache
Joshua Tobin, Stephen Flitman

Abstract

To explore the effect of symptomatic medication overuse (SMO) and headache type on occipital nerve block (ONB) efficacy. We conducted a chart review of all of the ONBs performed in our clinic over a 2-year period. Of 108 ONBs with follow-up data, ONB failed in 22% of injections overall. Of the other 78%, the mean decrease in head pain was 83%, and the benefit lasted a mean of 6.6 weeks. Failure rate without SMO was 16% overall, and with SMO was 44% overall (P < .000). In those who did respond, overall magnitude and duration of response did not differ between those with and those without SMO. Without SMO, ONB failure rate was 0% for postconcussive syndrome, 14% for occipital neuralgia, 11% for non-intractable migraine, and 39% for intractable migraine. With SMO, failure rate increased by 24% (P = .14) in occipital neuralgia, by 36% (P = .08) for all migraine, and by 52% (P = .04) for non-intractable migraine. SMO tripled the risk of ONB failure, possibly because medication overuse headache does not respond to ONB. SMO increased ONB failure rate more in migraineurs than in those with occipital neuralgia, possibly because migraineurs are particularly susceptible to medication overuse headache. This effect was much more pronounced ...Continue Reading

Associated Clinical Trials

References

Jan 1, 1992·Clinical Neurology and Neurosurgery·M Anthony
Oct 1, 1992·Cephalalgia : an International Journal of Headache·M E SluijterG Barendse
Feb 1, 1992·Cephalalgia : an International Journal of Headache·M J Gawel, P J Rothbart
Sep 17, 2002·Cephalalgia : an International Journal of Headache·M F P PeresS D Silberstein
Dec 5, 2002·Current Medical Research and Opinion·H C Diener, Z Katsarava
Sep 3, 2003·Cephalalgia : an International Journal of Headache·T J SteinerR B Lipton
Jan 21, 2004·The Journal of Head Trauma Rehabilitation·Jeffrey S Hecht
May 18, 2004·Journal of Neurology, Neurosurgery, and Psychiatry·J Olesen, T J Steiner
Aug 20, 2005·Cephalalgia : an International Journal of Headache·E Leinisch-DahlkeA May
Dec 24, 2005·Expert Opinion on Drug Safety·Mark ObermannZaza Katsarava
Mar 23, 2006·Journal of Child Neurology·Eric H Kossoff, Dhwani N Mankad
May 12, 2006·The Journal of Headache and Pain·Lorena ScattoniRosanna Cerbo
Jul 13, 2006·Neurology·K PaemeleireP J Goadsby
Sep 12, 2006·Cephalalgia : an International Journal of Headache·P ZeebergR Jensen
Sep 26, 2006·MMW Fortschritte der Medizin·Kasja Rabe, Zaza Katsarava
Nov 30, 2006·Pain Practice : the Official Journal of World Institute of Pain·Zoher M NajaOmar M Tawfik
Feb 21, 2007·Pain Practice : the Official Journal of World Institute of Pain·Zoher M NajaOmar M Tawfik
May 17, 2007·Current Pain and Headache Reports·Avi Ashkenazi, Morris Levin
May 17, 2008·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Licia GrazziGennaro Bussone
Jul 17, 2008·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Licia GrazziGennaro Bussone

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Citations

Jul 28, 2010·Current Pain and Headache Reports·William B Young
May 1, 2010·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Morris Levin
Jun 2, 2015·Expert Opinion on Drug Metabolism & Toxicology·Anna FerrariEmilio Sternieri
Jan 5, 2011·Headache·Joshua Tobin, Stephen Flitman
May 22, 2010·Headache·Avi AshkenaziUNKNOWN Interventional Procedures Special Interest Section of the American
Apr 29, 2015·Headache·Andrew BlumenfeldRandolph W Evans
Jan 22, 2011·Korean journal of anesthesiology·Se Hee NaDuck Mi Yoon
Dec 3, 2014·The Journal of Emergency Medicine·Crystal L Voigt, Maurice O Murphy
May 25, 2012·Cephalalgia : an International Journal of Headache·Andreas R GantenbeinPeter S Sándor
Mar 5, 2015·Cephalalgia : an International Journal of Headache·Anna AmbrosiniJean Schoenen
Nov 20, 2014·Journal of Child Neurology·Trevor A SeegerKaren M Barlow
Mar 2, 2017·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Hanzade Aybüke Ünal-ArtıkTahir Kurtuluş Yoldaş
Jul 1, 2015·Cephalalgia : an International Journal of Headache·Chia-Chun ChiangDavid W Dodick
Mar 25, 2016·Cephalalgia : an International Journal of Headache·Anna Ambrosini, Jean Schoenen
May 13, 2018·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Kang-Jae ShinHun-Mu Yang
Jul 26, 2019·Neurology. Clinical Practice·Ajal DaveJack W Tsao
Dec 29, 2019·Plastic and Reconstructive Surgery·Radbeh TorabiOren Tessler
Sep 1, 2017·Expert Review of Neurotherapeutics·Abouch V Krymchantowski, Carla da Cunha Jevoux
May 5, 2021·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Arman ArabFariborz Khorvash
May 19, 2021·Neurology India·Debashish ChowdhuryAnkit Mundra

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