Cargando…

Nerve blocks for occipital headaches: A systematic review and meta-analysis

Migraine surgeons have identified six “trigger sites” where cranial nerve compression may trigger a migraine. This study investigates the change in headache severity and frequency following nerve block of the occipital trigger site. This PRISMA-compliant systematic review of five databases searched...

Descripción completa

Detalles Bibliográficos
Autores principales: Evans, Adam G., Joseph, Kardeem S., Samouil, Marc M., Hill, Dorian S., Ibrahim, Maryo M., Assi, Patrick E., Joseph, Jeremy T., Kassis, Salam Al
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10410037/
https://www.ncbi.nlm.nih.gov/pubmed/37564833
http://dx.doi.org/10.4103/joacp.JOACP_62_21
_version_ 1785086371103244288
author Evans, Adam G.
Joseph, Kardeem S.
Samouil, Marc M.
Hill, Dorian S.
Ibrahim, Maryo M.
Assi, Patrick E.
Joseph, Jeremy T.
Kassis, Salam Al
author_facet Evans, Adam G.
Joseph, Kardeem S.
Samouil, Marc M.
Hill, Dorian S.
Ibrahim, Maryo M.
Assi, Patrick E.
Joseph, Jeremy T.
Kassis, Salam Al
author_sort Evans, Adam G.
collection PubMed
description Migraine surgeons have identified six “trigger sites” where cranial nerve compression may trigger a migraine. This study investigates the change in headache severity and frequency following nerve block of the occipital trigger site. This PRISMA-compliant systematic review of five databases searched from database inception through May 2020 is registered under the PROSPERO ID: CRD42020199369. Only randomized controlled trials utilizing injection treatments for headaches with pain or tenderness in the occipital scalp were included. Pain severity was scored from 0 to 10. Headache frequency was reported as days per week. Included were 12 RCTs treating 586 patients of mean ages ranging from 33.7 to 55.8 years. Meta-analyses of pain severity comparing nerve blocks to baseline showed statistically significant reductions of 2.88 points at 5 to 20 min, 3.74 points at 1 to 6 weeks, and 1.07 points at 12 to 24 weeks. Meta-analyses of pain severity of nerve blocks compared with treatment groups of neurolysis, pulsed radiofrequency, and botulinum toxin type A showed similar headache pain severity at 1 to 2 weeks, and inferior improvements compared with the treatment groups after 2 weeks. Meta-analyses of headache frequency showed statistically significant reductions at 1 to 6-week follow-ups as compared with baseline and at 1 to 6 weeks as compared with inactive control injections. The severity and frequency of occipital headaches are reduced following occipital nerve blocks. This improvement is used to predict the success of migraine surgery. Future research should investigate spinous process injections with longer follow-up.
format Online
Article
Text
id pubmed-10410037
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Wolters Kluwer - Medknow
record_format MEDLINE/PubMed
spelling pubmed-104100372023-08-10 Nerve blocks for occipital headaches: A systematic review and meta-analysis Evans, Adam G. Joseph, Kardeem S. Samouil, Marc M. Hill, Dorian S. Ibrahim, Maryo M. Assi, Patrick E. Joseph, Jeremy T. Kassis, Salam Al J Anaesthesiol Clin Pharmacol Review Article Migraine surgeons have identified six “trigger sites” where cranial nerve compression may trigger a migraine. This study investigates the change in headache severity and frequency following nerve block of the occipital trigger site. This PRISMA-compliant systematic review of five databases searched from database inception through May 2020 is registered under the PROSPERO ID: CRD42020199369. Only randomized controlled trials utilizing injection treatments for headaches with pain or tenderness in the occipital scalp were included. Pain severity was scored from 0 to 10. Headache frequency was reported as days per week. Included were 12 RCTs treating 586 patients of mean ages ranging from 33.7 to 55.8 years. Meta-analyses of pain severity comparing nerve blocks to baseline showed statistically significant reductions of 2.88 points at 5 to 20 min, 3.74 points at 1 to 6 weeks, and 1.07 points at 12 to 24 weeks. Meta-analyses of pain severity of nerve blocks compared with treatment groups of neurolysis, pulsed radiofrequency, and botulinum toxin type A showed similar headache pain severity at 1 to 2 weeks, and inferior improvements compared with the treatment groups after 2 weeks. Meta-analyses of headache frequency showed statistically significant reductions at 1 to 6-week follow-ups as compared with baseline and at 1 to 6 weeks as compared with inactive control injections. The severity and frequency of occipital headaches are reduced following occipital nerve blocks. This improvement is used to predict the success of migraine surgery. Future research should investigate spinous process injections with longer follow-up. Wolters Kluwer - Medknow 2023 2023-04-25 /pmc/articles/PMC10410037/ /pubmed/37564833 http://dx.doi.org/10.4103/joacp.JOACP_62_21 Text en Copyright: © 2023 Journal of Anaesthesiology Clinical Pharmacology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Review Article
Evans, Adam G.
Joseph, Kardeem S.
Samouil, Marc M.
Hill, Dorian S.
Ibrahim, Maryo M.
Assi, Patrick E.
Joseph, Jeremy T.
Kassis, Salam Al
Nerve blocks for occipital headaches: A systematic review and meta-analysis
title Nerve blocks for occipital headaches: A systematic review and meta-analysis
title_full Nerve blocks for occipital headaches: A systematic review and meta-analysis
title_fullStr Nerve blocks for occipital headaches: A systematic review and meta-analysis
title_full_unstemmed Nerve blocks for occipital headaches: A systematic review and meta-analysis
title_short Nerve blocks for occipital headaches: A systematic review and meta-analysis
title_sort nerve blocks for occipital headaches: a systematic review and meta-analysis
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10410037/
https://www.ncbi.nlm.nih.gov/pubmed/37564833
http://dx.doi.org/10.4103/joacp.JOACP_62_21
work_keys_str_mv AT evansadamg nerveblocksforoccipitalheadachesasystematicreviewandmetaanalysis
AT josephkardeems nerveblocksforoccipitalheadachesasystematicreviewandmetaanalysis
AT samouilmarcm nerveblocksforoccipitalheadachesasystematicreviewandmetaanalysis
AT hilldorians nerveblocksforoccipitalheadachesasystematicreviewandmetaanalysis
AT ibrahimmaryom nerveblocksforoccipitalheadachesasystematicreviewandmetaanalysis
AT assipatricke nerveblocksforoccipitalheadachesasystematicreviewandmetaanalysis
AT josephjeremyt nerveblocksforoccipitalheadachesasystematicreviewandmetaanalysis
AT kassissalamal nerveblocksforoccipitalheadachesasystematicreviewandmetaanalysis