Greater occipital nerve blockade in migraine, tension-type headache and cervicogenic headache

The blockade of the greater occipital nerve (GON) has been used in the treatment of migraine without aura (MWOA), tension-type headache (TTH) and cervicogenic headache (CH). There have been only a few reports about the effectiveness of the GON blockade in patients with MWOA and TTH and it has not yet been clarified whether or not it is a diagnostic tool for CH. In this study, we therefore investigated the diagnostic value of GON blockade in patients with CH, MWOA and TTH. Sixty patients who were affected by TTH, MWOA and CH participated in the study. They were divided into three main groups, each of which consisted of 20 patients with TTH, MWOA and CH respectively. Each group was then divided into two sub-groups with 10 patients, ten of whom were injected with 1 ml 2% prilocaine, and the other ten with 1 ml physiological saline (PS). Our results showed that GON blockade reduced pain in the orbitofrontal (OF) and orbitonuchal (ON) areas in patients with CH. In MWOA and TTH patients, GON blockade reduced pain only in the ON area. In the light of these findings, we may conclude that GON blockade is a diagnostic tool if it is effective in the ON and OF areas.