Greater occipital nerve blocks in chronic cluster headache: a prospective open-label study.
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| Title: | Greater occipital nerve blocks in chronic cluster headache: a prospective open-label study. |
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| Authors: | Lambru, G., Abu Bakar, N., Stahlhut, L., McCulloch, S., Miller, S., Shanahan, P., Matharu, M. S. |
| Source: | European Journal of Neurology. Feb2014, Vol. 21 Issue 2, p338-343. 6p. |
| Subjects: | National Hospital for Neurology & Neurosurgery (London, England), Cluster headache, Adrenocortical hormones, Local anesthetics, Cerebrovascular disease |
| Abstract: | Background and purpose Greater occipital nerve blockade ( GONB) has been shown to be effective in episodic cluster headache. However, its use in chronic cluster headache ( CCH) is less certain. The study aims to prospectively assess the efficacy and consistency of response to GONB in a large series of CCH patients. Methods CCH patients who had a unilateral GONB and were referred to the National Hospital for Neurology and Neurosurgery were studied prospectively. Headache characteristics were collected using headache diaries. Responders were considered to be patients with a complete or partial response lasting at least 7 days. In a subgroup of responders the outcomes of serial GONB performed at 3-monthly intervals were also analysed. Results Eighty-three CCH patients were studied. After the first GONB, a positive response was observed in 47 (57%) patients: 35 (42%) were rendered pain free, 12 (15%) had a partial benefit and one patient obtained <50% improvement. The duration of a positive response lasted a median of 21 days (range 7-504 days). There was a transient worsening of condition in 6% of patients. The overall rate and average duration of response remained consistent after the second [ n = 37; 31 responders (84%); median duration 21 days], third [ n = 28; 20 responders (71%); median duration 25 days] and fourth [ n = 14; 10 responders (71%); median duration 23 days] injections. Conclusion GONB seems to be an efficacious treatment with reproducible effects in CCH patients. Performed three monthly, GONB may have a useful role in the management of CCH. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | Background and purpose Greater occipital nerve blockade ( GONB) has been shown to be effective in episodic cluster headache. However, its use in chronic cluster headache ( CCH) is less certain. The study aims to prospectively assess the efficacy and consistency of response to GONB in a large series of CCH patients. Methods CCH patients who had a unilateral GONB and were referred to the National Hospital for Neurology and Neurosurgery were studied prospectively. Headache characteristics were collected using headache diaries. Responders were considered to be patients with a complete or partial response lasting at least 7 days. In a subgroup of responders the outcomes of serial GONB performed at 3-monthly intervals were also analysed. Results Eighty-three CCH patients were studied. After the first GONB, a positive response was observed in 47 (57%) patients: 35 (42%) were rendered pain free, 12 (15%) had a partial benefit and one patient obtained <50% improvement. The duration of a positive response lasted a median of 21 days (range 7-504 days). There was a transient worsening of condition in 6% of patients. The overall rate and average duration of response remained consistent after the second [ n = 37; 31 responders (84%); median duration 21 days], third [ n = 28; 20 responders (71%); median duration 25 days] and fourth [ n = 14; 10 responders (71%); median duration 23 days] injections. Conclusion GONB seems to be an efficacious treatment with reproducible effects in CCH patients. Performed three monthly, GONB may have a useful role in the management of CCH. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 13515101 |
| DOI: | 10.1111/ene.12321 |
