Ultrasound‑Guided Combined Greater Occipital Nerve Block at the C2 Level with Trapezius Trigger Point Injection and Supraorbital‑Supratrochlear Nerve Block: More Effective on Allodynia and Disability in Chronic Migraine
Annals of Indian Academy of Neurology, cilt.26, sa.6, ss.843-951, 2023 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 26 Sayı: 6
- Basım Tarihi: 2023
- Doi Numarası: 10.4103/aian.aian_677_23
- Dergi Adı: Annals of Indian Academy of Neurology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, CINAHL, EMBASE, Veterinary Science Database, Directory of Open Access Journals
- Sayfa Sayıları: ss.843-951
- Anahtar Kelimeler: Allodynia, migraine, nerve block, proximal GONB, trapezius muscle
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Chronic migraine (CM) patients with cutaneous allodynia (CA) show a poor response to treatment. Long-term studies have yet to be conducted to demonstrate the efficacy of blocks on CA. This study evaluated the improvement in allodynia and disability in CM treated with ultrasound (US)-guided blocks. Methods: In this prospective, non-randomized comparative study, 60 CM patients with CA were evaluated for the clinical effectiveness of the therapy using the numeric rating scale (NRS), headache impact test-6 (HIT-6), brush allodynia test, and allodynia symptom checklist (ASC-12). At the first visit, tenderness in the nerve or trapezius muscle was confirmed in the intervention group. US-guided greater occipital nerve block (GONB), GONB, and trapezius muscle injection (TPI), or GONB, TPI, and peripheral trigeminal nerve block (PTNB), respectively, were performed four times once a week for a month. Initial and third-month assessments were performed. Results: The ASC-12 scores decreased in the GONB+TPI+PTNB and GONB groups more than the GONB+TPI group (mean rank, respectively, 26.86, 27.40, 38.39; P = 0.018). The decrease in HIT-6 scores was greater in the GONB+TPI+PTNB group than in the GONB group (mean rank, respectively, 21.98, 39.95, P < 0.017) in the first month. In the third month, the GONB+TPI+PTNB group scored HIT-6 significantly lower than GONB and GONB+TPI (mean rank: 18.84, 38.73, 35.61; P < 0.001). Conclusions: GONB+TPI+PTNB was more successful in alleviating allodynia and disability.