Greater occipital and supraorbital nerve blockade for the preventive treatment of migraine: a single-blind, randomized, placebo-controlled study

Abstract

Objective: Nerve injections have been used for the acute and preventive treatment of migraine in recent decades. Most of these injections focused on greater occipital nerve (GON) blockade. However, few studies were placebo controlled, and only a few of them investigated GON and supraorbital nerve (SON) blockade together. This study aimed to evaluate the efficacy of GON and SON blockade with local anesthetics for the preventive treatment of migraine without aura.

Methods: Eighty-seven patients diagnosed with migraine without aura were included in the study. Patients were divided randomly. One group was injected with 1% lidocaine, the other group was injected with 0.9% saline. GON and SON injections were done bilaterally. The injections were repeated weekly for 3 weeks. Patients were followed up for 2 months to assess clinical response.

Results: Seventy-one patients completed the study. After 2 months, the number of headache days decreased significantly from 12.8 ± 10.9 to 5.3 ± 7.4, and VAS decreased from 8.3 ± 1.0 to 5.5 ± 1.9 in the blockade group. The number of headache days decreased from 12.4 ± 10.3 to 7.5 ± 7.2 and VAS decreased from 8.2 ± 1.1 to 7.4 ± 1.3 in the placebo group. Response was seen in 65.1% of the patients in the blockade group (65.4% for episodic migraine, 64.7% for chronic migraine) and 28.6% of the patients in the placebo group. The difference was significant.

Conclusions: The results suggest that GON and SON blockade with lidocaine was more effective than the placebo in the prophylactic treatment of both episodic and chronic migraine.

Trial registration: ClinicalTrials.gov identifier: NCT03435185.

Keywords:

• Headache
• Local Anesthetics
• Migraine
• Nerve Blocks
• Pain

Transparency

Declaration of financial/other interests

The authors declare that there is no conflict of interest regarding the publication of this paper. CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Data availability

The authors confirm that the data supporting the findings of this study are available within the article or its supplementary materials.

Acknowledgments

We thank our colleagues from the University of Health Sciences who provided insight and expertise that greatly assisted the research. We thank Jessica Wells for assistance with editing and for comments that greatly improved the manuscript.

Additional information

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.