[Cervicogenic headaches: aspects of diagnosis and analgesia]

Eighty-six patients with cervicogenic headaches underwent a comprehensive clinical and instrumental studies involving neurological and neuroorthopedic examinations; pain rating by the visual-analogue scale (VAS) and the rank scale, and neuroimaging and electrophysiologic techniques. The patients were divided into two groups: a study group (n = 43) and a control one (n = 43). In the study group, treatment policy was determined by the intensity and duration of the pain syndrome: local anesthetic blocks of the occipital nerve, facet joints, and the trigger points of the cervicocranial area were used to arrest acute pain of a VAS score of 5 or more. With a pain syndrome score of less than 5, treatment was initiated with reflex exposures. All the patients from the study group took nonsteroidal anti-inflammatory drugs (NSAID) and, if required, central myorelaxants. The control group received the conventional therapy, including drug (NSAID, central myorelaxants, and anticonvulsants) and non-drug (physiotherapy and massage) ones. Medicinal blocks and reflex analgesia could relieve the pain syndrome in cervicogenic headaches in shorter periods and reduce the dosage of the drugs used in the study group patients as compared with the controls.