Efficacy of the greater occipital nerve block in recurrent migraine type headaches

We aimed to evaluate six months of results following repeated GON blocks.

We evaluated the results from GON block performed on 60 patients. Briefly, we applied a standard 2 mL of 0.5% Bupivacaine GON blockage once a week for 4 weeks. We recorded the Visual Analog Scale (VAS) scores, the number of migraine attacks and the Migraine Disability Assessment Questionnaire (MIDAS) scores. The study subjects were not allowed to use medication for prophylaxis, and Ibuprofen (400 mg, 1200 mg at maximum) was prescribed for any migraine attacks.

The initial mean number of attacks per month before starting treatment was 8.33+2.31. After treatment, the initial MIDAS mean was found to be 2.82 per month; this declined to 1.47 in 3rd, and was 1.50 in the 6th month. The individual month values were found to be significant, and were listed respectively as, 1st month: 3.95+2.52, 2nd month: 3.23+1.82, 3rd month: 2.60+1.90, 4th month: 2.68+2.10, 5th month: 2.58+1.90 and 6th month: 2.58+1.90. The mean VAS scores were recorded as follows for each month: 6.28±1.24, 3.13±0.97, 2.55±1.19, 2.35±1.26, 2.38±1.20 and 2.48±1.30, respectively. This difference was noted to be statistically significant. No difference regarding the efficacy of the treatment was determined when the results were compared across age groups.

We assume that GON blockage with 2 mL of 0.5% Bupivacaine can be a supportive treatment in migraine treatment, with no serious adverse effects reported.