Multiple Cranial Nerve Blocks as an Alternative Preventative Therapy for Chronic Migraine

Area of Science:

• Neurology
• Pain Management

Background:

• Multiple cranial nerve blocks (MCNBs), including greater occipital nerve (GON) blocks, are utilized for acute migraine treatment.
• Limited evidence exists regarding the efficacy of repeated MCNBs for chronic migraine prevention.

Purpose of the Study:

• To evaluate the effectiveness of multiple cranial nerve blocks (MCNBs) as a preventative therapy for chronic migraine.

Main Methods:

• A prospective cohort study involving 64 chronic migraine patients treated between June 2017 and March 2019.
• Data collected included demographic information, reduction in headache days, Headache Impact Test 6 (HIT6) scores, and patient-reported effectiveness.
• Patients received either occipital nerve blocks alone or combined occipital and trigeminal nerve blocks.

Main Results:

• A mean reduction of 5.4 headache days and 5.3 points in HIT6 scores was observed post-MCNBs.
• 66% of patients experienced at least a 30% reduction in headache days, with an average duration of effect of 5.7 weeks.
• 13 patients transitioned to low-frequency episodic migraine, while 34% showed no significant improvement.

Conclusions:

• Repetitive MCNBs can be an effective preventative strategy for patients suffering from chronic migraine.
• The study supports the use of MCNBs for long-term management of chronic migraine.
• Minor complications were infrequent, occurring in 8% of injections.