Peripheral Nerve Blocks in Adolescents with Medically Refractory Migraine: A Retrospective Observational Study

Area of Science:

• Neurology
• Pain Medicine
• Pediatric Neurology

Background:

• Medically refractory migraine poses a significant challenge in adolescent populations.
• Limited effective treatment options exist for adolescents with severe, persistent migraines.
• Preventive therapies often show inadequate response in this demographic.

Purpose of the Study:

• To assess the efficacy and safety of peripheral nerve blocks (PNB) for adolescents experiencing medically refractory migraine.
• To evaluate the impact of PNB on headache frequency, pain severity, and functional outcomes.
• To determine the tolerability and adverse event profile of PNB in this patient group.

Main Methods:

• A study involving 28 adolescents with inadequate response to standard migraine therapies.
• Greater occipital nerve (GON) and/or lesser occipital nerve (LON) blocks administered across three sessions, spaced 8 weeks apart.
• Pain severity measured via Visual Analog Scale (VAS); functional outcomes and pain relief assessed through a structured questionnaire.

Main Results:

• Mean monthly migraine frequency decreased from 14.4 to 4.7 days post-treatment.
• Mean VAS pain scores reduced from 7.7 to 3.3.
• Significant improvements in pain control and patient-reported daily functioning were observed, with 18 patients showing marked benefit. Adverse effects were mild and transient.

Conclusions:

• Peripheral nerve blocks, specifically GON and LON blockade, demonstrate potential in reducing headache frequency and severity in adolescents with refractory migraine.
• PNB may enhance patient-reported daily functioning, offering a viable therapeutic avenue.
• Larger, controlled studies are recommended to further validate these findings and establish PNB as a standard treatment.