The first 5 minutes after greater occipital nerve block

Abstract

We performed greater occipital nerve blocks on 24 migraineurs with unilateral migraine and trigeminal nerve distribution allodynia. Using a visual analog scale for migraine pain, brush allodynia in the trigeminal nerve distribution and photophobia were reduced 64%, 75%, and 67%, respectively, after 5 minutes. Allodynia improved faster than headache. The results of this study suggest that greater occipital nerve blocks initiate an inhibitory process that shuts down several symptom generators.

Conflict of interest statement

Conflict of Interest: None

Figures

Figure

Percent change in visual analog scale (VAS) score for headache pain, brush allodynia, and photophobia over 300 seconds. The anchors for headache pain were “worst it can be” and severe; for allodynia and photophobia were “worst it can be.” Percent of initial VAS pain, allodynia, and photophobia scores over 5 minutes (a) and survival curves for 50% response on VAS for pain and for allodynia (b). The estimated hazard of achieving a 50% reduction in baseline VAS score was 1.5 times (95% CI = 1.04, 2.19) greater for allodynia than headache.