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Occipital nerve block prior to occipital nerve stimulation for refractory chronic migraine and chronic cluster headache: myth or prediction?

AbstractBACKGROUND:
Occipital nerve stimulation (ONS) results in beneficial outcomes, with marked pain relief, in otherwise intractable chronic migraine (CM) and chronic cluster headache (CCH). Some studies have reported that a positive response to occipital nerve block (ONB) administered prior to ONS predicts a positive response to ONS. However, other studies concerned with proper patient selection claimed no predictive value for ONB. The aim of this study was to re-evaluate the usefulness and predictive value of ONB prior to ONS.
METHODS:
Literature searches on the predictive value of ONB were performed in MEDLINE and PubMed. Patient data were extracted and a pooled analysis was performed.
RESULTS:
The literature review revealed 133 patients with CM and seven patients with CCH who received preoperative ONB. To date, a randomized controlled study examining the relationship between ONB and ONS has not been conducted in patients with CM.
CONCLUSIONS:
Current literature suggests that ONB does not sufficiently predict ONS responsiveness in patients with refractory CM and CCH; this important issue requires further investigation.
AuthorsThomas M Kinfe, Patrick Schuss, Hartmut Vatter
JournalCephalalgia : an international journal of headache (Cephalalgia) Vol. 35 Issue 4 Pg. 359-62 (Apr 2015) ISSN: 1468-2982 [Electronic] England
PMID24989870 (Publication Type: Journal Article, Review)
Copyright© International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Topics
  • Cluster Headache (therapy)
  • Humans
  • Migraine Disorders (therapy)
  • Nerve Block (methods)
  • Peripheral Nerves (physiology)
  • Skull (innervation)
  • Transcutaneous Electric Nerve Stimulation (methods)

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