Bilateral stellate ganglion block for migraine

Abstract

Rationale: Migraine is a recurrent, disabling neurovascular headache disorder. The patient's quality of life can be severely impaired by migraine attacks. Stellate ganglion block (SGB) can be used to relieve pain in the head, neck, and upper extremities. In the present cases, we performed SGB in 2 patients with migraine that responds poorly to drugs. Patient concerns: Patients 1 and 2 suffered from chronic, bilateral pulsating headache, accompanied by nausea and vomiting. Patient 1 presented with headache of 8 on the visual analog scale (VAS), and 37 on the migraine disability assessment (MIDAS). Patient 2 reported headache of 7 on the VAS, and 32 on the MIDAS. Diagnosis: The patients were diagnosed with migraine without aura based on the International Classification of Headache Disorders version 3. Interventions: Patient 1 was treated with bilateral SGB every week for a month and then every month for 3 months. Patient 2 received bilateral SGB every 2 weeks for a month and then every month for 3 months. Outcomes: Four months after SGB, patient 1 reported pain intensity of 4 on VAS and 6 on MIDAS and patient 2 rated pain intensity of 3 on VAS, and 6 on MIDAS, respectively. Lessons: The SGB can be an effective option to improve headache-related disability and relieve pain intensity in the patients with refractory migraine.

Real-Time Ultrasound-Guided Stellate Ganglion Block for Migraine: An Observational Study

“…The application of trigger point therapy in migraine has also been reported [22]. Moreover, SGB block has been con rmed to effectively treat migraine [4]. However, studies evaluating SGB in the treatment of migraine are limited, and even a case report shows that SGB causes migraine attacks [23].…”

“…In addition, migraine-related disability and malpractice cause substantial nancial costs [3]. Although there are some drugs for acute treatment and prevention of migraine, other treatment options for patients with poor drug response or intolerance to drug treatment should be considered [4].…”

“…However, the time point of pain assessment was 1 day after SGB, with no long-term follow-up data. One study showed that bilateral SGB was effective to reduce pain and improve the Migraine Disability Assessment Scale (MIDAS) score in two migraine patients [4].…”

Treatment of stellate ganglion block in diseases: Its role and application prospect

“…Although the mechanism of pain remains unclear, the application of SGB in the treatment of various types of pain remains feasible. Studies have revealed that the application of SGB to alleviate most of the symptoms of migraine in the treatment of migraine[ 11 , 12 ] and cluster headache[ 13 ] may be attributed to the inhibition of sympathetic overactivity or weakening of vascular inflammatory response. Furthermore, a previous study reported that ultrasound-guided SGB can effectively relieve cervical headache[ 14 ].…”

Ultrasound‐guided stellate ganglion block for the treatment of migraine in elderly patients: A retrospective and observational study

“…Stellate ganglion block (SGB), a well‐established anesthesia technique, is performed for the treatment of head, face, neck, and upper limb pain 10–12 . Recent findings showed that SGB is beneficial for migraine 13,14 . Moon et al 13 first reported that two patients with refractory migraine (bilateral headache) had a significant reduction in headache intensity and improvement in headache‐related disability after receiving multiple bilateral SGBs.…”