Greater Occipital Nerve Infiltration During Pregnancy in Cluster Headache: A Case Report

Asioli, Gian Maria; Merli, Elena; Favoni, Valentina; Sartori, A.; Pierangeli, Giulia; Cevoli, Sabina

doi:10.1111/head.13553

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…It was not possible to assess a dose–response effect within any of the studies as no patients received sequential injections with different dosages. Only one of the five studies had sufficient reporting of the GON blockade technique to allow for replication 33…”

Section: Resultsmentioning

confidence: 99%

Effectiveness and safety profile of greater occipital nerve blockade in cluster headache: a systematic review

Gordon

Roe

Villar-Martínez

et al. 2023

J Neurol Neurosurg Psychiatry

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BackgroundGreater occipital nerve (GON) blockade is a short-term preventive therapy for cluster headache (CH). We conducted a systematic review to evaluate the effectiveness and safety of GON blockade in patients with CH.MethodsOn 23 October 2020, we searched MEDLINE, Embase, Embase Classic, PsycINFO, CINAHL, CENTRAL and Web of Science databases from their inception date. Studies included participants with a CH diagnosis who received corticosteroid and local anaesthetic suboccipital region injections. Outcomes were change in the frequency/severity/duration of attacks; proportion of participants responding to treatment, time to attack freedom from an attack, change in attack bout length and/or the presence of adverse effects after GON blockade. Risk of bias was assessed with the Cochrane Risk of Bias V.2.0 (RoB2)/Risk of Bias in Non-randomized Studies - of Interventions (ROBINS- I) tools and a specific tool for case reports/series.ResultsTwo RCTs, eight prospective and eight retrospective studies, and four case reports were included in the narrative synthesis. Every effectiveness study found a significant response in one or more of frequency/severity/duration of individual attacks or proportion of patients responding to treatment (47.8%–100.0%). There were five instances of potentially irreversible adverse effects. A higher injectate volume and use of concurrent prophylaxis may be associated with an increased likelihood of response. Methylprednisolone may have the best safety profile of available corticosteroids.DiscussionGON blockade is safe and effective for CH prevention. Higher injectate volumes may improve likelihood of response, and the likelihood of serious adverse events may be reduced by using methylprednisolone.PROSPERO registration numberCRD42020208435.

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Section: Resultsmentioning

confidence: 99%