Nerve Block for the Treatment of Headaches and Cranial Neuralgias – A Practical Approach

Dach, Fabíola; Éckeli, Alan Luiz; Ferreira, Karen dos Santos; Speciali, José Geraldo

doi:10.1111/head.12516

Cited by 76 publications

(84 citation statements)

References 80 publications

(195 reference statements)

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“…I also argue that if a nerve is truly being compressed, it would likely manifest as a cranial neuralgia. If Dr. de Ru challenges that nerve blocks only work via peripheral mechanisms, how is it possible that nerve blocks can be useful for the treatment of primary headache disorders (migraine, cluster headache, and nummular headache) in addition to cranial neuralgias (glossopharyngeal and occipital neuralgia)? BTX injections and nerve blocks may be useful screening tools, but the results should not be taken in isolation as grounds to proceed with surgery.…”

Section: Dr Mathew's Commentsmentioning

confidence: 99%

Cranial Neuralgia vs Entrapment Neuropathy Decompression … Better Names Than Migraine Trigger Site Deactivation Surgery

Mathew

Robbins

2015

Headache

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Section: Dr Mathew's Commentsmentioning

confidence: 99%

Cranial Neuralgia vs Entrapment Neuropathy Decompression … Better Names Than Migraine Trigger Site Deactivation Surgery

Mathew

Robbins

2015

Headache

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“…[7,8] Based on this view, an appropriate therapeutic method directed at cervical nociceptive structures offers benefit for CEHs. After evaluating the upper cervical nerve root and facet joints, [9,10] the role of degenerative cervical discs in CEHs was noticed. [11,12] Since surprising headache relief after standard neck surgery for myelopathy or radicular shoulder-arm syndrome was previously reported, [11,12] a positive association between CEHs and open cervical surgery has been indicated.…”

Section: Introductionmentioning

confidence: 99%

Cervicogenic headache alleviation after cervical coblation nucleoplasty

Yue

Yang

et al. 2016

Medicine

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A degenerative cervical disc is a pain generator for headaches, and headaches can benefit from cervical prolapse surgery. However, as an alternative intervention for open cervical surgery, no study has reported whether headaches can benefit from cervical nucleoplasty.The objective of this study was to evaluate the efficacy of cervical coblation nucleoplasty in the treatment of cervicogenic headaches.In a prospective cohort study performed between December 2013 and August 2015, 20 patients with cervicogenic headaches undergoing cervical nucleoplasty for shoulder-arm pain were recruited into group C, and 20 patients with cervicogenic headaches undergoing lumbar nucleoplasty for low back pain, matched for age and sex, were recruited into group L. Cervicogenic pain was diagnosed according to the International Headache Society criteria. During the 24-month follow-up, pain visual analog scale (VAS) scores were collected as the primary outcomes, and significant pain relief rate, Neck Disability Index (NDI) headache scores, and Patients Satisfaction Index (PSI) scores were recorded as secondary outcomes to evaluate headache severity and physical function postoperatively.During the 24-month follow-up, a significant decrease in headache VAS scores was observed in group C but not in group L. NDI and PSI scores in group C were better than those in group L. In comparison with the final follow-up, no significant differences in the NDI and PSI scores were found in all observations after surgery. In comparison to group L, ≥50% pain relief was significantly better in group C. No serious complications were observed except for ≤20% of ecchymoma at the needle insertion site.This prospective study indicated that cervicogenic headaches may benefit from nucleoplasty.

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“…When the greater occipital nerve, lesser occipital nerve, or auriculotemporal nerve is painful at palpation, they suggest to block the nerve(s) with a solution of lidocaine and dexamethasone. If supraorbital, infraorbital, supratrochlear, or infratrochlear nerves are painful, they are blocked only with lidocaine due to aesthetic issues (application of corticosteroids on the face or forehead is linked with skin atrophy, hyper‐ or hypopigmentation, and hair loss) …”

mentioning

confidence: 99%

“…On the other hand, in relation to the treatment of headache attributed to craniotomy, Dach et al suggest amitriptyline and blockade of all painful points found in the scar.…”

mentioning

confidence: 99%