Evaluation of Treatment Results and Quality of Life in Patients with Refractory Headache, Treated with Nerve Block

Document Type : Original Article

Authors

1 Department of Neurology, School of medicine, Ardabil University of Medical Science, Ardabil,Iran

2 Department of Community Medicine, School of medicine, Ardabil University of Medical Science, Ardabil,Iran

3 School of medicine, Ardabil University of Medical Science, Ardabil,Iran

Abstract

Introduction:
Headache is one of the most common causes of emergency hospitalizations in world. Different therapies are used in both acute and prophylactic phase of headaches, but some patients do not have great response to pharmaceutical therapies. These patients can benefit from injection of peripheral nerve blocks depending on the headache type. This study aimed to evaluate the effects of nerve blocks in treatment of patients with refractory primary headaches.
Materials and Methods:
This cross-sectional study was done on 187 patients who refered to the emergency of Alavi hospital in Ardabil at year 2021 that hadnot response to the decrease in severity of headache up to 50% based on MIDAS and also cured with nerve blocks. The necessary cheklist were completed for all patients and the severity, frequency and the interval of headaches were registered and compared in one day, one week and one month after the blocks  and collected data were analyzed by statistical test like independent and Paired t-tests and Anova in SPSS version 21.
Results:
The mean severity of headache in patients significantly decreased during the study periods compared to before nerve blocker injection. The most common complications after nerve block in patients were anesthetized with 53%, followed by injection site pain and swelling each with 22.5% and then tachycardia with 19.8%.
Conclusion:
Peripheral nerve block in patients with primary headache can reduce the severity of pain in one month after the block nerve injection and in acute phase it can improve symptoms in middle-term.

Keywords

Main Subjects

References

  1. Lucado J, Paez K, Elixhauser A. Headaches in US Hospitals and Emergency Departments, 2008: Statistical Brief. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. 2011; 24: 1 – 12.
  2. Smitherman TA, Burch R, Sheikh H, Loder E. The prevalence, impact, and treatment of migraine and severe headaches in the United States: a review of statistics from national surveillance studies. Headache. 2013; 53 (3): 427– 36
  3. Yu SY, Cao XT, et al. The burden of headache in China: Validation of diagnostic questionnaire for a population-based survey. J Headache Pain. 2011; 12:141-146.
  4. Soto E, Bobr V, Bax JA. Interventional techniques for headaches. Techniques in Regional Anesthesia & Pain Managament. 2012; 16:30-40.

5.Fundementals of pain medicine,1st edition, Cleveland, OH, USA: Springer; 2018;31:281–282.

  1. Linde M, Gustavsson A, Stovner L.J, Steiner T.J, Barré J, Katsarava Z, ET AL. The cost of headache disorders in Europe: the Eurolight project. European Journal of Neurology.2012; 19: 703-711. https://doi.org/10.1111/j.1468-1331. 2011. 03612.x
  2. Bloudek L.M, Stokes M, Buse D.C. Cost of healthcare for patients with migraine in five European countries: results from the International Burden of Migraine Study (IBMS). J Headache Pain.2012; 13, 361–378. https:// doi. org/10. 1007/s10194-012-0460-7.
  3. Allen SM, Mookadam F, Cha SS, Freeman JA, Starling AJ, Mookadam M. Greater occipital nerve block for acute treatment of migraine headache: a large retrospective cohort study. The Journal of the American Board of Family Medicine. 2018; 31(2):211-8.
  4. Wahab S, Kataria S, Woolley P, O'Hene N, Odinkemere C, Kim R, Urits I, Kaye AD, Hasoon J, Yazdi C, Robinson CL. Literature Review: Pericranial Nerve Blocks for Chronic Migraines. Health Psychol Res. 2023 Apr 29; 11:74259. doi: 10.52965/001c.74259. PMID: 37139462; PMCID: PMC10151122.
  5. Ashkenazi A, Young WB. The effects of greater occipital nerve block and trigger point injection on brush allodynia and pain in migraine. Headache. 2005; 45:350–4.
  6. Cuadrado ML, Aledo-Serrano A, Navarro P. Short-term effects of greater occipital nerve blocks in chronic migraine: a double-blind, randomised, placebo-controlled clinical trial. Cephalalgia. 2017; 72-37:864
  7. Chowdhury D, Datta D, Mundra A. Role of Greater Occipital Nerve Block in Headache Disorders: A Narrative Review. Neurol India. 2021 Mar- Apr; 69(Supplement): S228-S256. doi: 10.4103/0028-3886.315993. PMID: 34003170.
  8. Reed KL, Black SB, Banta CJ 2nd, Will KR. Combined occipital and supraorbital neurostimulation for the treatment of chronic migraine headaches: initial experience. Cephalalgia. 2010; 30:260–71.
  9. Leinisch-Dahlke E, Jürgens T, Bogdahn U, Jakob W, May A. Greater Occipital Nerve Block is Ineffective in Chronic Tension Type Headache. Cephalalgia. 2005;25(9):704-708.
  10. Hascalovici JR, Robbins MS. Peripheral nerve blocks for the treatment of headache in older adults: a retrospective study. Headache: The Journal of Head and Face Pain. 2017;57(1):80-6.
  11. Stern JI, Chiang CC, Kissoon NR, Robertson CE. Narrative review of peripheral nerve blocks for the management of headache. Headache. 2022 Oct;62(9):1077-1092. doi: 10.1111/head.14385. PMID: 36286600.
  12. Han KR, Kim C, Chae YJ, Kim DW. Efficacy and safety of high concentration lidocaine for trigeminal nerve block in patients with trigeminal neuralgia. International journal of clinical practice. 2008;62(2):248-54.
  13. Hascalovici JR, Robbins MS. Peripheral Nerve Blocks for the Treatment of Headache in Older Adults: A Retrospective Study. Headache. 2017 Jan;57(1):80-86. doi: 10.1111/head.12992. Epub 2016 Nov 30. PMID: 27901275.
  14. Fernandes L, Randall M, Idrovo L. Peripheral nerve blocks for headache disorders. Practical Neurology. 2021;21(1):30-5.
Journal of Patient Safety & Quality Improvement
Volume 11, Issue 4
October 2023
Pages 215-222

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