Greater occipital nerve blockade in cervicogenic headache.
Cervicocogenic headache (CeH) is a relatively common disorder. Although on ideal treatment is available so far, blockades in different structures and nerves may be temporarily effective. We studied the effects of 1-2 mL 0.5% bupivacaine injection at the ipsilateral greater occipital nerve (GON) in 41 CeH patients. The pain is significantly reduced both immediately and as long as 7 days after the blockade. The improvement is less marked during the first two days, a phenomenon we called "tilde pattern". GON blockades may reduce the pool of exaggerated sensory input and antagonize a putative "wind-up-like effect" which may explain the headache improvement.
Vincent
M B
MB
Serviço de Neurologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Brasil. vincent@unisys.com.br
Luna
R A
RA
Scandiuzzi
D
D
Novis
S A
SA
D000704:Analysis of Variance; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002045:Bupivacaine / Q000627:therapeutic use*; D003391:Cranial Nerves; D005260:Female; D006261:Headache / Q000188:drug therapy*; D006801:Humans; D008297:Male; D009333:Neck; D009407:Nerve Block / Q000379:methods*; D009778:Occipital Lobe; D013997:Time Factors
D000779:Anesthetics, Local; D002045:Bupivacaine