title: Pulsed radiofrequency therapy versus greater occipital nerve block in the management of refractory cervicogenic headache - a pilot study.
abstract: The aim of this pilot study was to compare the efficacy of pulsed           radiofrequency to the greater occipital nerve versus a greater occipital nerve block           with a mixture of local anaesthetic and steroid in the management of refractory           cervicogenic headache. We enrolled 30 patients suffering from refractory           cervicogenic headache. Patients were randomly allocated into two groups of fifteen.           A greater occipital nerve block with steroid was utilised in group A, while a pulsed           radiofrequency treatment was employed in group B. Success of both procedures           was evaluated by comparing pre and post intervention Visual Analogue Scale of           pain, Medication Quantification Scale - III. and Global Perceived Effect at three and           9 months after the procedures. At three months post therapy a significant decrease           in Visual Analogue Scale (p<0.001) was identified (3.2 points in group A, 3.3 points           in group B respectively). In group B pain remained reduced even after 9 months           (p<0.001) when compared to pre treatment scores. The consumption of analgesic           medication was reduced significantly in both groups at three months (p<0.001)           and 9 months (p<0.01), respectively. No serious complication was noted. Greater           occipital nerve block is a safe, efficient technique in the management of cervicogenic           headaches. Despite the lack of high quality scientific evidence (level III or IV) in           the literature, we have extensive experience with steroid application and pulsed           radiofrequency to the greater occipital nerve and report the beneficial results           in our study.
authors.affiliation: Department of Anesthesiology and Intensive Care, Faculty of Medicine and Dentistry, Palacký University in Olomouc and University Hospital Olomouc, Czech Republic. gabrhelikt@post.cz
authors.forename: T
authors.initials: T
authors.lastname: Gabrhelík
authors.forename: P
authors.initials: P
authors.lastname: Michálek
authors.forename: M
authors.initials: M
authors.lastname: Adamus
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010147:Pain Measurement; D051298:Post-Traumatic Headache / Q000628:therapy*; D061208:Pulsed Radiofrequency Treatment; D055815:Young Adult