title: Pericranial nerve blockade as a preventive treatment for migraine: Experience in 60 patients.
abstract: BACKGROUND
  Anaesthetic blockade of pericranial nerves is frequently used to treat headache disorders. There is no evidence on indication of this treatment for migraine. We aim to evaluate its effectiveness as a preventive treatment for migraine using specific indication criteria.
  
  
  METHODS
  Between January 2009 and May 2013 we offered pericranial nerve blockade to migraine patients with a history of preventive drug intolerance or failure. We selected patients with tenderness to palpation of at least one greater occipital nerve (GON) or supraorbital nerve (SON). Responses at 3 months were categorised as complete response (no pain), partial response (reduction of at least 50% in severity or frequency of headache episodes), or no response.
  
  
  RESULTS
  Anaesthetic blockade was performed in 60 patients (52 females, 8 males; mean age 40.6 ± 12.4 years, range 19-76). The most common procedure was blockade of GON and SON on both sides. Complete response lasting at least 2 weeks was recorded in 23 patients (38.3%), with partial response in 24 patients (40%), and no response in 13 (21.7%). In the group presenting complete response, age and length of history of migraine were significantly lower. No severe side effects were detected. Response time ranged from 2 weeks to 3 months.
  
  
  CONCLUSIONS
  Pericranial nerves blockade using tenderness to palpation as an inclusion criterion is safe and potentially effective as prophylactic treatment for migraine. The best responses in our series were observed in younger patients with shorter histories of migraine.
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: M
authors.initials: M
authors.lastname: Ruiz Piñero
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: P
authors.initials: P
authors.lastname: Mulero Carrillo
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: M I
authors.initials: MI
authors.lastname: Pedraza Hueso
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: C
authors.initials: C
authors.lastname: de la Cruz Rodríguez
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: L
authors.initials: L
authors.lastname: López Mesonero
authors.affiliation: Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España. Electronic address: gueneurol@gmail.com.
authors.forename: A L
authors.initials: AL
authors.lastname: Guerrero Peral
mesh_terms: D000328:Adult; D000368:Aged; D000758:Anesthesia; D003391:Cranial Nerves; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis / Q000517:prevention & control*; D009407:Nerve Block / Q000379:methods*; D010173:Palpation; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anaesthetic blockade; Bloqueo anestésico; Chronic migraine; Great occipital nerve; Migraine; Migraña; Migraña crónica; Nervio occipital mayor; Nervio supraorbitario; Preventive therapy; Supraorbital nerve; Tratamiento preventivo