title: Nerve block for the treatment of headaches and cranial neuralgias - a practical approach.
abstract: BACKGROUND
  Several studies have presented evidence that blocking peripheral nerves is effective for the treatment of some headaches and cranial neuralgias, resulting in reduction of the frequency, intensity, and duration of pain.
  
  
  OBJECTIVE
  In this article we describe the role of nerve block in the treatment of headaches and cranial neuralgias, and the experience of a tertiary headache center regarding this issue. We also report the anatomical landmarks, techniques, materials used, contraindications, and side effects of peripheral nerve block, as well as the mechanisms of action of lidocaine and dexamethasone.
  
  
  CONCLUSIONS
  The nerve block can be used in primary (migraine, cluster headache, and nummular headache) and secondary headaches (cervicogenic headache and headache attributed to craniotomy), as well in cranial neuralgias (trigeminal neuropathies, glossopharyngeal and occipital neuralgias). In some of them this procedure is necessary for both diagnosis and treatment, while in others it is an adjuvant treatment. The block of the greater occipital nerve with an anesthetic and corticosteroid compound has proved to be effective in the treatment of cluster headache. Regarding the treatment of other headaches and cranial neuralgias, controlled studies are still necessary to clarify the real role of peripheral nerve block.
authors: Headache Clinic, University Hospital of School of Medicine, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
authors: Fabíola
authors: F
authors: Dach
authors: Álan L
authors: ÁL
authors: Éckeli
authors: Karen Dos S
authors: Kdos S
authors: Ferreira
authors: José G
authors: JG
authors: Speciali
mesh_terms: D003389:Cranial Nerve Diseases / Q000150:complications / Q000628:therapy*; D006261:Headache / Q000628:therapy*; D006801:Humans; D009407:Nerve Block / Q000379:methods*; D009437:Neuralgia / Q000150:complications / Q000628:therapy*
keywords: facial pain; headache; lidocaine; nerve block; neuralgia; treatment