Efficacy and safety of ultrasound-guided peripheral nerve blocks in management of chronic resistant migraine.

IF 7.3 1区医学 Q1 CLINICAL NEUROLOGY

Journal of Headache and Pain Pub Date : 2025-04-16 DOI:10.1186/s10194-025-02013-3

Nourhan Abdelmohsen Taha, Mai Fathy, Ahmed Elsadek, Tamer Hussein Emara, Sherien Mohamed Farag, Ramez Reda Moustafa, Mohamad Osama Abdulghani

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引用次数: 0

Abstract

Background: Migraine is a common primary headache disorder with different treatment modalities emerging as ultrasound guided peripheral nerve blocks. We compared the efficacy and safety of ultrasound guided bilateral sphenopalatine ganglion (SPG) block versus bilateral greater occipital nerve (GON) block, in chronic resistant migraine patients and controls.

Methods: This study was an interventional randomized controlled trial, including 53 patients, 22 in sphenopalatine ganglion arm, 21 greater occipital nerve arm and 10 in sham group. All patients were assessed initially by headache diary (for 3 months), HIT-6 and MIDAS scales. The patients (blindly allocated) underwent nerve block ultrasound guided, then followed up after one month by headache diary and HIT- 6 scale and three months by MIDAS. Results were analysed on SPSS, using mixed AVOVA and Tukey's Post-Hoc analysis, Fisher's exact and paired t-test.

Results: The two groups were matched as regards the gender, age, type of migraine, frequency and years lived with headache. The study revealed that GON and SPG block, were equally effective (p < 0.05) as regards reducing the headache diary parameters, as well as the total pain index and the functional impact on HIT-6 and MIDAS scale. SPG block was more effective in patients with autonomic manifestations and temporal location of pain.

Conclusion: Ultrasound guided SPG is as effective as GON as a treatment modality for chronic resistant migraine and may be more useful in the presence of autonomic manifestations and temporal location of pain.

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超声引导周围神经阻滞治疗慢性难治性偏头痛的疗效和安全性。

背景：偏头痛是一种常见的原发性头痛疾病，超声引导下的周围神经阻滞是不同的治疗方式。我们比较了超声引导下双侧蝶腭神经节（SPG）阻滞与双侧枕大神经（GON）阻滞在慢性难治性偏头痛患者和对照组中的疗效和安全性。方法：采用介入性随机对照试验，纳入53例患者，蝶腭神经节组22例，枕大神经组21例，假手术组10例。所有患者最初通过头痛日记（3个月）、HIT-6和MIDAS量表进行评估。患者（随机分组）接受神经阻滞超声引导，随访1个月，采用头痛日记和HIT- 6量表，随访3个月，采用MIDAS。结果在SPSS上进行分析，使用混合AVOVA和Tukey's事后分析，Fisher's精确和配对t检验。结果：两组患者在性别、年龄、偏头痛类型、发作频率和头痛生活年限等方面基本一致。结论：超声引导下的SPG作为慢性难治性偏头痛的一种治疗方式与GON一样有效，并且在存在自主神经表现和颞部疼痛的情况下可能更有用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Headache and Pain 医学-临床神经学

CiteScore

11.80

自引率

13.50%

发文量

143

审稿时长

6-12 weeks

期刊介绍： The Journal of Headache and Pain, a peer-reviewed open-access journal published under the BMC brand, a part of Springer Nature, is dedicated to researchers engaged in all facets of headache and related pain syndromes. It encompasses epidemiology, public health, basic science, translational medicine, clinical trials, and real-world data. With a multidisciplinary approach, The Journal of Headache and Pain addresses headache medicine and related pain syndromes across all medical disciplines. It particularly encourages submissions in clinical, translational, and basic science fields, focusing on pain management, genetics, neurology, and internal medicine. The journal publishes research articles, reviews, letters to the Editor, as well as consensus articles and guidelines, aimed at promoting best practices in managing patients with headaches and related pain.