Three men in a boat: The comparison of the combination therapy of botulinum toxin and greater occipital nerve block with bupivacaine, with botulinum toxin monotherapy in the management of chronic migraine

被引:2
作者
Karaoglan, Mustafa [1 ]
机构
[1] Ordu State Hosp, Dept Algol, Ordu, Turkiye
关键词
Botulinum toxin; Greater occipital nerve block; Gon block; Combination therapy; Chronic migraine; DOUBLE-BLIND; INTERNATIONAL BURDEN; ONABOTULINUMTOXINA; PROPHYLAXIS; HEADACHE; STIMULATION; MEDICATIONS; TOPIRAMATE; DISABILITY;
D O I
10.1016/j.clineuro.2023.107609
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: This study compared the impact of the combination therapy of onabotulinum toxin A and greater occipital nerve block (GoNT-A) with onabotulinum toxin A monotherapy (BoNT-A) based on its efficacy and safety in relation to the quality of life of adult chronic migraine (CM) patients. Background: Prophylactic treatment of CM is still difficult and complex. Combination treatments do not have an evidence base yet. Methods: : This retrospective study included 85 patients. For greater occipital nerve block (GONB), 4 ml of the solution prepared using 1 ml of 0.5% bupivacaine and 3 ml of saline on both sides were bilaterally applied to 30 patients. For BoNT-A treatment, a total of 155 units of onabotulinum toxin A (BOTOX (R)) was intramuscularly injected into 31 specific points around the head and neck in 27 patients. Both protocols were similarly applied to 28 patients for GoNT-A treatment. MIDAS and HIT-6 scores were evaluated to measure patients' quality of life three months after the treatment. Results: When MIDAS and HIT-6 score groups were statistically compared, both GONB and GoNT-A applications showed a statistically significant reduction compared to the BoNT-A application (p < 0.05). The decrease in the MIDAS and HIT-6 scores of GONB and GoNT-A applications did not show a statistical difference (p > 0.05). Conclusion: The combination of BoNT-A and GONB was superior to BoNT-A applied as monotherapy. Alternately, no significant difference was found between GONB therapy and combination therapy in all data. Combination treatments were well tolerated
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页数:10
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