Addition of lesser occipital nerve blockade to greater occipital nerve blockade in patients with chronic migraine

Objectives: The aim of this study was to compare greater occipital nerve blockade (GONB) alone and GONB combined with lesser occipital nerve blockade (LONB) in chronic migraine patients. Methods: Patients were randomly divided into two groups: Group A consisted of 22 patients who received only GONB; while Group B consisted of 20 patients who underwent GONB and LONB. The demographics and clinical characteristics of the patients were evaluated. The injections were given unilaterally and to the side where the subjects experienced greater pain. GONB with or without LONB was performed on each patient once a week for 4 weeks and then two more times a month apart; 6 times in total. The number of headache days, severity of attacks and duration of headache episodes was recorded from headache diaries before treatment and the on the first, second and third month following the start of treatment. Treatment efficiencies were evaluated within and between the groups. Results: The duration of pretreatment headaches was significantly longer in Group B (p=0.032). There were no differences between the groups in terms of other demographic and clinical characteristics. When the treatments applied in group A and group B were evaluated separately compared to the control group, there was a statistically significant decrease in the number of headache days, VAS scores and headache duration (p 0.05). When the results of treatment between groups were compared, there was no difference in terms of the number of headache days and VAS scores. Although the duration of headache was longer in the pretreatment period in group B, this difference disappeared on posttreatment follow-up (p 0.05). Conclusions: This study suggests that there is no difference in the number of headache days or headache intensity between GONB alone or in combination with LONB in chronic migraine patients. GONB combined with LONB in patients may be more effective than GONB alone when headaches of longer duration are present.