Nerve block methods are an interventional treatment used in migraine, especially for the improvement of drug-resistant chronic migraine and with the aim of reducing the amount of analgesics used.
Nerve block is an interventional (invasive) therapy.
It is based on injecting various medications with special techniques around nerves that are thought to be associated with the brain centers responsible for migraine attacks, thereby blocking these nerves.
It can be applied simultaneously to several nerves related to headache. Most commonly, it is performed on the nerve known as the greater occipital nerve (GON), because this nerve is directly related to the trigeminovascular system, the brain region responsible for migraine attacks. GON block has been shown to reduce the frequency, severity, and duration of migraine attacks. Therefore, it can be used as a preventive treatment to stop migraine attacks. It can be considered an effective and safe treatment option for pregnant patients and for migraine patients who cannot use medication for various reasons.
How does it work?
Medications injected with special techniques around the greater occipital nerve reversibly block sodium ion channels in the nerve fibers. Thus, the generation of pain signals in the regions connected to this nerve and associated with migraine headache is prevented.
How is it performed?
GON block is applied to the back of the head. The nerve is located using the anatomical structures at the back of the head. Once the greater occipital nerve is identified, locally acting anesthetic prepared in various doses is injected with special injection techniques. It can be done unilaterally or bilaterally. After the injection, numbness and temporary loss of sensation occur in the treated area. The procedure can be easily performed in a clinical setting.
How often should it be done?
In general, 3–5 injections can be given at one-week intervals. Afterwards, monthly applications may also be performed. It has been shown that repeated GON blocks significantly reduce the frequency, severity, and duration of migraine attacks. The decision on how often and to which patient it should be applied must be made individually by the treating physician.
Does it have side effects?
Besides being effective, it is also a very “safe” method. When performed carefully and in accordance with the rules, side effects are very rare.
Side effects that may occur are similar to those seen with injections performed anywhere in the body: injection-site infection, subcutaneous bleeding, feeling faint, drop or rise in blood pressure, nausea, etc. Rarely, hypersensitivity or allergic reactions may occur due to the local anesthetic used.