Preoperative Greater Occipital Nerve Block in Total Thyroidectomy Patients Can Reduce Postoperative Occipital Headache and Posterior Neck Pain

Thyroid ◽  
2006 ◽  
Vol 16 (6) ◽  
pp. 599-603 ◽  
Author(s):  
Dong Woo Han ◽  
Bon Nyeo Koo ◽  
Woung Youn Chung ◽  
Cheong Soo Park ◽  
So Yeon Kim ◽  
...  
Keyword(s):  
Neck Pain ◽  
Total Thyroidectomy ◽  
Nerve Block ◽  
Occipital Nerve ◽  
Greater Occipital Nerve Block ◽  
Greater Occipital Nerve ◽  
Posterior Neck ◽  
Occipital Headache ◽  
Occipital Nerve Block

Predicting the outcome of the greater occipital nerve block – an observational study on migraine patients with and without musculoskeletal cervical impairment

Cephalalgia ◽  
2020 ◽  
pp. 033310242095451
Author(s):  
Annika Schwarz ◽  
Christian Ziegeler ◽  
Sima Daneshkhah ◽  
Arne May ◽  
Kerstin Luedtke
Keyword(s):  
Observational Study ◽  
Neck Pain ◽  
Nerve Block ◽  
Headache Frequency ◽  
Local Pain ◽  
Occipital Nerve ◽  
Greater Occipital Nerve Block ◽  
Greater Occipital Nerve ◽  
Manual Palpation ◽  
Occipital Nerve Block

Background and objective The importance of neck pain and the trigeminocervical complex in migraine is of high pathophysiological interest since a block to the greater occipital nerve is more effective for some primary headaches than others. This observational study hypothesised that the response to manual palpation of the upper cervical spine predicts the efficacy of the greater occipital nerve-block. Methods We divided patients, scheduled by a neurologist to receive a greater occipital nerve-block to reduce their migraine symptoms, into three groups: Patients with no pain response to manual palpation of the neck, patients with local pain, and those with referred pain to the head. Primary outcome was the percentage change in headache frequency. Additionally, items from the quantitative sensory testing protocol were included. Results Eighty-seven chronic migraine patients were recruited consecutively from a specialised outpatient clinic and 71 were included for analyses and stratified into the three groups: No pain (n = 11), local pain (n = 28), and referred pain to the head (n = 32). Overall, patients experienced a reduction of 1.9 headache days per month (SD 3.4, p < 0,0001). The groups differed significantly in the percentage change of headache frequency ( p = 0.041) with the “no pain” group showing the largest reduction. The pressure-pain-threshold over C2 and headache on the day of the intervention influenced the outcome significantly (R2 0,27, p = 0,00078). No serious adverse events occurred. Sixty-five percent of the patients had headaches during the examination. The groups did not differ regarding the distribution of patients with neck-pain in absence of migraine at baseline ( p = 0.618). Conclusion Patients that were less sensitive to palpation in the cervical region and headache-free on the day of the intervention improved more after the greater occipital nerve-block. Registration: Registered a priori at the German Clinical Trials Register (DRKS00015995).

Greater occipital nerve block modulates nociceptive signals within the trigeminocervical complex

2021 ◽  
pp. jnnp-2021-326433
Author(s):  
Jan Hoffmann ◽  
Jan Mehnert ◽  
Elena M Koo ◽  
Arne May
Keyword(s):  
Nerve Block ◽  
Clinical Effects ◽  
Double Blind ◽  
Occipital Nerve ◽  
Randomised Study ◽  
In Vivo Experiments ◽  
Greater Occipital Nerve Block ◽  
Greater Occipital Nerve ◽  
Occipital Nerve Block

IntroductionThe pharmacological block of the greater occipital nerve has been proven effective in numerous headache and facial pain syndromes. This clinical effect supports the hypothesis of a strong functional interaction between the occipital and trigeminal nerves which has been proposed in neurophysiological in vivo experiments in rodents. Although it is likely that the interaction has to occur in the central nervous system, the exact site and the mechanisms of the interaction remain largely unknown.MethodsFocusing on these questions we investigated in a double-blind, placebo-controlled, randomised study the influence of an occipital nerve block with lidocaine 1% on neuronal activation in the trigeminocervical complex using high-resolution functional magnetic resonance on a 3T scanner. In order to investigate potential clinical effects on the trigeminal nerve, we further performed quantitative sensory testing and analysed a potential shift in thermal detection and pain thresholds.ResultsThe pharmacological block of the greater occipital nerve induced an occipital anaesthesia ipsilateral to the block. Functional imaging revealed that the occipital injection of lidocaine but not placebo significantly reduced nociceptive trigeminal activation.ConclusionsThese data suggest that the functional inhibition of the occipital nerve block on trigeminal nociceptive activity is likely to occur at the C2 level where the occipital nerve enters the trigeminocervical complex and converges on the same central nuclei before the signal crosses the midline at that level and is then transmitted to higher processing centres.

Efficacy of the greater occipital nerve block in recurrent migraine type headaches

2016 ◽  
Vol 50 (3) ◽  
pp. 151-154 ◽  
Author(s):  
Korgun Okmen ◽  
Yasar Dagistan ◽  
Emine Dagistan ◽  
Necati Kaplan ◽  
Emre Cancan
Keyword(s):  
Nerve Block ◽  
Occipital Nerve ◽  
Greater Occipital Nerve Block ◽  
Greater Occipital Nerve ◽  
Occipital Nerve Block
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