Abstract
Objective: The aim of the study was to overview the evidence for administration of Greater Occipital Nerve Block (GONB) in children with chronic headache and evaluate the safety and benefits of the procedure.
Methods: GONB was offered to patients where clinically indicated. Injection of 1 ml of Depo-Medrone (10mg lidocaine and 40mg methylprednisolone) given
to infiltrate the area around GON on one or both sides. Diagnosis was made on ICHD3. Good response was defined as resolution of headache for at least 2
weeks and partial response as relief of headache for less than 2 weeks or reduction in headache intensity. Statistical analysis performed using R software. The literature search included PubMed, google Scholar, Embase and Cochrane databases.
Results: 98 patients (10-17 years old, 77% females) with chronic headache were given 164 treatment sessions on one (32%) or both sides (68%). 64% of
treatment sessions resulted in good or partial response (51% and 13% respectively) which was associated with a diagnosis of chronic or episodic migraine and younger age of patients at the first treatment. There were no statistical predictive value in response rate for other variables such as gender,
number of previously used medications, site of injections (unilateral or bilateral), presence or absence of tenderness over pressure points before injections
or achieving scalp numbness immediately after injection. Response to the first treatment can predict response to subsequent treatments. The procedure
was well tolerated with only mild to moderate adverse reactions in 20% of treatment sessions. Data on 271 patients from 8 publications were very similar
to our study with overall response rate of 66% for the whole group of patients and 67% for patients with chronic migraine.
Conclusion: GONB is a safe, well tolerated and an effective treatment option for children and adolescents with chronic headache and migraine in particular, even for those patients who have failed to respond to multiple preventative strategies.
Methods: GONB was offered to patients where clinically indicated. Injection of 1 ml of Depo-Medrone (10mg lidocaine and 40mg methylprednisolone) given
to infiltrate the area around GON on one or both sides. Diagnosis was made on ICHD3. Good response was defined as resolution of headache for at least 2
weeks and partial response as relief of headache for less than 2 weeks or reduction in headache intensity. Statistical analysis performed using R software. The literature search included PubMed, google Scholar, Embase and Cochrane databases.
Results: 98 patients (10-17 years old, 77% females) with chronic headache were given 164 treatment sessions on one (32%) or both sides (68%). 64% of
treatment sessions resulted in good or partial response (51% and 13% respectively) which was associated with a diagnosis of chronic or episodic migraine and younger age of patients at the first treatment. There were no statistical predictive value in response rate for other variables such as gender,
number of previously used medications, site of injections (unilateral or bilateral), presence or absence of tenderness over pressure points before injections
or achieving scalp numbness immediately after injection. Response to the first treatment can predict response to subsequent treatments. The procedure
was well tolerated with only mild to moderate adverse reactions in 20% of treatment sessions. Data on 271 patients from 8 publications were very similar
to our study with overall response rate of 66% for the whole group of patients and 67% for patients with chronic migraine.
Conclusion: GONB is a safe, well tolerated and an effective treatment option for children and adolescents with chronic headache and migraine in particular, even for those patients who have failed to respond to multiple preventative strategies.
| Original language | English |
|---|---|
| Article number | LP076 |
| Journal | Headache: The Journal of Head and Face Pain |
| Volume | 26 |
| Issue number | Supplement 2 |
| DOIs | |
| Publication status | Published - 23 Jun 2025 |
| Event | European headache Congress: Towards a better headache treatment for everyone - Rotterdam, Netherlands Duration: 4 Dec 2024 → 7 Dec 2024 Conference number: 18 http://www.headache-congress.org |