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Efficacy of ultrasound-guided greater occipital nerve pulsed radiofrequency therapy in chronic refractory migraine

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Abstract

Objective

Ultrasound (US) guided pulsed radiofrequency (PRF) therapy can be used on the greater occipital nerve (GON) in patients with chronic migraine (CM) who are unresponsive to conservative treatments. We aimed to demonstrate the change in pain intensity, duration of migraine episodes, frequency of attacks, migraine disability, depression, and sleep disturbance scores before and after treatment in patients with CM who underwent US-guided GON PRF and the effectiveness of treatment.

Patients and methods

According to the International Classification of Headache Disorders III beta version diagnostic criteria, 25 of 43 patients with CM whom treated with GON PRF were included in the study. The Migraine Disability Assessment Scale (MIDAS), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and a visual analog scale (VAS) were used on patients before GON PRF treatment and at post treatment months 1 and 3.

Results

The median duration and number of migraine episodes in the post-interventional 1st month and 3rd month were significantly shorter and fewer compared with the pre-intervention period (p < 0.001). In the comparison with the pre-intervention values, all of the scoring concepts, namely the MIDAS, VAS, BDI, and PSQI, revealed a significant drop in the postintervention 1st and 3rd month (p < 0.001).

Conclusion

In this study, we observed that US-guided GON PRF therapy applied at the proximal (C2) level was a safe and effective treatment option. With GON PRF, we observed a decrease in pain intensity, pain frequency, and duration of episodes, and an improvement in depression symptoms, migraine disability, and sleep disorder scores accompanying chronic migraine.

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Acknowledgements

All of the authors declare that they have all participated in the design, execution, and analysis of the paper, and that they have approved the final version. There is no sponsor contribution.

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Authors and Affiliations

  1. Pain Department, Tepecik Training and Research Hospital, Izmir University of Health Sciences, Izmir, Turkey

    Derya Guner

  2. Pain Department, Ege University Faculty of Medicine, Izmir, Turkey

    Can Eyigor

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  1. Derya Guner
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Correspondence to Derya Guner.

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There are no conflicts of interest in connection with this paper, and the material described is not under publication or consideration for publication elsewhere.

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The ethical approval of the current study was obtained from the Local Ethics Committee of Tepecik Education and Research Hospital and was conducted in accordance with the Declaration of Helsinki.

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Guner, D., Eyigor, C. Efficacy of ultrasound-guided greater occipital nerve pulsed radiofrequency therapy in chronic refractory migraine. Acta Neurol Belg 123, 191–198 (2023). https://doi.org/10.1007/s13760-022-01972-7

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