Migraine prophylaxis: nerve interventions
Evidence-based neurology checklist on migraine prophylaxis: nerve interventions: Greater occipital nerve injection (GONI) This is injection of 2% Lidocaine or 0.5% Bupivacaine Triamcinolone 40mg may be added but this may not improve the response It improves headache intensity and frequency over…
Greater occipital nerve injection (GONI)
- This is injection of 2% Lidocaine or 0.5% Bupivacaine
- Triamcinolone 40mg may be added but this may not improve the response
- It improves headache intensity and frequency over two months
- About 45% get complete or partial response
- Responsiveness is predicted by tenderness over the GON
- Alopecia is a rare complication
Other forms of neurostimulation
Other migraine interventions
References
- Saracco MG, Valfrè W, Cavallini M, Aguggia M. Greater occipital nerve block in chronic migraine. Neurol Sci 2010; 31(Suppl 1):S179-180.
- Afridi SK, Shields KG, Bhola R, Goadsby PJ. Greater occipital nerve injection in primary headache syndromes-prolonged effects from a single injection. Pain 2006; 122:126-129.
- Lambru G, Matharu MS. Occipital nerve stimulation in primary headache syndromes. Ther Adv Neurol Disord 2012; 5:57-67.
- Schoenen J, Roberta B, Magis D, Coppola G. Noninvasive neurostimulation methods for migraine therapy: the available evidence. Cephalalgia 2016; pii: 0333102416636022 (Epub ahead of print).
- Robbins MS, Lipton RB. Transcutaneous and percutaneous neurostimulation for headache disorders. Headache 2016; doi: 10.1111/head.12829 (Epub ahead of print).
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