TY - JOUR AU - Cvetkovic, Vlasta Vukovic AU - Icco, Roberto De AU - Do, Thien Phu AU - Pellesi, Lanfranco AU - Ashina, Messoud AU - Hansen, Jakob Møller PY - 2021/11/16 Y2 - 2024/03/29 TI - Greater Occipital Nerve Block with Local Anesthetics and Corticosteroids in Treatment-Resistant Chronic Migraine JF - Headache Medicine JA - Headache Med VL - 12 IS - 3 SE - Review DO - 10.48208/HeadacheMed.2021.30 UR - https://headachemedicine.com.br/index.php/hm/article/view/448 SP - 160-167 AB - <p><strong>Objective</strong>: We investigated the efficacy and tolerability of greater occipital nerve block with lidocaine plus betamethasone in adults with chronic migraine in whom two or more previous preventive treatments were unsuccessful.</p><p><strong>Methods</strong>: Ten participants were enrolled in a 24-weeks, randomized, double-blind, placebo-controlled, crossover trial conducted at a single tertiary headache center in Copenhagen (Denmark). After a 4-week run-in period, participants underwent treatment with bilateral greater occipital nerve block with lidocaine plus betamethasone (GONb) or lidocaine plus saline (placebo) with a 4-week interval wash-out phase between the 8-week crossover periods. The primary aim was to compare the number of migraine days during crossover periods after GONb or placebo. This trial is registered at ClinicalTrials.gov (NCT02686983).</p><p><strong>Results</strong>: This study was stopped before achieving the a priori sample size, due to a slow enrollment. Ten participants were recruited, completed the study and were included in the analyses. At the baseline, the mean number of monthly migraine days was 22.9 (range, 14-30). No difference between GONb and placebo on the reduction of monthly migraine days was observed (<em>p</em> = 0.147; 95% CI between 0.6 and 3.7 days). Adverse events were recorded in two patients after GONb, compared with three patients after placebo.</p><p><strong>Conclusions</strong>: GONb is not beneficial in patients with difficult-to-treat chronic migraine.</p> ER -