Occipital nerve block is effective in craniofacial neuralgias but not in idiopathic persistent facial pain

The Journal of Headache and Pain

Original

H. Seedorf¹  J. Regelsberger²  T. P. Jürgens³  A. May³  P. Müller³ 

[1] Department of Dental Prosthetics, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany;Department of Neurosurgery, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany;Department of Systems Neuroscience, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany;

关键词: Trigeminal neuralgia;    Facial pain;    Trigeminal neuropathic pain;    Occipital nerve block;    Occipital;    Neuralgia;   

DOI  :  10.1007/s10194-012-0417-x

 received in 2011-10-24, accepted in 2012-01-18,  发布年份 2012

来源: Springer

【 摘 要 】

Occipital nerve block (ONB) has been used in several primary headache syndromes with good results. Information on its effects in facial pain is sparse. In this chart review, the efficacy of ONB using lidocaine and dexamethasone was evaluated in 20 patients with craniofacial pain syndromes comprising 8 patients with trigeminal neuralgia, 6 with trigeminal neuropathic pain, 5 with persistent idiopathic facial pain and 1 with occipital neuralgia. Response was defined as an at least 50% reduction of original pain. Mean response rate was 55% with greatest efficacy in trigeminal (75%) and occipital neuralgia (100%) and less efficacy in trigeminal neuropathic pain (50%) and persistent idiopathic facial pain (20%). The effects lasted for an average of 27 days with sustained benefits for 69, 77 and 107 days in three patients. Side effects were reported in 50%, albeit transient and mild in nature. ONBs are effective in trigeminal pain involving the second and third branch and seem to be most effective in craniofacial neuralgias. They should be considered in facial pain before more invasive approaches, such as thermocoagulation or vascular decompression, are performed, given that side effects are mild and the procedure is minimally invasive.

【 授权许可】

CC BY   
© The Author(s) 2012