Headache Clinical Trial
Official title:
Pulsed Radiofrequency of the Occipital Nerves for Chronic Headache Management.
Pulsed radiofrequency of the occipital nerves (greater and lesser) for primary headache management.
Patients participating suffered from primary headaches (migraine, cluster, and tension
headache) and occipital neuralgia were enrolled in the study. They have all received in the
past the standard systemic pharmacotherapy prophylaxis for headache management (with
topiramate or amitriptylline) as well as tryptanes for rescue treatment, and were scheduled
for a diagnostic nerve block of the occipital nerves in cases of intractable pain. Inclusion
criteria included: not adequate response to systemic pharmacotherapy, pain over crises of
>4/10, occipital tenderness bilaterally or unilaterally, and days with headache of more than
10/month. Exclusion criteria were age<18 years old, pregnancy or lactation, presence of
cardiac pacemaker, previous therapy with PRF, severe psychiatric disorder and patient
refusal. In cases of a positive response to the diagnostic nerve block with local anesthetic,
with >50% pain relief they were scheduled for pulsed radiofrequency of GON and LON
bilaterally.
Primary outcome measure was the days with headache per month, before and after treatment. In
addition, pain during headache crisis (with Visual Analogue Scale, VAS, 0-10), the analgesic
consumption (number per month) and the quality of life (measured with EQ6D) were studied. All
measurements were performed before treatment, as well as after 1, 3, 6, and 12 months. All
patients completed the Brief Pain Inventory questionnaire in Greek language and signed an
informed consent prior treatment. All measurements were accomplished by an independed
(blinded) researcher of the pain unit. All complications and side effects were also recorded.
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