Comparison of greater occipital nerve blockade with radiofrequency and steroid in chronic migraine

According to the International Headache Society's 2018 classification of headaches, headaches are divided into three categories: I. primary headaches, II. secondary headaches, and III. neuropathies and facial pains. Among these categories, primary headaches include migraines, tension-type headaches, trigeminal autonomic cephalalgias, and other primary headaches [1]. Globally, migraine is the second largest cause of disability due to neurological disorders in 2016 [2]. It imposes an additional economic burden on patients and their families. Individual costs for patients with migraine are estimated to be approximately $9000 per year in the United States alone [3]. Various risk factors have been identified for migraines, including genetics, advanced age, history of head trauma, low socioeconomic status, excessive caffeine consumption, medication overuse, stress, sleep problems, obesity, proinflammatory, or prothrombotic conditions [4]. In addition to these risk factors, many other risk factors have been proposed for chronic migraines, a subgroup of migraines, including ineffective treatment during acute episodes and medication overuse [5]. Therefore, early and effective treatment of migraines is crucial for preventing their progression chronic migraines. Chronic migraine is a prevalent neurological disorder, affecting approximately 1–2 % of the population worldwide [6]. Various methods are used in the treatment of chronic migraines which include antiepileptics, antidepressants, beta-blockers, calcium channel blockers, cognitive-behavioral therapy, and botulinum toxin. However, the treatment of chronic migraines remains a challenge [7]. Greater occipital nerve (GON) blocks and pulsed RF treatment may be an effective treatment in patients resistant to medical therapy for chronic migraines [7], [8]. The mechanisms by which Pulsed RF exerts its effects remain unclear. However, it is believed to reduce transmission in C and A delta fibers by creating an electrical field around sensory nerves [9].

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