Occipital nerve block is effective in craniofacial neuralgias but not in idiopathic persistent facial pain |
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Authors: | T P Jürgens P Müller H Seedorf J Regelsberger A May |
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Affiliation: | (1) Department of Systems Neuroscience, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany;(2) Department of Dental Prosthetics, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany;(3) Department of Neurosurgery, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; |
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Abstract: | 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. |
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Keywords: | Trigeminal neuralgia Facial pain Trigeminal neuropathic pain Occipital nerve block Occipital Neuralgia |
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