Greater and Lesser Occipital Nerve Blocks for Frequent and Severe Headaches in Children and Adolescents: A Protocolized Repetitive Intervention Study
Neurology and Therapy, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s40120-026-01061-4
- Dergi Adı: Neurology and Therapy
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals, Academic Search Ultimate (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Anahtar Kelimeler: Headache in children and adolescents, Headache management, Migraine in childhood, Pediatric patients with headaches, Peripheral nerve block
- Recep Tayyip Erdoğan Üniversitesi Adresli: Evet
Özet
Introduction: Headache management in children and adolescents remains challenging, particularly in patients with high headache-related disability, medication overuse, and comorbid conditions, for whom evidence-based preventive treatment options are limited and often ineffective. This study aimed to evaluate the clinical outcomes and safety of a protocolized, repetitive bilateral greater and lesser occipital nerve block (GONB/LONB) strategy in pediatric patients with frequent and severe headaches. Methods: This retrospective study included adolescents aged 11–18 years who underwent bilateral GONB and LONB for headache between 2018 and 2025. At each treatment session, 1 mL of 2% lidocaine was administered at each of four injection sites (bilateral GON and LON), corresponding to a total volume of 4 mL (80 mg) per session. Blocks were administered weekly for 4 weeks, followed by additional applications at 1 and 3 months. Headache severity and disability were evaluated using the visual analog scale (VAS) and the Pediatric Migraine Disability Assessment (PedMIDAS) before and after completion of the block protocol. Results: Forty-five patients (91.1% female) received a total of 258 bilateral GONB/LONB procedures. The mean number of headache days per month was 20.8 ± 7.9, and the mean headache duration was 11.6 ± 10.7 months. Significant reductions were observed in both VAS and PedMIDAS disability grades following treatment (p < 0.001). At the patient level, 41 of 45 patients (91.1%) met the predefined criteria for clinical response. No serious adverse events occurred. Conclusions: Protocolized repetitive bilateral GONB/LONB was well tolerated and was associated with reductions in headache severity and headache-related disability in this predominantly adolescent cohort. However, the uncontrolled retrospective design precludes attribution of these improvements specifically to the intervention. Prospective sham-controlled studies are needed to establish treatment-specific efficacy.