Yet Another Bulletin Board

Welcome, Guest. Please Login or Register.
Jun 19th, 2019, 5:49am

Home Home Help Help Search Search Members Members Member Map Member Map Login Login Register Register
Clusterheadaches.com Message Board « Suboccipital injection - W/UPDATE No. 1_11 »


   Clusterheadaches.com Message Board
   Cluster Headache Help and Support
   Medications, Treatments, Therapies
(Moderator: DJ)
   Suboccipital injection - W/UPDATE No. 1_11
« Previous topic | Next topic »
Pages: 1 2 3 4  Reply Reply Notify of replies Notify of replies Send Topic Send Topic Print Print
   Author  Topic: Suboccipital injection - W/UPDATE No. 1_11  (Read 23378 times)
wildhaus
CH.com Alumnus
New Board Hall of Famer
Switzerland 
*****






   


Gender: male
Posts: 572
Re: Suboccipital injection - WITH UPDATE No. (3)_4
« Reply #25 on: Feb 13th, 2008, 2:41pm »
Quote Quote Modify Modify

So after 6 days (injection on Tuesday Feb. 05.08 ) it seems the effect started to wear off....
and the hits, started Monday Feb. 11.08  (one (1) a day, at 11PM) and some shadows, started to hunt me again today.....
 
Now I will wait until Feb. 27.08 to try and see if it will work again.... just with a full dose this time.......if the doctors will give me such a large dosage at all  
 
Until then.....   O2, Zomig as abortives, and Verapamill at a low dose of 160mg a day as preventive......
 
To sum the short experience.....  in any case it is worth the effort,
 evry PF day is a blessing..... (for me)
and on the long way to finding a good and comprehensive
preventive, it is good step toward the goal, I will bend  
the words of a very famous American Astronaut (Neil
Alden Armstrong)  That's one small step for CH research… one… Big leap for (my) Clusterheadache… .
 
Still set on the course of trying .......  still set on working with the pain klinik, and neuro. to find a way.
 
Michael
« Last Edit: Feb 29th, 2008, 12:48pm by wildhaus » IP Logged


wildhaus
CH.com Alumnus
New Board Hall of Famer
Switzerland 
*****






   


Gender: male
Posts: 572
Re: Suboccipital injection - W/UPDATE No. 1_5
« Reply #26 on: Feb 21st, 2008, 2:17am »
Quote Quote Modify Modify

So after 14 days (Today Feb. 21.08; injection on Tuesday Feb. 05.08 )  the effect is totaly wearen off....  
The hits, started Monday Feb. 11.08  (one (1) a day, at 11PM) and some very light shadows.
Now  (from Feb. 20.08 ) I am back to 5 and more a day with an avrage of 6-7 Kip.
 
I did "map" on 3D my head for the neuro, I add an image to this post....
 

 
I will NOT wait until Feb. 27.08 to try and see if it will work again.... I will go ahead and do it Friday Feb. 22.08 (If Dr's will do it) .  
 
Got used to PF and / or almost PF, and have to say it is so good to be PF!!!
 
Michael
 
(Vaduz 210208_539)
« Last Edit: Feb 21st, 2008, 2:21am by wildhaus » IP Logged


Charlotte
CH.com Alumnus
New Board Hall of Famer
USA 
*****




I love YaBB 1G - SP1!

   
Email

Gender: female
Posts: 1932
Re: Suboccipital injection - W/UPDATE No. 1_5
« Reply #27 on: Feb 21st, 2008, 2:28am »
Quote Quote Modify Modify

I'm sorry it has worn off.
 
 Charlotte
IP Logged
DragonSlayer
New Board Veteran
USA 
***




That pain is only 1/2 as bad as you think it is!!!

   
Email

Gender: male
Posts: 132
Re: Suboccipital injection - W/UPDATE No. 1_5
« Reply #28 on: Feb 21st, 2008, 3:24am »
Quote Quote Modify Modify

Sorry it's back Michael!!
All my best wishes for PF time for you!!
IP Logged

Mr. Spock tried Vulcan mind meld during one of my K10 hits. You saw how he reacted on TV... then the movie "he's dead Jim"... But he came back....
wildhaus
CH.com Alumnus
New Board Hall of Famer
Switzerland 
*****






   


Gender: male
Posts: 572
Re: Suboccipital injection - W/UPDATE No. 1_5
« Reply #29 on: Feb 21st, 2008, 1:09pm »
Quote Quote Modify Modify

The anasthesiologist from the Pain clinic in St. Gallen just
called and he will go ahed and do the "Injection"........
 
And then me off to Paris France for a week....... just not
under romantic trip......  simply work....  and with out CH
I hope.....
 
Michael
 
Wildhaus 210208_567
IP Logged


Ace
New Board Newbie
USA 
*





   
Email

Gender: male
Posts: 42
Re: Suboccipital injection - W/UPDATE No. 1_5
« Reply #30 on: Feb 22nd, 2008, 12:07pm »
Quote Quote Modify Modify

Michael,
 
I have had these injections as well. They are GREAT for short-term relief. I'd much rather deal with the pain from the injection site than a CH.  
 
I didn't see anyone post about the frequency of the injections being a danger to your neck...(i.e. the steroids wearing away your muscle)...must be careful.
 
I mix it up so I have steroids once a month and xylocaine and other drugs in between.
 
One thing I am thinking of trying is getting an injection of steroids at the occipital insertion point in the neck and purposely causing a little muscle atrophy.  
 
From different studies and treatments on me I know that the insertion point for the occipital nerve can play an aggravating role during a CH attack.  
 
I am going to try and "open up" this insertion point a little bit so when the nerve swells there will be room for it to do so without the muscle cutting off blood flow and further irritating the nerve.  
 
Keep us posted on your trials and tribulations. And as always...good luck to being PF.
 
-Ace
IP Logged

My Head Hurts Too
wildhaus
CH.com Alumnus
New Board Hall of Famer
Switzerland 
*****






   


Gender: male
Posts: 572
Re: Suboccipital injection - W/UPDATE No. 1_5
« Reply #31 on: Feb 22nd, 2008, 12:09pm »
Quote Quote Modify Modify

today at 15:30 (3:30pm) had another injection....
and this is what it looks like:
 

 

 

 

 
Let's see how good it will do this time
 
 
Michael
 
St.-Gallen 220208_612
« Last Edit: Feb 22nd, 2008, 12:10pm by wildhaus » IP Logged


Jackie
CH.com Alumnus
New Board Hall of Famer
USA 
*****



Go For It!!!

   
Email

Gender: female
Posts: 2963
Re: Suboccipital injection - W/UPDATE No. 1_5
« Reply #32 on: Feb 22nd, 2008, 12:33pm »
Quote Quote Modify Modify

Positive thoughts to you.....let's hope it works REALLY well.
 
Bless your heart.....
 
Jacki
IP Logged
E-Double
CH.com Alumnus
New Board Hall of Famer
USA 
*****




Are we ourselves?

  Edoubleitk   Edoubleitk1
Email

Gender: male
Posts: 6458
Re: Suboccipital injection - W/UPDATE No. 1_5
« Reply #33 on: Feb 22nd, 2008, 1:41pm »
Quote Quote Modify Modify

you rock brother
IP Logged

I can't believe that I have to bang my
Head against this wall again
But the blows they have just a little more
Space in-between them
Gonna take a breath and try again.
sandie99
New Board Hall of Famer
Finland 
*****




Wish it, dream it, do it - inspite the pain!

   


Gender: female
Posts: 10429
Re: Suboccipital injection - W/UPDATE No. 1_5
« Reply #34 on: Feb 22nd, 2008, 1:54pm »
Quote Quote Modify Modify

Michael,
 
I hope so much that it will help you! Smiley
That injection....  Shocked Looks scary to me.
 
Lots of PF days your way,
Sanna
IP Logged

CH happends, Live anyway! PF days to us all!

"Do what you can and let God take care of the rest. Leave your heart wide open and always wish for the best" (Sanna Hillu)

"No matter how far out your dreams are, it's possible" (Marketa Irglova)


wildhaus
CH.com Alumnus
New Board Hall of Famer
Switzerland 
*****






   


Gender: male
Posts: 572
Re: Suboccipital injection - W/UPDATE No. 1_6
« Reply #35 on: Feb 22nd, 2008, 4:49pm »
Quote Quote Modify Modify

As I see it now after the 3rd “Injection” the only open question is:
 
HOW OFTEN CAN IT BE REPETED, AND AT WHAT INTERVAL
 
As in all the studies we have looked at, the Neuro, the Pain specialist
and anaesthesiologist, and my self (with the help of some of you), there has been no reference
to this subject!
 
I will try and get in contact with Dr. Anna Ambrosini in Italy, and try to find out what
is her input on this, as she is the one that initiated this Suboccipital injection
and might have some Information that could be helpful, she or her associates
did not publish about it (that we could find) in any major Journal.
I will try to get a hold of Dr. May in Germany, which has some Experian’s as well.
 
In any case we have decided to go on and use this method in the future as well,
and we will monitor the effects on the production of Cortisone in the body as well as  
“sugar” level, to eliminate (controllable) factors that are known to “suffer” during higher
usage of Cortisone  and try to monitor other factors, to eliminate (if possible) any
long term negative effects.
 
I am very positive that (with maybe some adjustments) this “simple” treatment could bring
some light into the tunnel, and could be of help to some of us…..  
 
If any one has any reference to a study that has done it repeatedly - Suboccipital injection - injection
with a mixture of rapid - and long-acting betamethasone near the ipsilateral greater occipital nerve
for the treatment of cluster headache and has published in a journal, do let me know
 
I will continue updating on this thread, as I do believe it’s a treatment with a good potential
for some of us, and will try and update the table that DJ has helped me to post on his server
and make available to all, bless you DJ!
 
It is not a cure! But it is another (big? ) brick in the wall…..
 
 
Michael
IP Logged


Annette
CH.com Alumnus
New Board Hall of Famer
Australia 
*****




Veni Vidi Velcro

   
Email

Gender: female
Posts: 1874
Re: Suboccipital injection - W/UPDATE No. 1_6
« Reply #36 on: Feb 22nd, 2008, 5:44pm »
Quote Quote Modify Modify


Thank you so much Michael for posting and sharing your experiences with such details. The photographs, the charts, the links are incredibly helpful.
 
Marta, thank you so very much for taking the photos  Kiss
 
Wishing you the best of results and that this injection will booster the others making it last for a long long time.
 
Enjoy your work in France and we will catch up again when you come back.  Smiley
 
Much love to you all.  
IP Logged

Mediocrity knows nothing higher than itself; but talent instantly recognizes genius.
Arthur Conan Doyle
Ace
New Board Newbie
USA 
*





   
Email

Gender: male
Posts: 42
Re: Suboccipital injection - W/UPDATE No. 1_6
« Reply #37 on: Feb 24th, 2008, 4:24am »
Quote Quote Modify Modify

The pictures are helpful. I have found that most docs are not informed about CH and pictures always help.
 
What i don't get is all the posts saying "thanks for sharing" or "thanks for the info"
 
I posted about the occipital nerve and it's involvment in CH and was flamed for not having CH.
 
If the occipital nerve (which is outside the skull) wasn't involved then this gentlemen wouldn't get relief or even try occipital injections.  
 
I have done the injection thing. I thought it was widely known as a treatment. But the replies to this post indicate otherwise.  
 
I'm just pissed that I got flamed for sharing the same info. I guess I needed pictures.  
 
As a side note....I tried verapimil based on info from this sight. It made me pass out and then it activated my CH and it was severe. I have found that a lot of medications that aimed to help CH can actually trigger CH and only work after the dose is increased and you "push" through the CH side affect. Example: "Tramadol"
 
The occipital injections work for a bit. I had one work for 3 days and one work for 3 weeks. It's just a shame you can't get them very often due to muscle atrophy from the steroids.  
 
IP Logged

My Head Hurts Too
Ace
New Board Newbie
USA 
*





   
Email

Gender: male
Posts: 42
Re: Suboccipital injection - W/UPDATE No. 1_6
« Reply #38 on: Feb 24th, 2008, 5:16am »
Quote Quote Modify Modify

A couple of things:
 
I noticed that your injections are on the right side. So are your pictures. I have some pictures as well (done by a neurologist) and they are on the right side. So are my headaches.  
 
It would be interesting to know if CH is predominately right-sided or left-sided.
 
Michael:
 
If your up to the task...Try a TENS units in between injections. You can get one off the interent or from a physical therapist or neurologist. You have to place the pads higher than any physical therapist would be comfotable with but it is not dangerous.
 
Place one pad on the right side of the scalp in between the occpital protuberance and nuchal ridge. If I was using your picture (the one with the needle) this would be just above and to the left of the injection site.
 
The other pad goes on the neck mucle below and in-line with the top pad. Turn on the TENS unit until the muscle contracts. Set it for pulses (i.e. not constant electricity)
 
You may need to puch on the top pad to get good contact (due to your hair being in the way)
 
The muscle should contract and as it does the insertion point of the occipital nerve will contract and squezze the nerve providing relief and numbing to the area.
 
I haven't heard anyone else doing this but me and you seem interested in trying out different therapies. I would like to know if you get numbing of the entire right side of the posterior scalp. If you do, let me know. This would further promote what the true pathology of CH is.
 
-Ace
IP Logged

My Head Hurts Too
wildhaus
CH.com Alumnus
New Board Hall of Famer
Switzerland 
*****






   


Gender: male
Posts: 572
Re: Suboccipital injection - W/UPDATE No. 1_6
« Reply #39 on: Feb 24th, 2008, 8:12am »
Quote Quote Modify Modify

Quote:
The pictures are helpful. I have found that most docs are not informed about CH and pictures always help.  
 
What i don't get is all the posts saying "thanks for sharing" or "thanks for the info"  
 
I posted about the occipital nerve and it's involvment in CH and was flamed for not having CH.

 
I am not going to go into this….. as this is a board for Medications, Treatments, Therapies, and if
you would like to go into this Pls do it on the General Board!
 
Quote:
If the occipital nerve (which is outside the skull) wasn't involved then this gentlemen wouldn't get relief or even try occipital injections.  

 
“this gentlemen” dose get Relief (look at the info “this gentlemen” gave) as to the
involvement of the occipital nerve and CH, or why the occipital block can work for some, just no
explanation of why, needs to be deeper researched, the point is that it dose help (for me) and could
help other along the way.
 
Quote:
I have done the injection thing. I thought it was widely known as a treatment. But the replies to this post indicate otherwise.  

 
Can’t say if it’s widely known or not, but I am sure most of us are aware of this treatment
As I am aware of, OUCH UK has it on its website…. in Mr.
Peter Goadsby's presentation at the 2007 OUCH UK
Conference! (Provided to me by cluster, will add it at the end of the post)
And there are some publications, (I posted some, and I will post some more) but it is still in research and there for not widely used, or recommended, and it is understandable.
the long term risks and effects need to be looked at, and other equations that are still opened.
 
Quote:
I'm just pissed that I got flamed for sharing the same info. I guess I needed pictures.  

 
As I asked above, this is a board for Medications, Treatments, Therapies,
and If you would like to go into this Pls do it on the General Board!
 
 
Quote:
As a side note....I tried verapimil based on info from this sight. It made me pass out and then it activated my CH and it was severe. I have found that a lot of medications that aimed to help CH can actually trigger CH and only work after the dose is increased and you "push" through the CH side affect. Example: "Tramadol"

 
Do not know why it happened or if it is common, I used Verapamill, and it did help, but had to get off it
as my Hart didn’t “like” it (BP went way to low, hart rate was of a top sports profi. and frequency problems) ……..  but I can say it did help me a lot!
 
Don’t know Tramadol…. sorry cant comment
 
As we try to see if the Block works by it self / and or with O2 I am going to go to only 80mg a day of Verapamill, to singulate the effects of the “injection”
 
Quote:
The occipital injections work for a bit. I had one work for 3 days and one work for 3 weeks. It's just a shame you can't get them very often due to muscle atrophy from the steroids.  

 
Can’t say much as we are starting to monitor the effects of the Injection from the next treatment,
and we do keep in mind the known side effects, and try to schedule the tremens to prevent any
known non welcome effect, and still give me a decent relief from the attacks, it will take some time
to determine the right way, and is then the right way for me! and dose not epllay to other, at this point
of time, in order to be able to say it can be used for all it needs a larger study.
and not just some single case studies, or the studies we have until now, it’s a start, and a very good one!
 
 
Quote:
I noticed that your injections are on the right side. So are your pictures

 
It is my CH side
 
Quote:
It would be interesting to know if CH is predominately right-sided or left-sided.

 
I don’t know but look it up on the net you might find some answers, can’t say or give you
any help on this.
 
Quote:
If your up to the task...Try a TENS units in between injections

 
 
1.)Don’t know what are TENS units……
2.)We try to see if the Injection works in combination with O2 only and there for can not add
one more thing. we need to stay limited to the line we have chosen!
 
but thanks for the idea….. will ask the Neuro / Pain specialist what she / he think about it.
 
 
Michael
 
Wildhaus 240208_730
 
 
quote from Edited transcript of Professor Peter Goadsby’s presentation to the OUCH (UK) Conference
held on Sunday 24th June 2007 at UCL Institute of Child Health, London (on OUCH UK Website)

 
We became interested in the occipital nerve. That is obviously – this is not a person as such. I mean
most people don’t turn up with their occipital nerve so easy to find like that (laughter!). It’s not that
gory, it’s a little gory I suppose – it shows you what we do. Michael Anthony who is an Australian
neurologist taught me to do this. He is so believing of greater occipital nerve injection, he used to
get his senior registrar, which I was on one occasion one year, to inject his occipital nerve once a
year and he said he never got a headache. I think it was quite a crazy thing to do, but injecting your
bosses head was a whole other deal. He kept his hair quite short, so it was easy to do. Those of you
who have had this you will know that for some people it is exceedingly useful and for some people it
is useless. If it happens to be useful the injection is more or less without side effect.

 
« Last Edit: Feb 24th, 2008, 8:13am by wildhaus » IP Logged


wildhaus
CH.com Alumnus
New Board Hall of Famer
Switzerland 
*****






   


Gender: male
Posts: 572
Re: Suboccipital injection - W/UPDATE No. 1_6
« Reply #40 on: Feb 24th, 2008, 3:06pm »
Quote Quote Modify Modify

Some more info.  (given to me by cluster)
it is in German, so if you would like to read it,
just Google it into English.

 
P8.10 Suboccipitale Injektion von Corticosteroiden und Lokalanästhetika bei Clusterkopfschmerzen: Drei Kasuistiken  
S. Lanz, D. Boujong, N. Grießinger, R. Sittl, K. Ulrich  
Schmerzzentrum, Universitätsklinikum Erlangen  
 
Einleitung: Bei der Behandlung von Patienten mit Clusterkopfschmerzen fällt der Kopfschmerz-Prophylaxe eine entscheidende Rolle zu. Umso problematischer sind therapierefraktäre Fälle, in denen konventionelle pharmakotherapeutische Maßnahmen zu keiner Kopfschmerzreduktion führen.  
 
So möchten wir kasuistisch über unsere Erfahrungen mit dem Einsatz einer suboccipitalen Injektion von Corticosteroiden und Lokalanästhetika bei drei therapierefraktären Clusterkopfschmerz-Patienten berichten.  
 
Kasuistiken: Wir behandelten drei männliche Patienten im Alter von 46 (Patient Nr. 1), 47 (Nr. 2) und 51 (Nr. 3) Jahren, die seit 6 bis 8 Jahren unter episodischen (Nr. 2) bzw. chronischen (Nr. 1 und Nr. 3) Clusterkopfschmerzen litten.  
 
Bei allen Patienten entschieden wir uns, in Anlehnung an eine 2005 durchgeführte Studie (1) eine suboccipitale Infiltration im Bereich der Austrittspunkte der Nn. occipitales majores beidseits durchzuführen. Die Injektion erfolgte in der Mitte zwischen Prozessus mastoideus und Protuberantia occipitalis externa mit einer Injektionstiefe bis knapp vor das Os occipitale. In leichter Modifikation der als Vorlage dienenden Studie (1) verwendeten wir hierbei 4 mg Betametason in Depotform, 4 mg Dexamethason in schnell freisetzender Form und 1 ml 1% Scandicain. Es folgte hierauf eine Beobachtungszeit von drei Wochen. Auf die Injektion zu beziehende Nebenwirkungen konnten während dieser Zeit nicht beobachtet werden.  
 
Verlauf bei Patient Nr. 1: Die im Vorfeld durchgeführte Prophylaxe mit Lithium (nach Spiegel), Valproat (nach Spiegel) und Prednisolon (bis 250 mg/d) hatte keinen und die Einnahme von Melatonin (12 mg/d) einen nur geringen Effekt. Die Attackenfrequenz vor Durchführung der Injektion betrug durchschnittlich drei pro Tag. Leichte Attacken konnten mit reinem Sauerstoff und starke Attacken mit 6 mg Sumatriptan subcutan coupiert werden. Nach der suboccipitalen Injektion traten keine weiteren Clusterkopfschmerz-Attacken in dem Beobachtungszeitraum auf. Der Einsatz von reinem Sauerstoff oder Sumatriptan war somit seit der Injektion nicht mehr nötig.  
 
Verlauf bei Patient Nr. 2: Die Prophylaxe aus Lithium (nach Spiegel), Valproat (nach Spiegel) und Prednisolon (bis 250 mg/d) hatte keinen und die Einnahme von Topiramat (150 mg/d) einen nur geringen Effekt. Die Attackenfrequenz vor Durchführung der Injektion betrug durchschnittlich fünf pro Tag. Leichte Attacken konnten mit reinem Sauerstoff coupiert werden, bei starken Attacken wurde anfangs 5 mg Zolmitriptan nasal eingesetzt, jedoch nach Auslösung eines akuten Koronarsyndroms auf 200 μg bis 400 μg Fentanyl in transmukosaler Form (Actiq®) umgestellt, das vorübergehend täglich und mit schmerzreduzierendem Effekt verwendet wurde. Nach der suboccipitalen Injektion wurde über zwei Tage hinweg ein Sistieren der Kopfschmerzen beobachtet, gefolgt von erneuten, aber selteneren und deutlich leichteren Attacken, die nun immer mit Sauerstoff behandelbar waren. Transmukosales Fentanyl (Actiq®) musste nicht mehr verwendet werden. Die Wirkung hielt eine Woche lang, so dass wir bei diesem Patienten die Infiltration in wöchentlichen Abständen wiederholten.  
 
Verlauf bei Patient Nr. 3: Die im Vorfeld durchgeführte Prophylaxe mit Lithium (nach Spiegel), Valproat (nach Spiegel) und Prednisolon (bis 250mg/d) hatte keinen und die Einnahme von Verapamil (950mg/d) einen nicht ausreichenden Effekt. Täglich traten vor Durchführung der Injektion durchschnittlich drei Attacken auf, meist davon eine Attacke tagsüber, bei der der Patient reinen Sauerstoff verwendete und zwei Attacken nachts, bei denen 6mg Sumatriptan subcutan eingesetzt wurde.  
 
Nach der suboccipitalen Injektion trat nach einem Sistieren der Attacken über zwei Tage hinweg der Kopfschmerz mit reduzierter Attackenfrequenz (eine Attacke pro Tag) auf. Seitdem wurde im Durchschnitt einmal pro Tag Sumatriptan eingesetzt.  
 
Schlussfolgerung: Die geschilderten Fälle demonstrieren, dass durch die suboccipitalen Injektion von Corticosteroiden und Lokalanästhetika Cluster-Kopfschmerzen reduziert werden können. Sie zeigen, dass diese Maßnahme auch bei weitgehend therapierefraktären Fällen erfolgversprechend sein kann. Als wesentliche Vorteile sind die geringe Nebenwirkungsrate, die einfache Handhabung und die schnelle Durchfürbarkeit zu nennen.  
 
Die Wirksamkeit dieser Maßnahme wurde in bislang einer placebo-kontrollierten Studie belegt (1). Auch hier wurde eine Kombination aus Corticosteroiden (Betamethason) in Depotform und in schnell freisetzender Form verwendet, da sich diese in offenen Studien bewährt hatte (1). In einer weiteren Untersuchung, bei der die Wirkung der suboccipitalen Injektion bei verschiedenen Kopfschmerzformen überprüft wurde, fand man bei Clusterkopfschmerzen vergleichsweise höhere Ansprechraten (2).  
 
Weitere Studien erscheinen erforderlich, insbesondere um zu klären, in welchem Ausmaß neben dem lokalen Effekt systemische Medikamenteneinflüsse zu der Wirkung beitragen, ob die gewählte Medikamentenkombination entscheidende Vorteile gegenüber einer Monotherapie bietet und ob Unterschiede zwischen lang- und kurzwirksamen Lokalanästhetika bzw. Corticosteroiden bestehen.
 
 1.) Ambrosini A. et al. Suboccipital injection with a mixture of rapid- and long-acting steroids in cluster headache: A double-blind placebo-controlled study. Pain 2005; 118 (1-2): 92-96.  
 
2.) Afridi S.K. et al. Greater occipital nerve injection in primary headache syndromes – prolonged effects from a single injection. Pain 2006; 122 (1-2): 126-129.
 
Quelle: Deutscher Schmerzkongress 2007: Schmerz in Deutschland - Abstracts. Der Schmerz. 2007 Oct; 21 Sup.1: 1-148. DOI, PDF-Datei. <= Links! - Seite 105.

 
And one more he has send me..... this one in English.
 
Repeated suboccipital steroid injections in cluster  
headache with poor response to preventive medication  
D. Samal, M. Vigl, C. Wöber, Karin Zebenholzer  
Department of Neurology, Medical University Vienna, Austria  
 
Objectives Ambrosini et al. (2005) demonstrated the efficacy  
of single suboccipital steroid injections in cluster headache  
(CH). We report our experience with repeated injections in a  
patient with severe CH.  
 
Case report In 1998, this male patient developed CH which  
was chronic for 30 months, episodic for the following 5 years  
and thereafter chronic again. The attack frequency ranged  
between 2/month and 6/day with occasional constant pain.  
Cluster periods lasted 3–6 months and remissions 2–6 months.  
Treatment with prednisolon was effective only initially. Vera-  
pamil at daily doses of up to 960 mg was inconsistently effective,  
nevertheless the patient continued to take verapamil 240  
mg daily. Lithium and topiramate were not tolerated, other  
treatments were ineffective. In March 2006, the attack frequency  
increased to 5–6/day. Repeated injections with bupivacaine  
in the left suboccipital region at an anaesthesiological  
clinic decreased the frequency to 1–3/month. From December  
1, 2006, the frequency increased to 2–3/day and constant pain  
occurred. On December 15 we injected 2.5 ml of a mixture  
containing betamethasone dipropionate, betamethasone disodiumphosphate  
and lidocaine without changing the dose of  
verapamil. Within 1 day the patient was free of attacks, the  
constant pain was milder but still present. Therefore, we  
repeated the injection 3, 5 and 6 days after the first one. Since  
then the patient has been pain-free for 5 weeks up to now.  
During 9 years of follow-up this was the shortest cluster  
period ever.  
 
Conclusion Repeated suboccipital steroid injections might be  
useful in CH with poor response to preventive medication.  
 
Source: ''Cephalalgia.'' 2007 June; '''27'''(6): 742-3. Poster F073.

 
 
Michael
IP Logged


Annette
CH.com Alumnus
New Board Hall of Famer
Australia 
*****




Veni Vidi Velcro

   
Email

Gender: female
Posts: 1874
Re: Suboccipital injection - W/UPDATE No. 1_6
« Reply #41 on: Feb 24th, 2008, 9:46pm »
Quote Quote Modify Modify


Thank you very much Micheal  Smiley
 
Do you know the mechanism behind the treatment ? How does it work and why they chose betamethasone with xylocaine ?
IP Logged

Mediocrity knows nothing higher than itself; but talent instantly recognizes genius.
Arthur Conan Doyle
wildhaus
CH.com Alumnus
New Board Hall of Famer
Switzerland 
*****






   


Gender: male
Posts: 572
Re: Suboccipital injection - W/UPDATE No. 1_6
« Reply #42 on: Feb 26th, 2008, 1:36pm »
Quote Quote Modify Modify

Hi
 
Am in Paris (France) last night got hit, should not have happend, (must be the stress of driving  800 Km in one go)  
but it did, and it did get to me, couldent help it.
 
I do hope it will let me be tonight - was a long day
now out for dinner......
 
Annette, I cant say I have the answer right now,
will have to look into it when I am at home, if evry thing
will go right should be at home by Friday;
 
Michael
IP Logged


Sandy_C
CH.com Alumnus
New Board Hall of Famer
USA 
*****




Burn that bra!

   
Email

Gender: female
Posts: 2585
Re: Suboccipital injection - W/UPDATE No. 1_6
« Reply #43 on: Feb 26th, 2008, 5:13pm »
Quote Quote Modify Modify

Michael, hang on sweetie.
 
Thank you so much for being a guinea pig and trying this solution to CH.
 
My thoughts and prayers are with you and I hope you find relief.
 
Keep posting the results.  It seems you have some success, yet not complete success...YET.  Keep the hopes up.
 
Sandy
IP Logged

Lean on me when you're not strong
And I'll be your friend
I'll help you carry on
For it won't be long
Till I'm gonna need
Somebody to lean on
wildhaus
CH.com Alumnus
New Board Hall of Famer
Switzerland 
*****






   


Gender: male
Posts: 572
Re: Suboccipital injection - W/UPDATE No. 1_7
« Reply #44 on: Feb 29th, 2008, 12:58pm »
Quote Quote Modify Modify

am home agin......
 
and would like to add this:
 
http://www.clusterheadaches.com/michael/injections.xls
 
I have to add the xls. table:
 
Had a hit on Monday night.... Tuesday.... Wedensday (x2)... and last night - Thursday (X2) all night time hits......
 
as I would like to think that it was stress related, and I do hope so, I will try agin another "injection" and then will be able to say it was stress related, or simply it stoped doing "wonders" for me....... still to say the last will have to repet it 2 more times.
 
 
Tks DJ for your help!
 
 
Michael
IP Logged


wildhaus
CH.com Alumnus
New Board Hall of Famer
Switzerland 
*****






   


Gender: male
Posts: 572
Re: Suboccipital injection - W/UPDATE No. 1_6
« Reply #45 on: Mar 3rd, 2008, 12:12pm »
Quote Quote Modify Modify

The last 2 days Sat. & Sun as well as most Mon. March 03.08 are PF, I just wonder.......   but very happy!
 
Michael
IP Logged


Annette
CH.com Alumnus
New Board Hall of Famer
Australia 
*****




Veni Vidi Velcro

   
Email

Gender: female
Posts: 1874
Re: Suboccipital injection - W/UPDATE No. 1_6
« Reply #46 on: Mar 3rd, 2008, 6:38pm »
Quote Quote Modify Modify


Thanks Micheal !
 
Hope the break through hits were just stress related and that the injections will continue to work its wonder for you. Painfree time is precious !  
 
HUGS
 
 Kiss
IP Logged

Mediocrity knows nothing higher than itself; but talent instantly recognizes genius.
Arthur Conan Doyle
wildhaus
CH.com Alumnus
New Board Hall of Famer
Switzerland 
*****






   


Gender: male
Posts: 572
Re: Suboccipital injection - W/UPDATE No. 1_6
« Reply #47 on: Mar 8th, 2008, 2:08am »
Quote Quote Modify Modify

So as of Monday March O3.08 the effect of the injection
is off!
Attaks, only night up to 3 times.....
 
Will have to see now with the Neuro / Painklinik if and when we can try agin........
 
Michael
IP Logged


Garys_Girl
New Board Veteran
USA 
***




Kill the Beast!

   
WWW

Gender: female
Posts: 240
Re: Suboccipital injection - W/UPDATE No. 1_6
« Reply #48 on: Mar 12th, 2008, 10:36pm »
Quote Quote Modify Modify

Michael, I'm so sorry they're back, but I'm also really happy that you've been able to experience (what seems like to me) quite a few days of pain free time.
 
We got much of this info to Gary's pain management Doc, and he ordered the betamethasone.  He went by himself last time and chickened out (the last time he tried an occipital block he was in a lot of pain from the injection and it didn't help at all.  Doesn't help that he no longer keeps a headache diary, because he remembers an increased level of activity after the shot, but I don't think that's the case).
 
Anyway, hopefully in two weeks at his next appointment he'll be able to go through with it.
 
I didn't remind Gary, but his 2-year anniversary of being chronic was March 5th.  He's still getting hit 5 - 8x per day, most of them K6 - K9 in strength.  We work together from home conducting research - but he's down to being able to put in 3 - hours a day of work - and that's on a good day.
 
So I still hold out hope, and thank you for sharing in such an organized and informative fashion your experiences.
 
Ace - sorry you got flamed.  Missed your original posts about it.
 
Hope you find more pain free time after the next injection.
 
All my best,
 
Laurie
IP Logged

____________________________________
Laurie

"It's comin' like a freight train - can't you hear it?" - Gary
wildhaus
CH.com Alumnus
New Board Hall of Famer
Switzerland 
*****






   


Gender: male
Posts: 572
Re: Suboccipital injection - W/UPDATE No. 1_8
« Reply #49 on: Mar 13th, 2008, 1:35pm »
Quote Quote Modify Modify

As soon as I am home agin I will add some more info.
and try and update.....
 
Only can say that at the moment I get up to 3 hits at night, and started to get day hits agin.......
 
Oh well, will have to go on and try agin......
 
Micahel
IP Logged


Pages: 1 2 3 4  Reply Reply Notify of replies Notify of replies Send Topic Send Topic Print Print

« Previous topic | Next topic »


Clusterheadaches.com Message Board » Powered by YaBB 1 Gold - SP 1.3.1!
YaBB © 2000-2003. All Rights Reserved.


©1998-2010 Web Vision Enterprises All rights reserved. All information on this site is protected by international copyright laws. You may not re-distribute any information from this site without written permission from Web Vision Enterprises and the webmaster of this site. Violators will be prosecuted.
You may view our privacy policy and financial disclosure statement here

test rss