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Topic: Suboccipital Nerve Blocks - new research (Read 569 times) |
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floridian
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Suboccipital Nerve Blocks - new research
« on: Oct 6th, 2005, 11:46am » |
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Very promising study from Italy - 85% of patients PF at the one week mark, 62% PF at the 4 week mark.
Quote: Pain. 2005 Sep 30; [Epub ahead of print]
Suboccipital injection with a mixture of rapid- and long-acting steroids in cluster headache: A double-blind placebo-controlled study.
Ambrosini A, Vandenheede M, Rossi P, Aloj F, Sauli E, Pierelli F, Schoenen J.
Headache Clinic, INM Neuromed, IRCCS, Via Atinense, 18, I-86077 Pozzilli, Isernia, Italy.
Oral steroids can interrupt bouts of cluster headache (CH) attacks, but recurrence is frequent and may lead to steroid-dependency. Suboccipital steroid injection may be an effective 'single shot' alternative, but no placebo-controlled trial is available. The aim of our study was to assess in a double-blind placebo-controlled trial the preventative effect on CH attacks of an ipsilateral steroid injection in the region of the greater occipital nerve. Sixteen episodic (ECH) and seven chronic (CCH) CH outpatients were included. ECH patients were in a new bout since no more than 1 week. After a one-week run-in period, patients were allocated by randomization to the placebo or verum arms and received on the side of attacks a suboccipital injection of a mixture of long- and rapid-acting betamethasone (n=13; Verum-group) or physiological saline (n=10; Plac-group). Acute treatment was allowed at any time, additional preventative therapy if attacks persisted after 1 week. Three investigators performed the injections, while four others, blinded to group allocation, followed the patients. Follow-up visits were after 1 and 4 weeks, whereafter patients were followed routinely. Eleven Verum-group patients (3 CCH) (85%) became attack-free in the first week after the injection compared to none in the Plac-group (P=0.0001). Among them eight remained attack-free for 4 weeks (P=0.0026). Remission lasted between 4 and 26 months in five patients. A single suboccipital steroid injection completely suppresses attacks in more than 80% of CH patients. This effect is maintained for at least 4 weeks in the majority of them. |
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http://www.med-owl.com/clusterheadaches/tiki-index.php?page=Suboccipital +Nerve+Block
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| « Last Edit: Oct 6th, 2005, 11:48am by floridian » |
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debpa
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Re: Suboccipital Nerve Blocks - new research
« Reply #1 on: Oct 6th, 2005, 12:12pm » |
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Very interesting and it does sound promising. My question is (keep in mind I believe there is no such thing as a stupid question) what the heck is a subocciptal injection? If you told me it was a shot administered directly into the pupil of the eye my husband would be first in line for the treatment.  Seriously though. What is it and when are they going to be doing trials here in the U.S.? The sooner the better.
Thanks for the info.
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floridian
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Re: Suboccipital Nerve Blocks - new research
« Reply #2 on: Oct 6th, 2005, 12:59pm » |
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It is an injection in the neck - the occipital region is that bump on the back of the head at the base of the skull. The injections go slightly below that, around the nerves but not in the nerves. The steroids turn down those nerves, which somehow can turn down or turn off the cluster attacks.
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debpa
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Re: Suboccipital Nerve Blocks - new research
« Reply #3 on: Oct 6th, 2005, 1:02pm » |
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Thanks for clearing that up for me.
Deb
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unsolved1
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Re: Suboccipital Nerve Blocks - new research
« Reply #4 on: Oct 6th, 2005, 2:31pm » |
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I don't know about trials, but they already give Occipital nerve blocks in the US. I've had about 7 of them. THe first one brought me 17 days pain free, all the rest failed 
UNsolved
*edited to add that you can get an ON block at a skilled neuro's office or at a pain management clinic
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| « Last Edit: Oct 6th, 2005, 2:33pm by unsolved1 » |
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nani
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Re: Suboccipital Nerve Blocks - new research
« Reply #5 on: Oct 6th, 2005, 11:40pm » |
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Flo, is "sub" occipital nerve block different than what Michael had? Your's sounds like it's below the nerve. Just curious.
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unsolved1
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Re: Suboccipital Nerve Blocks - new research
« Reply #6 on: Oct 7th, 2005, 7:07am » |
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Nani brings up a good question: Is a "greater Occipital nerve block" the same as a "subOccipital nerve block" ??
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Gator
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Re: Suboccipital Nerve Blocks - new research
« Reply #7 on: Oct 7th, 2005, 10:20pm » |
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I also had a greater occipital nerve block done. It was pretty much a pain in the neck (if you'll excuse the pun) and not much else.
If this is different, it sounds interesting.
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kimmeesue
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Re: Suboccipital Nerve Blocks - new research
« Reply #8 on: Oct 9th, 2005, 12:33am » |
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I had trigger point injections in that region. Would that be even remotely the same? Only short term success.
Kim
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If I wasn't doing this I'd probably be doing something else.
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her_redhed
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Re: Suboccipital Nerve Blocks - new research
« Reply #9 on: Oct 13th, 2005, 6:37am » |
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thanks floidian. i've beamed your info to my wife's h/a specialist. he refers to the italian researchers all the time. (wonder why they get all the clusters?) over the summer she's had 3 of the little blocks in the neuro's office, one worked for a whole day. then a pretty big one into the trigeminal nerve, that gave another p/f day. recently they did an RF nerve block (burn) which only reduced her regular attack by a few kips. this nerve guy wants to do some more, guess we'll see. say, has anyone else had trouble with insurance paying for these procedures? or found a way to get them to ante up?
thanks, best, michael
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