Has anyone heard of an occipital nerve transection? 

I have had episodic Cluster Headaches for close to ten years.  My clusters may last a few days or several months.  I may have several a year or none at all for more than a year.

I have tried all of the common meds. Oxygen often works to stop an attack and if it doesn't Imitrex (injectable) usually does the job.

Prednisone used to shut down the cluster but the last few times it was no help.  Verapamil has never helped.

I am about three months into this cluster.  No help from prednisone. I am on Lithium now for about two weeks and it does not seem to be helping either. 

Went to a new neurologist about four weeks ago and he did a occipital nerve block.  It worked great and immediately.  I went from two or three bad headaches a day to none.  this lasted almost two weeks then the headaches returned in full force.  My neuro did another block and the headaches where gone again for nearly two weeks.

Today my neuro suggested sending me to a pain specialist for an occipital nerve transection. He said that since the blocks worked cutting the nerve may lead to long term headache relief. I can't find any information at all  about this procedure.  I have found articles about ON stimulation or trigeminal nerve transection but nothing about cutting the ON.

Has anyone heard of this or had this done? I don't mind the pain of the procedure.  I just hate to do somethng irreversible like cutting a nerve if its not going to help.

Kyle

lawvet wrote on Aug 26^th, 2009 at 2:06am:

Has anyone heard of an occipital nerve transection?  I have had episodic Cluster Headaches for close to ten years.  My clusters may last a few days or several months.  I may have several a year or none at all for more than a year. I have tried all of the common meds. Oxygen often works to stop an attack and if it doesn't Imitrex (injectable) usually does the job. Prednisone used to shut down the cluster but the last few times it was no help.  Verapamil has never helped. I am about three months into this cluster.  No help from prednisone. I am on Lithium now for about two weeks and it does not seem to be helping either.  Went to a new neurologist about four weeks ago and he did a occipital nerve block.  It worked great and immediately.  I went from two or three bad headaches a day to none.  this lasted almost two weeks then the headaches returned in full force.  My neuro did another block and the headaches where gone again for nearly two weeks. Today my neuro suggested sending me to a pain specialist for an occipital nerve transection. He said that since the blocks worked cutting the nerve may lead to long term headache relief. I can't find any information at all  about this procedure.  I have found articles about ON stimulation or trigeminal nerve transection but nothing about cutting the ON. Has anyone heard of this or had this done? I don't mind the pain of the procedure.  I just hate to do somethng irreversible like cutting a nerve if its not going to help. Kyle

I don't know about it, but am anxious to learn.
    How do they do an occipital nerve block?
lorac

Occipital nerve block - yes, that sounds very interesting.

This is an injection of some kinda cortisone or something I suppose?

Wondering where the heck they inject you for that....Ok I could just just Google for it, and probably will when I get a minute, but would love to hear more details on how it went down for you lawvet.

Thanks for the hedzup!

I haven't heard of this however there have been a few here that have had the trigeninal nerve clipped done.

You will find the replies to read something like this.

Paralysis on the afflicted side
Cluster headache returns on the other side.

there are other ways my friend

E

lorac wrote on Aug 26^th, 2009 at 8:21am:

lawvet wrote on Aug 26th, 2009 at 2:06am: Has anyone heard of an occipital nerve transection?  Went to a new neurologist about four weeks ago and he did a occipital nerve block.  It worked great and immediately.  I went from two or three bad headaches a day to none.  this lasted almost two weeks then the headaches returned in full force.  My neuro did another block and the headaches where gone again for nearly two weeks. Kyle I don't know about it, but am anxious to learn.     How do they do an occipital nerve block? lorac

Quote:

Posted by: bejeeber Posted on: Yesterday at 14:49:58 Occipital nerve block - yes, that sounds very interesting. This is an injection of some kinda cortisone or something I suppose?

Hi

(Quote) "Has anyone heard of an occipital nerve transection?  "

No, I have no idia what that is....... nor did my neuro-
surgon.....

As to the Occipital Nerve Block (ONB) I have posted
extensevly about it with images and reference studies
on this board.....

Link:(old Message Board)

START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

and: the continuation to the thread on the Old
-Message Board


START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE


Michael

Thanks for the replies.

I don't think I want to do anything as drastic, and permanent as cutting a nerve.  I am very concerned about the headaches jumping to the other side like it can do with trigeminal transection.  Also, the fact that no one has even heard of doing the procedure is enough to scare me away from it.

The blocks did work great for me, if only temporarily. Maybe a few more blocks and this cluster will leave me alone.

If the blocks are working for you (they don't work for everyone) then--by all means--I'd personally pursue it.  As an episodic, however, I don't think I'd consider transection. 

Seems a pretty drastic solution to alleviate a temporary problem. 

That's just me, of course.

Best,

George

stick with what works

I've never heard anyone with a clipped nerve having good success.  I would definitely look into it MUCH more thoroughly before having it done, especially as you are episodic. 

I would suggest you try Kudzu as a prevent.  It has worked pretty well for me, and doesn't have the side effects others have had.  Look under the old board and do a search for it.  There is an extensive post and followup started by Nani that is pretty indepth.

Jerry

I have always assumed that ch was a result of a blood vessel in the wrong place that when dilated and filled with blood, would press against this occ. nerve and cause the pain. this is why I thought prednisone and other meds that were used primarily to shrink swelling worked.
So why after this surgery do they switch to the other side of the head? I have also had rare attacks on the wrong side of the head.
Some Dr years ago told me that usually you get to an age and they just go away? I'm 58 and a periodic (usually every year Dec thru Jan, about 8 attacks per day) They morph too. used to get them in the daytime only, last couple of cycles include the sleep/wakeup with ch 4-5 times a night,scared to go back to sleep but so tired from fighting it off..
I have so much respect and admiration for the chronics, however do you maintain a life? do you learn to carry on every day stuff during an attack?
I'm doing the pred taper now and so far so good, although just started and after 2 days starting to feel shadows?

I've had many occipital nerve blocks done over the years at my local pain clinic. They help at the start but don't work so well anymore. I now get pulse radiofrequency blocks. It's where they go in with x-ray and and burn nerve endings in the occipital area for 60-90 seconds at a time. Once again used to work but after years it doesn't work as will at it once did.

I've just run a search on PubMed and could not find one article on resectioning. The reports on blockade and electro stimulation are mixed re. outcome but overall tending to the positive.

In my judgment, I'd not move in that direction until I had fully exhausted the usual medical approaches, paying attention to the latest dosing/drug combination approaches.

Have you tried Zyprexa as an abortive? It is slowly gaining attention here and now appears in a couple of lists of recommended abortives. (If interested, get back for an abstract for your doc.)