- Bilateral Greater Occipital Nerve Block for Preventing the OnabotulinumtoxinA Wear-off Phenomenon in the Treatment of Chronic Migraine: A Case Series of 12 Patients
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Sanghyun Kim, Jae Young An, Dae Woong Bae
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Headache Pain Res. 2024;25(2):111-116. Published online October 23, 2024
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DOI: https://doi.org/10.62087/hpr.2024.0021
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- Purpose: OnabotulinumtoxinA is widely used to treat chronic migraines; however, the wear-off phenomenon before the next scheduled dose has emerged as a challenge. This study suggests a new strategy for preventing the wear-off phenomenon using bilateral greater occipital nerve block.
Methods
We conducted a retrospective review of patients diagnosed with chronic migraine who were treated with onabotulinumtoxinA and bilateral greater occipital nerve block at St. Vincent Hospital from January 2023 to December 2023. Twelve chronic migraine patients with a history of the wear-off phenomenon received a greater occipital nerve block 8 weeks after the initial onabotulinumtoxinA injection for two sessions. Responses to treatment were evaluated with regular follow-ups and daily headache diaries.
Results
All patients who had previously experienced the wear-off phenomenon with conventional onabotulinumtoxinA treatment did not experience the wear-off phenomenon during two sessions with an additional greater occipital nerve block administered 8 weeks after each onabolulinumtoxinA injection.
Conclusion
Bilateral greater occipital nerve block administered 8 weeks after the initial onabotulinumtoxinA injection effectively prevents the wear-off phenomenon, enabling sustained therapeutic benefits in chronic migraine patients. Further research is needed to confirm these findings in larger cohorts.
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Citations
Citations to this article as recorded by  - When Should Headache Specialists Hold a Needle? The Role of Botulinum Toxin Injections and Occipital Nerve Blocks
Soo-Jin Cho
Headache and Pain Research.2024; 25(2): 73. CrossRef
- The Effect of Cognitive Impairment on the Frequency of Headaches in the Elderly
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Dae Woong Bae, Si Ryoung Han, Jae Young An
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Published online December 31, 2018
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- 두개내 저혈압과 동반한 일측성 청력저하 및 MRI 소견
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