CT-guided infiltration of greater occipital nerve for refractory craniofacial pain syndromes other than occipital neuralgia.
Diagn Interv Imaging
; 101(10): 643-648, 2020 Oct.
Article
em En
| MEDLINE
| ID: mdl-32482584
ABSTRACT
PURPOSE:
The purpose of this study was to evaluate the effectiveness of computed tomography (CT)-guided infiltration of greater occipital nerve (GON) for the treatment of refractory craniofacial pain syndromes other than occipital neuralgia. MATERIALS ANDMETHODS:
Fifty-six patients suffering from refractory craniofacial pain syndromes were included between 2011 and 2017. There were 33 women and 23 men with a mean age of 50.7 years±13.1 (SD) (range 27-74 years). CT-guided infiltration was performed at the intermediate site of the GON with local anesthetics and cortivazol. Twenty-six (26/56; 46%) patients suffered from chronic migraine, 14 (14/56; 25%) from trigeminal neuralgia and 16 (16/56; 29%) from cluster headaches. Clinical success at 1, 3, and 6 months was defined by a decrease of at least 50% of pain as assessed using visual analog scale (VAS).RESULTS:
Mean overall VAS score before infiltration was 8.7±1.3 (SD) (range 6 - 10). Mean overall VAS scores after infiltration were 2.3±3 (SD) (range 0 - 10) (P<0.01) at one month, 3.5±3.3 (SD) (range 0 - 10) (P<0.01) at three months and 7.6±1.3 (SD) (range 1-10) (P<0.01) at six months. After infiltration, clinical success was achieved in 44 patients (44/56; 78.5%) at 1 month, 37 patients (37/56; 66%) at 3 months and 13 patients (13/56; 23%) at 6 months. Clinical success according to the clinical presentation were as follows 88% (23/26) at one month, 73% (19/26) at 3 months, and 23% (6/26) at 6 months in patients with chronic migraine, 81% (13/16), 69% (11/16) and 31% (5/16) in those with cluster headaches and 57% (8/14), 50% (7/14) and 14% (2/14) in those with trigeminal neuralgia. No major complications due to CT-guided GON infiltration were reported in any patient.CONCLUSION:
CT-guided infiltration at the intermediate site of the GON appears as an effective treatment of craniofacial pain syndromes especially in patients with chronic migraine and those with cluster headaches.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neuralgia Facial
/
Neuralgia
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article