Greater occipital nerve block for chronic headache management in children and adolescents: A longitudinal observational study and systematic review
Abstract
OBJECTIVES/BACKGROUND: Treatment options for children and adolescents with chronic headache are limited. Greater occipital nerve block (GONB) has been shown to be effective in headache relief in adults, with minimal side effects, whereas similar evidence for pediatric patients remains to be determined. This study was undertaken to assess the effectiveness, acceptability, and tolerability of GONB in the management of chronic headache in children and adolescents, based on our own clinic experience and a systematic review of the literature. METHODS: This longitudinal observational study included all children and adolescents with chronic headache who received GONB at a large tertiary hospital for children between February 2018 and June 2024. Patients were given 10 mg lidocaine with 40 mg methylprednisolone on one or both sides. Data were collected on patients' demographics, clinical diagnosis of the headache disorder, previous treatments, GONB procedure details, response to the treatment, and reported adverse reactions. Diagnoses of headache disorders were made based on the International Classification of Headache Disorders, 3rd edition. A good response was defined as resolution of headache for at least 2 weeks, whereas a partial response was defined as relief of headache lasting less than 2 weeks or a reduction in headache intensity. Statistical analysis assessed responses to the first procedure and all subsequent treatment sessions separately. The findings from this study were…
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