Greater occipital nerve block in the treatment of triptan-overuse headache: A randomized comparative study

Objectives: This study aims to investigate the efficiency of a single and repeated greater occipital nerve (GON) block using lidocaine in the treatment of triptan-overuse headache (TOH), whose importance has increased lately. Materials and methods: In the study, 105 consecutive subjects diagnosed with TOH were evaluated.The subjects were randomized into three groups.In Group 1 (n= 35), only triptan was abruptly withdrawn.In Group 2 (n= 35), triptan was abruptly withdrawn and single GON block was performed.In Group 3 (n= 35), triptan was abruptly withdrawn and three-stage GON block was performed.All patients were injected bilaterally with a total amount of 5 cc 1% lidocaine in each stage.During follow-up, the number of headache days per month, the severity of pain (VAS), the number of triptans used, and hsCRP and IL-6 levels were recorded three times; in the pretreatment period, in the second month post-treatment, and in the fourth month post-treatment.They were then compared. Results: There was a statistically significant difference in the post-treatment fourth month in comparison with the pretreatment period in Group 3 (P<.05).Compared to Group 1, the number of headache days, VAS, and decrease in triptan need in Group 3 was statistically significant compared to Group 2 (P<.05).Compared to pretreatment, in the fourth month post-treatment, both hsCRP and IL-6 levels were lower only in Group 3 (P<.05). Conclusions: We are of the opinion that repeated GON block in addition to the discontinuation of medication has significant efficacy for TOH cases.