Greater Occipital Nerve Block, Headache, Medication-overuse Headache, Treatment
Conditions
Brief summary
The aim of this study to evaluate pre-injection patient-related factors that may influence treatment response in patients with medication-overuse headache who underwent ultrasound-guided greater occipital nerve block.
Interventions
OTHERTreatment outcome
Before the injection, patients will be evaluated for the number of headache days, headache severity, the number of days of analgesic use for headache, headache-related disability, pressure pain threshold over the bilateral greater occipital nerve, anxiety and depression scores, and sleep quality. At 1 and 2 months after the injection, they will be reassessed for the number of headache days, headache severity, and the number of days of analgesic use for headache. In addition, at 1 hour after the injection, the pain experienced during the injection procedure will be assessed.
Sponsors
Sultan 1. Murat State Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Inclusion criteria
* Age between 18 and 65 years * Diagnosis of medication-overuse headache according to the International Classification of Headache Disorders, 3rd edition (ICHD-3) * Diagnosis of medication-overuse headache associated with the use of triptans or nonsteroidal anti-inflammatory drugs * Previous diagnosis of chronic migraine or chronic tension-type headache according to the ICHD-3 criteria
Exclusion criteria
* History of severe head or neck trauma or previous neurosurgical intervention * Presence of a severe psychiatric disorder (e.g., severe depression, schizophrenia) * History of infectious disease, chronic inflammatory disease, or malignancy * Previous diagnosis of secondary headache * History of substance abuse * Pregnancy or breastfeeding * History of an additional neurological disorder (e.g., cerebrovascular disease, multiple sclerosis) * Difficulty with cooperation * Presence of a concomitant systemic disease that may affect quality of life (e.g., congestive heart failure, chronic kidney disease, chronic liver disease, pulmonary disease, uncontrolled diabetes, or peripheral vascular disease)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the number of days of analgesic use for headache | Baseline | Patients will be questioned the total number of days on which they used analgesics for headache during the past month. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Headache severity | Baseline | Patients will be questioned about headache severity using the Visual Analog Scale (VAS). A 10-cm-long horizontal straight line will be used for VAS assessment. 0 is considered no pain, and 10 is considered the most severe pain. |
| Post-injection pain severity | Baseline | Patients will be questioned about post-injection pain severity using the Visual Analog Scale (VAS). A 10-cm-long horizontal straight line will be used for VAS assessment. 0 is considered no pain, and 10 is considered the most severe pain. |
| Headache-related disability | Baseline | Patients will be questioned about headache-related disability using the Headache Impact Test-6 (HIT-6). The HIT-6 consists of six items, each scored on a 5-point Likert scale. The total score is calculated by summing the scores of all six items, with higher scores indicating a greater impact of headache on daily life. |
| Pressure pain threshold | Baseline | The pressure pain threshold over the bilateral greater occipital nerve will be assessed using a manual pressure algometer (Baseline Dolorimeter®). Pressure pain threshold measurement will be performed over the medial one-third of an imaginary line drawn between the external occipital protuberance and the mastoid process. During the measurement, the 1.52 cm² flat circular probe of the algometer will be placed on the relevant area, and pressure will be increased at a rate of 1 kg per second. Patients will be asked to indicate the moment they first perceived pain. The value for the reference area will be calculated as the arithmetic mean of the right and left measurements. |
| Anxiety and depression levels | Baseline | Patients' anxiety and depression symptoms will be assessed using the Hospital Anxiety and Depression Scale (HADS). The HADS is a 14-item scale consisting of two subscales: anxiety and depression. For each subscale, the minimum score is 0 and the maximum score is 21. Higher scores indicate greater severity of anxiety and depression symptoms. |
| Sleep quality | Baseline | Patients will be evaluated in terms of sleep quality using a 4-point Likert-type scale. They wii be asked to describe their sleep quality by selecting one of the following options: "good," "mildly impaired," "moderately impaired," or "severely impaired." |
Countries
Turkey (Türkiye)
Outcome results
None listed