Chronic Migraine, Headache
Conditions
Brief summary
Comparative Study of Greater Occipital Nerve Block and Pulsed Radiofrequency in the Management of Chronic Migraine : Clinical Outcomes and Neurophysiological Correlates A Prospective Randomized Study
Interventions
DRUGGreater occiptal nerve block
Injection Procedure: 1. Local skin infiltration with 1-2 mL of 1% lidocaine at puncture site. 2. GON block using 3-5 mL of local anesthetic, optionally combined with 20-40 mg triamcinolone ( Bilaterally ) 3. Needle placement confirmed by ultrasound visualization of the nerve and spread of injectate. 4. Observe patient for 15-20 minutes post-injection for immediate adverse events.
DEVICEPulsed radiofrequency
1. Introduce RF cannula adjacent to GON under ultrasound guidance. 2. Confirm sensory stimulation: paresthesia at occipital scalp at \<0.5 V. 3. PRF settings: * Temperature: ≤42°C * Pulse duration: 20 ms * Frequency: 2 Hz * Duration: 120 seconds per cycle, 2 cycles per side 4. Continuous monitoring of patient comfort and vital signs.
Sponsors
Sohag University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* patient with Diagnosis of chronic migraine for \> 3 months. * migraine days ≥ 15 days/month. * Failure or inadequate response to standard medical treatment.
Exclusion criteria
* Secondary headache disorders. * Coagulopathy or anticoagulant therapy. * Infection at injection site. * History of cervical spine surgery. * Pregnancy or breastfeeding. * Previous PRF or occipital nerve surgery within last 3 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The change in the VAS score of Pain over period of follow up | 6 months | after do GONB and Pulsed radio frequency we assess improvement of Episodic Pain over period of Follow up |
Contacts
CONTACTshehab Mahmoud mohamed, assisstant lecturer
Outcome results
None listed