Botulinum Toxin and/or Greater Occipital Nerve Block for Patients With Chronic Migraine

Summary

Chronic migraine is a debilitating neurological disorder that significantly affects patients' daily functioning, mental health, and quality of life. Management typically includes acute and preventive treatments, but effectiveness can be limited due to medication overuse or delayed onset of action. OnabotulinumtoxinA injections provide proven long-term preventive benefits, while Greater Occipital Nerve (GON) block offers rapid but short-term relief. Although both treatments are used individually, evidence on the combined effect is limited. This randomized controlled trial aims to evaluate the efficacy and safety of combining OnabotulinumtoxinA injections with GON block, assessing improvements in headache frequency, severity, and patient quality of life compared to single therapy.

Timeline

Start

2026-04

Primary completion

2026-10

Completion

2026-12

Publications

• Results Arata WH, Midha RK, Varrassi G, Sala K, Plessala MJ, Brodtmann J, Dufrene K, Palowsky Z, Griffin P, Ahmadzadeh S, Shekoohi S, Kaye AD. Occipital nerve block for headaches: a narrative review. J Oral Facial Pain Headache. 2024 Jun;38(2):1-10. doi: 10.22514/jofph.2024.010. Epub 2024 Jun 12.
• Results Inan LE, Inan N, Unal-Artik HA, Atac C, Babaoglu G. Greater occipital nerve block in migraine prophylaxis: Narrative review. Cephalalgia. 2019 Jun;39(7):908-920. doi: 10.1177/0333102418821669. Epub 2019 Jan 6.
• Results Ashkenazi A, Matro R, Shaw JW, Abbas MA, Silberstein SD. Greater occipital nerve block using local anaesthetics alone or with triamcinolone for transformed migraine: a randomised comparative study. J Neurol Neurosurg Psychiatry. 2008 Apr;79(4):415-7. doi: 10.1136/jnnp.2007.124420. Epub 2007 Aug 6.
• Results Ashkenazi A, Levin M. Greater occipital nerve block for migraine and other headaches: is it useful? Curr Pain Headache Rep. 2007 Jun;11(3):231-5. doi: 10.1007/s11916-007-0195-3.

Drugs

Indications