Comparison of greater occipital and supraorbital nerve block with amitriptyline use in migraine treatment

Abstract

Objective: Migraine, a condition requiring long-term preventive therapy, especially for individuals with frequent and severe attacks. This study aims to compare the effectiveness of GON and SON (Greater Occipital Nerve and Supraorbital Nerve) blockades with amitriptyline in migraine management. Method: This retrospective study included 57 patients diagnosed with migraines. The first group consisted of patients who received a daily dose of 25 mg of amitriptyline for six months. The second group consisted of patients who initially received bilateral GON and SON blockades administered weekly for one month, followed by monthly blockade treatments for a total of 5 months. Pain frequency, analgesic consumption, and VAS (Visual Analog Scale) scores recorded in patients' follow-up files were compared between the groups before treatment and at the 1(st), 3(rd), and 6(th) months. Results: Records of 57 patients, comprising 5 males and 52 females, were examined. Among them, 25 received GON and SON blockades, while 32 were treated with amitriptyline. Both groups showed a decrease in pain frequency and fewer painful days over time, with significant differences observed at all time points compared to baseline and between the 1(st) and 3(rd) months. Regardless of time factors, a significant difference in pain intensity (VAS) existed between the groups, with lower VAS scores in the GON and SON blockades group. Both groups experienced a statistically significant reduction in VAS scores over time, with notable differences from baseline to subsequent assessments. Conclusion: This study suggests that GON and SON blockades could be an effective prophylactic treatment for migraines, highlighting its potential as an alternative to amitriptyline therapy.