NERVE BLOCKAGES

In cases of Migraine, Cluster, Trigeminal Neuralgia and Tension Type Headaches, in cases resistant to drug treatment or in cases where drug treatment cannot be used (pregnancy etc.), nerve blockade methods can be used.

What is referred to as nerve blockade is based on the principle of administering a number of drugs (lidocaine, bupivacaine, triamcinolone, physiological serum etc.) to the nerves that cause pain attacks and are thought to be connected to the pain centers in the brain (Trigeminovascular and trigeminocervical system) using special injection techniques. Nerve blocks are interventional procedures.

Blockade can be applied to many nerves associated with head and facial pain (greater occipital nerve, lesser occipital nerve, supraorbital nerve, infraorbital nerve, supratrochlear nerve, auriculotemporal nerve, mental nerve etc.). More than one nerve can be blocked at the same time.

The most common is the greater occipital nerve blockade (GON = Greater Occipital Nerve). This nerve is directly related to the Trigeminovascular/Trigeminocervical system.

GON blockade:

Although its popularity has increased in recent years, its application history dates back to the 1940s. It can be applied as both an attack and a preventive treatment for migraine headaches. It is an effective and safe method for the treatment of migraine patients who are resistant to drug treatment or who cannot use medication due to various reasons such as pregnancy.

How is it applied?

Drugs applied to the greater occipital nerve with a special technique, sometimes (not necessarily) with ultrasound guidance, at neuroanatomically determined points, block the reversible sodium channels in the nerve fibers. Thus, the formation of pain stimuli in the nerve and vascular centers to which the nerve is connected, especially in the Trigeminocervical systems, and which are related to migraine headaches, is prevented. This effect also has a REGULATORY effect on the mechanisms that create migraine pain, which we call NEUROMODULATION.

The nerve, whose neuroanatomical localization is made with a special injection technique, is blocked by injecting a mixture of local anesthesia and physiological serum.

The injection can be made unilaterally or bilaterally.

Since local anesthesia is applied, there may be temporary numbness, matting or loss of sensation in the applied area.

How long is the application?

The procedure is completed within 1-2 minutes after the preparations are completed.

It can be applied weekly for 4-6 weeks. Afterwards, the application is continued monthly.

Since it is not only an attack treatment but also a preventive treatment, the application should be repeated at the times determined by the neurologist.

Does it have any side effects?

Although it is a very reliable method, some rare side effects can be seen.

As with all injection methods, infection at the injection site (if the area is not cleaned sufficiently), subcutaneous bleeding, secondary syncope/fainting or fainting due to injection, low blood pressure, nausea, palpitations may occur.

Local anesthetics can rarely cause heart rhythm disorders, allergic reactions and hypersensitivity reactions. Therefore, it is recommended to apply in a clinical environment.

In cases where steroids are applied, thinning of the scalp and hair loss may be observed in the application area.

Indications are primarily MIGRAINE type resistant headaches;

Occipital neuralgia

Cervicogenic headache

Cluster headache

Headaches due to muscle spasm

Diseases seen in intra-segmental structures

Regional cancer pain

In neural therapy applications, for interference areas

Contraindications (situations that should not be performed)

Those with bleeding disorders

Those using blood thinners (doctor decides according to the patient)

In the area to be treated or in the presence of systemic infection

In case of regional metastasis