Paul Ballinger. Double blind studies  1. Cluster headache-13 active steroid,10 saline.11 patients (85%) became attack free in 1 st week and 8 remained.

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Presentation transcript:

Paul Ballinger

Double blind studies  1. Cluster headache-13 active steroid,10 saline.11 patients (85%) became attack free in 1 st week and 8 remained attack free at 4 weeks  Ambrosini A, Vandenheede M, Rossi P, et al. Pain. 2005; 118 :92-96  2.CEH-24 in treatment arm 23 in placebo. Active group showed a 50% reduction in pain at 2 weeks.  Naja ZM, El-Rajab M, Al-Tannir MA etal. Pain Pract.2006; 6 :89-95.

Cervicogenic headache-Anthony  160mg depo medrone plus 3ml lignocaine to GON in 180 patients.169 derived significant pain relief lasting days( mean 23 days)  Anthony M. Cervicogenic headache:. Clin Exp Rheumatol. 2000; 18 (suppl. 19):S59-S64. 

MIGRAINE CLUSTERNDPHHCOTHER Number Patients Number injections Complete response Partial response

 47 CEH patients 2 weekly GON blocks -1 to 12 injections. 95 pc achieved 6 months pain relief. Efficacy increased with number of injections.  Naja ZM, El-Rajab M, Al-Tannir MA et al.Pain Pract. 2006;6:  27 Migraine patients given GON/SON blocks alternate days between 5 and 10 ib total. 85% obtained 50 % improvement at 6 months. Caputi CA, Firetto V. Headache. 1997;37:

Immediate effects  Reversal of allodynia, headache reduction.  Study 1-17/19 patients had 46% reduction in pain and 75% reduction in allodynia 15 mins after block.  Ashkenazi A, Young WB.. Headache. 2005; 45 :  Study 2-25 patients given block.Headache 64% better,allodynia 75% better, photophobia 67% better

 No DB studies but effective in supraorbital neuralgia.  18 patients with supraorbital neuralgia all responded to SON injection

 1. Incidence 94% in migraine,29% in controls. 42% in temporal region,33% suboccipital  migraine patients evaluated after series of injections evaluated 4 weeks after injection. 60%much improved,26% reverted to episodic migraine  3.Cluster-5/6 patients had cluster attack aborted in 15 minutes.6/7 had attacks prevented.  Calandre EP, Hidalgo J, Garcia-Leiva etal. Eur J Neurol 2006, 13:

No benefitBenefit%pain decrease Duration benefit Medication overuser %5.5 weeks Non-overuser137085%6.1 weeks