Bilateral Greater Occipital Nerve Block for Preventing the OnabotulinumtoxinA Wear-off Phenomenon in the Treatment of Chronic Migraine: A Case Series of 12 Patients|RISS 상세보기

다국어 초록 (Multilingual Abstract)

Purpose: OnabotulinumtoxinA is widely used to treat chronic migraines; however, the wear-off phenomenon before the next scheduled dose has emerged as a challenge. This study suggests a new strategy for preventing the wear-off phenomenon using bilateral greater occipital nerve block. Methods: We conducted a retrospective review of patients diagnosed with chronic migraine who were treated with onabotulinumtoxinA and bilateral greater occipital nerve block at St. Vincent Hospital from January 2023 to December 2023. Twelve chronic migraine patients with a history of the wear-off phenomenon received a greater occipital nerve block 8 weeks after the initial onabotulinumtoxinA injection for two sessions. Responses to treatment were evaluated with regular follow-ups and daily headache diaries. Results: All patients who had previously experienced the wear-off phenomenon with conventional onabotulinumtoxinA treatment did not experience the wear-off phenomenon during two sessions with an additional greater occipital nerve block administered 8 weeks after each onabolulinumtoxinA injection. Conclusion: Bilateral greater occipital nerve block administered 8 weeks after the initial onabotulinumtoxinA injection effectively prevents the wear-off phenomenon, enabling sustained therapeutic benefits in chronic migraine patients. Further research is needed to confirm these findings in larger cohorts.

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참고문헌 (Reference)

1 Quintas S, "Wearing off response to onabotulinumtoxinA in chronic migraine : analysis in a series of 193 patients" 20 : 1815-1821, 2019

2 Khan FA, "Wearing off effect of onabotulinumtoxinA near the end of treatment cycle for chronic migraine : a 4-year clinical experience" 60 : 430-440, 2020

3 Ruscheweyh R, "Wear-off of onabotulinumtoxinA effect over the treatment interval in chronic migraine : a retrospective chart review with analysis of headache diaries" 60 : 1673-1682, 2020

4 Karaoğlan M, "Three men in a boat : The comparison of the combination therapy of botulinum toxin and greater occipital nerve block with bupivacaine, with botulinum toxin monotherapy in the management of chronic migraine" 226 : 107609-, 2023

5 Ashkenazi A, "The effects of greater occipital nerve block and trigger point injection on brush allodynia and pain in migraine" 45 : 350-354, 2005

6 Bartsch T, "Stimulation of the greater occipital nerve induces increased central excitability of dural afferent input" 125 : 1496-1509, 2002

7 Abbas A, "Serum CGRP changes following ultrasound-guided bilateral greater-occipital-nerve block" 14 : 199-206, 2022

8 Malekian N, "Preventive effect of greater occipital nerve block on patients with episodic migraine : a randomized double-blind placebo-controlled clinical trial" 42 : 481-489, 2022

9 류상효, "OnabotulinumtoxinA(Botox®)Injection in the treatment for chronic migraine" 42 : 102-106, 2024

10 Masters-Israilov A, "OnabotulinumtoxinA wear-off phenomenon in the treatment of chronic migraine" 59 : 1753-1761, 2019