Supraorbital and infraorbital nerve blockade in migraine patients: results of 6-month clinical follow-up.

BACKGROUND: Nerve blockades are used for the treatment of acute migraine episodes in emergency room conditions and beneficial results are obtained from this clinical use. Although this is the case, there are limited numbers of studies investigating the long-term effects of such an approach.

PATIENTS AND METHODS: In this investigation, we had 26 patients diagnosed as migraine based on the ICHD II criteria, these were injected with 1% lidocaine at supraorbital and infraorbital nerve localizations and clinical results were evaluated after 6 months of follow-up. All patients received 1.5 ml of 1% lidocaine bilaterally for supraorbital and infraorbital nerves with three day intervals for three times. Clinical evaluation was conducted by recording the number of migraine episodes per month together with migraine disability assessment scale (MIDAS) and visual analog scale (VAS) scores before and six months after the treatment.

RESULTS:  Mean age of the patients recruited in the study was 31.1±10.2 years. Disease duration was 8.1±5.4 years, the duration of the headache was 28.4±18.4 hours, mean number of episodes before treatment was 9.9±5.2, mean MIDAS was calculated as 3.2±0.8, and VAS as 9.0±1.0. Six months after the treatment, mean number of attacks was 2.0±3.0, MIDAS was 1.4±0.9 and VAS was 3.5±3.6. There was a statistically significant difference between the results obtained before and after the treatment.

CONCLUSIONS:  Injecting 1% of lidocaine to supraorbital and infraorbital nerve for three times prevents the acute migraine episodes effectively during the 6-months of follow-up without having any significant side effects.