MİGREN HASTALARINA UYGULANAN BÜYÜK OKSİPİTAL SİNİR PULSED RADYOFREKANS İŞLEMİNİN ETKİNLİĞİ

Yıl 2021, Cilt: 28 Sayı: 4, 635 - 640, 30.12.2021

Miraç Alasu Fahrettin Kırçiçek Pakize Kırdemir

https://doi.org/10.17343/sdutfd.970553

Öz

Amaç
Bu çalışmanın amacı migren hastalarına uygulanan
büyük oksipital sinir (GON) pulsed radyofrekans
(PRF) işleminin baş ağrısı şiddet, sıklık ve sürelerine
etkisini değerlendirmektir.
Gereç ve Yöntem
Bu retrospektif çalışmada dirençli migren tanısı olan
ve GON PRF işlemi uygulanmış 27 hastanın verileri
tarandı. Hastaların işlemden önceki sayısal derecelendirme
ölçeği (NRS), baş ağrısı sıklığı ve süresi,
işlemden sonraki 1.,3.,6.,9. aylardaki NRS, baş ağrısı
sıklık ve süre değerleriyle karşılaştırıldı.
Bulgular
Hastaların yaş ortalamaları 41,11±12,18’di. Hastalık
tanı süreleri (yıl) ortalama 12,74±9,42’di. Hastaların
GON PRF işlemi öncesi NRS değerleri 8,81±0,62,
atak sıklık (ay) değerleri 7,70±4,19, atak süreleri
(saat) değerleri 36,44±20,82’di. Hastaların GON PRF
işlemi sonrası 1.,3.,6.,9. aylardaki NRS, atak sıklığı
ve atak süreleri işlem öncesi NRS, atak sıklığı ve atak
süreleri ile kıyaslandığında istatistiksel olarak anlamlı
derecede düşük bulundu.
Sonuç
Biz çalışmamızda GON PRF işleminin 9 aylık süre
boyunca migren atak şiddetini, sıklığını ve süresini
azalttığını gözlemledik.

Anahtar Kelimeler

migren, pulsed radyofrekans, büyük oksipital sinir

EFFICACY OF PULSED RADIOFREQUENCY PROCEDURE OF GREATER OCCIPITAL NERVE PERFORMED TO MIGRAINE PATIENTS

Öz

Objective
The aim of this study is to evaluate the effect of the
greater occipital nerve (GON) pulsed radiofrequency
(PRF) procedure performed to migraine patients on
headache severity, frequency and duration.
Material and Methods
İn this retrospective study, the data of 27 patients with
a diagnosis of resistant migraine who underwent GON
PRF were scanned. The numerical evaluation scale
(NRS), headache frequency and duration before the
procedure, 1, 3, 6, 9 months after the procedure,
NRS, frequency and duration values of the patients
were compared.
Results
The mean age of the patients was 41.11±12.18. The
mean duration of disease diagnosis (years) was
12.74±9.42. The mean NRS values of the patients
before the GON PRF procedure were 8.81±0.62,
the mean attack frequency (month) values were
7.70±4.19, and the mean attack duration (hour) values
were 36.44±20.82. After the GON PRF procedure,
1, 3, 6, 9 months NRS, attack frequency and attack
duration of the patients were found to be statistically
significantly lower when compared with pre-procedure
NRS, attack frequency and attack duration.
Conclusions
In our study, we observed that the GON PRF
procedure reduced the severity, frequency and
duration of attacks over a 9-month period.

Anahtar Kelimeler

migraine, pulsed radiofrequency, greater occipital nerve

Kaynakça

• 1. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211.
• 2. Global, regional, and national burden of migraine and tension- type headache, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 Lancet Neurol 2018;17(11): 954–76.
• 3. Lantéri-Minet M, Duru G, Mudge M, Cottrell S. Quality of life impairment, disability and economic burden associated with chronic daily headache, focusing on chronic migraine with or without medication overuse: a systematic review. Cephalalgia. 2011;31(7):837-50.
• 4. Sacco S, Braschinsky M, Ducros A, Lampl C, Little P, Brink AM, et al. European headache federation consensus on the definition of resistant and refractory migraine. J Headache Pain 2020;21(1):76
• 5. D'Antona L, Matharu M. Identifying and managing refractory migraine: barriers and opportunities? J Headache Pain. 2019;20(1):89.
• 6. Tang Y, Kang J, Zhang Y, Zhang X. Influence of greater occipital nerve block on pain severity in migraine patients: A systematic review and meta-analysis. Am J Emerg Med. 2017;35(11):1750-54.
• 7. Kwak S, Chang MC. Management of refractory chronic migraine using ultrasound-guided pulsed radiofrequency of greater occipital nerve: Two case reports. Medicine (Baltimore). 2018;97(45):e13127.
• 8. Cho SJ, Song TJ, Chu MK. Treatment update of chronic migraine. Curr Pain Headache Rep. 2017;21(6):26.
• 9. Hadden S. Neuralgic headache and facial pain. Arch Neurol Psychiatr 1940;43:405-8.
• 10. Zipfel J, Kastler A, Tatu L, Behr J, Kechidi R, Kastler B. Ultrasound- Guided Intermediate Site Greater Occipital Nerve Infiltration: A Technical Feasibility Study. Pain Physician. 2016;19(7):E1027-34.
• 11. Turkiye Klinikleri J Neurol-Special Topics 2017;10(4): 367-70.
• 12. Çatav S, Solmaz FA, Kırdemir P. Migren başağrısında büyük oksipital sinir bloğu uygulama sonuçlarımız. Agri 2017;29(1):33– 37.
• 13. Inan LE, Inan N, Unal-Artık HA, Atac C, Babaoglu G. Greater occipital nerve block in migraine prophylaxis: Narrative review. Cephalalgia. 2019;39(7):908-920
• 14. Loukas M, El-Sedfy A, Tubbs RS, Louis RG Jr, Wartmann CH, Curry B, Jordan R. Identification of greater occipital nerve landmarks for the treatment of occipital neuralgia. Folia Morphol (Warsz). 2006;65(4):337-42.
• 15. Greher M, Moriggl B, Curatolo M, Kirchmair L, Eichenberger U. Sonographic visualization and ultrasound-guided blockade of the greater occipital nerve: a comparison of two selective techniques confirmed by anatomical dissection. Br J Anaesth 2010;104(5):637–42.
• 16. Sluijter ME. Pain in Europe, Barcelona. 2nd Annual Congress of the European Federation of IASP Chapters;.Non-thermal Radiofrequency procedures in the treatment spinal pain; 1997; 326.
• 17. Sluijter ME, Cosman ER, Rittman WB, van Kleef M. The effects of pulsed radiofrequency field applied to the dorsal root ganglion: a preliminary report. Pain Clin. 1998;11:109–117.
• 18. Erdine S, Yucel A, Cimen A, Aydin S, Sav A, Bilir A. Effects of pulsed versus conventional radiofrequency current on rabbit dorsal root ganglion morphology. Eur J Pain. 2005;9(3):251-56.
• 19. Cohen SP, Foster A. Pulsed radiofrequency as a treatment for groin pain and orchialgia. Urology. 2003;61(3):645.
• 20. Hagiwara S, Iwasaka H, Takeshima N, Noguchi T. Mechanisms of analgesic action of pulsed radiofrequency on adjuvant- induced pain in the rat: roles of descending adrenergic and serotonergic systems. Eur J Pain. 2009;13(3):249-52.
• 21. Y. Higuchi, B.S. Nashold Jr., M. Sluijter, E. Cosman, R.D. Pearlstein Exposure of the dorsal root ganglion in rats to pulsed radiofrequency currents activates dorsal horn lamina I and II neurons. Neurosurgery 2002;50(4):850–55.
• 22. Arakawa K, Kaku R, Kurita M, Matsuoka Y, Morimatsu H. Prolonged-duration pulsed radiofrequency is associated with increased neuronal damage without further antiallodynic effects in neuropathic pain model rats. J Pain Res. 2018;11:2645-51.
• 23. Li J, Yin Y, Ye L, Zuo Y. Pulsed Radiofrequency of C2 Dorsal Root Ganglion Under Ultrasound-Guidance and CT Confirmed for Chronic Headache: Follow-Up of 20 Cases and Literature Review. J Pain Res. 2020;13:87-94.
• 24. Cohen SP, Peterlin BL, Fulton L, Neely ET, Kurihara C, Gupta A, et al. Randomized, double-blind, comparative-effectiveness study comparing pulsed radiofrequency to steroid injections for occipital neuralgia or migraine with occipital nerve tenderness. Pain 2015;156(12): 2585-94.
• 25. Gabrhelík T, Michálek P, Adamus M. Pulsed radiofrequency therapy versus greater occipital nerve block in the management of refractory cervicogenic headache a pilot study. Prague Med Rep. 2011;112:279–87.
• 26. Manolitsis N, Elahi F. Pulsed radiofrequency for occipital neuralgia. Pain Physician 2014;17:709–17.