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The Effects of Greater Occipital Nerve Block
and Trigger Point Injection on Brush
Allodynia and Pain in Migraine
Avi Ashkenazi, MD and William B. Young, MD
Posted: June 2005  
Headache 2005;45:350-354

Objective:  To evaluate the effect of GONB, with or without trigger point injection (TPI), on dynamic mechanical (brush) allodynia (BA) and on head pain in migraine.

Background:   Patients with migraine often have cutaneous allodynia that is related to sensitization of central pain neurons. Greater occipital nerve block (GONB) is an effective treatment for migraine headache; however, its effect on cutaneous allodynia in migraine is unknown.

Results:  Nineteen patients were studied. Mean age was 43.6 years. Twenty minutes after treatment, headache was reduced in 17 patients and did not change in 2. The average headache level was 6.53 before treatment and 3.47 20 minutes after it. The average allodynia score decreased after 20 minutes in all patients. Average allodynia score per site was reduced by 18.69 mm and 13.74 mm in the trigeminal and cervical areas, respectively. There was a positive correlation between allodynia index, obtained through the questionnaire, and allodynia score, obtained by examination.

Conclusion:   GONB, with or without TPI, reduced both head pain and brush allodynia in this migraine patient group.