Could pulsed radiofrequency stimulation of the proximal greater occipital nerve be a treatment option for refractory chronic migraine patients?

Objectives: This study aimed to demonstrate the change in pain intensity, frequency of attacks, and life quality before and after treatment in patients with chronic migraine who underwent greater occipital nerve (GON) pulsed radiofrequency (PRF). Patients and methods: This prospective, cross-sectional study was conducted with 30 patients (1 male, 29 females; mean age: 43.7±9.8 years; range, 26 to 64 years) with chronic migraine diagnosed according to the beta version of the third edition of the International Classification of Headache Disorders. Patients who did not respond to conventional treatments were enrolled in the study. The PRF procedure on the proximal GON at the C2 vertebra level was performed under the guidance of ultrasound at 5 Hz and 5 msec pulsed width for 360 sec at 45 V. The Visual Analog Scale (VAS), pain frequency (per week), analgesic consumption frequency (per week), and the SF-12 (12-item Short-Form Health Survey) were used to compare pain intensity and quality of life (QoL) before and three months after treatment. Results: There was significant decrease in pain frequency (5.5 to 2.0), analgesic consumption frequency (7.0 to 2.0), and VAS scores (9.0 to 7.0) three months after the intervention compared to baseline (p<0.001). At the end of the first month, 17 patients reported more than 50% reduction in pain. In this study, a prominent improvement was observed in mental and physical components of QoL scores, indicating that disability rates of chronic migraine patients decreased with PRF compared to pretreatment. Conclusion: According to the results, PRF can be considered an effective treatment option in patients with refractory chronic migraine.