A comparison of the efficacy of bilateral and unilateral pulsed radiofrequency treatments in the management of chronic migraine

In our study, we aim to compare the effectiveness of unilateral and bilateral pulsed radiofrequency (PRF) treatment applied to the greater occipital nerve. Patients aged 18 and over diagnosed with chronic migraine according to the International Classification of Headache Disorders were studied. The patients received greater occipital nerve (GON) block and additional GON pulsed radiofrequency treatment under ultrasound guidance, using bilateral or unilateral local anesthetics. In patients with consistently bilateral headaches (n:22), the intervention was performed bilaterally, while in asymmetric cases (n:17), the intervention was conducted on the symptomatically dominant side. Patients' age, gender, average frequency of migraine attacks before the block, average attack duration, VAS score, and number of days analgesics were used were compared between the two groups at 1, 3, and 6 months post-application. Significant decreases in VAS scores were observed in both treatment groups, indicating that both treatments were effective. The average monthly migraine attack frequency, attack duration, and number of days of analgesic use were significantly lower within the groups compared to the pre-treatment period; however, no significant difference was found between the groups. Our study demonstrates that both treatment methods are effective in managing chronic migraine. For patients with asymmetric symptoms, intervening only on the dominant side may be sufficient.