Comparing Two Types of Nerve Blocks Using Bupivacaine and Methylprednisolone to Treat and Prevent Episodic Migraines

What this Trial Is About

Researchers are studying how well blocking multiple scalp nerves with bupivacaine anesthetic and low-dose methylprednisolone works to treat and prevent episodic migraines. The study compares the effects of blocking two greater occipital nerves alone versus blocking up to ten different scalp nerves. This research aims to find out if more complete nerve blockage can eliminate migraine pain quickly and reduce headache frequency over months. Participants will be randomly assigned to receive either bilateral greater occipital nerve blocks or multiple peripheral nerve blocks including other nerves like lesser occipital, auriculotemporal, supraorbital, and supratrochlear nerves. The nerve blocks involve injections of bupivacaine mixed with methylprednisolone, performed during an acute migraine episode. The study includes a one-month run-in period of headache diaries, followed by nerve block treatment and a 12-week post-injection follow-up. During the study, participants will keep weekly electronic headache diaries to track headache days, pain intensity, symptoms, medication use, and missed activities. Pain scores will be recorded frequently during nerve block administration to confirm effectiveness. Researchers will measure pain freedom at 20 minutes after blocking, headache pain severity at various time points, and the impact on headache frequency and daily activities over three months. Safety monitoring includes checking for side effects and repeated injections if needed.

Efficacy of Nerve Blocks for Episodic Migraine