Peripheral nerve blocks for primary and secondary headache disorders: review of current evidence and a practical approach

TL;DR

This paper reviews the use of peripheral nerve blocks for treating various headache disorders and provides practical guidelines for their application.

Contribution

The paper updates the current evidence and offers a practical approach for using peripheral nerve blocks in headache treatment.

Findings

Peripheral nerve blocks are widely used for treating primary and secondary headache disorders.

PNBs have demonstrated safety, tolerability, and efficacy in clinical practice.

The paper outlines indications, techniques, and potential pitfalls of common PNB procedures.

Abstract

Headache is prevalent, disabling, and a frequent neurological referral in the
healthcare system. Clinic-based procedures have evolved in recent years to play
an important role in headache medicine, with growing evidence on the safety,
tolerability and efficacy of peripheral nerve blocks (PNBs). Despite novel
headache therapies, PNBs are still widely used in headache services to treat
primary and secondary headache disorders, including cluster headache and other
trigemino-autonomic cephalalgias, migraine, occipital neuralgia, and other less
frequent headache disorders. We aim to provide an update of the current evidence
and a practical approach for delivering the most common PNBs used in clinical
practice. We aim to describe PNBs indications, contraindications, injection
locations and techniques, drug constituents, and potential pitfalls.