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DOI: 10.1055/a-2364-5564
Case Series and Literature Review of Up-to-date Surgical Management of Occipital Neuralgia
Funding None.
Abstract
Nerve decompression is an emerging surgical treatment option for patients with occipital neuralgia. However, limited research is available on the efficacy of this treatment in South Korea. This retrospective study evaluates the efficacy of nerve decompression surgery in patients with chronic migraines, specifically focusing on occipital neuralgia, in South Korea. Between January 2019 and December 2022, six patients diagnosed with occipital neuralgia, who had not responded to conservative treatments, underwent nerve decompression surgery. This procedure, performed under local anesthesia, involved decompression of the greater and/or lesser occipital nerves. Patient data were analyzed for headache frequency and intensity (using the Numeric Rating Scale [NRS]) and the decrease in oral medications needed postsurgery. Results showed significant improvement in headache symptoms postsurgery, with the average preoperative NRS score of 7.9 dropping to 3.7 postoperatively. Additionally, the average number of medications used decreased from 3.2 to 1.3. No significant surgical complications were reported. The study highlights the potential of nerve decompression as an effective treatment for occipital neuralgia, particularly in cases resistant to traditional medical management.
Authors' Contributions
Conceptualization: W.S.J.
Writing original draft: S.J.L.
Data collection: J.S.P.
Writing final draft: S.J.L. and J.S.P.
Final editing and reviewing: W.S.J.
Ethical Approval
This study was approved by the institutional review board of the Asan Medical Center (#2023-0640) and performed in accordance with the principles outlined in the Declaration of Helsinki.
Patient Consent
The requirement for informed consent was waived because of the retrospective nature of the study, and the analysis used anonymous clinical data. However, informed consent was obtained from two patients specifically for the use of their clinical photographs in this study.
Publikationsverlauf
Eingereicht: 04. August 2023
Angenommen: 24. Juni 2024
Accepted Manuscript online:
11. Juli 2024
Artikel online veröffentlicht:
09. September 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 International Headache Society. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders. 3rd edition. Cephalalgia 2018; 38: 1-211
- 2 Jensen R, Stovner LJ. Epidemiology and comorbidity of headache. Lancet Neurol 2008; 7 (04) 354-361
- 3 Lipton RB, Hutchinson S, Ailani J. et al. Discontinuation of acute prescription medication for migraine: results from the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study. Headache 2019; 59 (10) 1762-1772
- 4 Kim BK, Chu MK, Lee TG, Kim JM, Chung CS, Lee KS. Prevalence and impact of migraine and tension-type headache in Korea. J Clin Neurol 2012; 8 (03) 204-211
- 5 Ashina M, Buse DC, Ashina H. et al. Migraine: integrated approaches to clinical management and emerging treatments. Lancet 2021; 397 (10283): 1505-1518
- 6 ElHawary H, Gorgy A, Janis JE. Migraine surgery: two decades of innovation. Plast Reconstr Surg 2021; 148 (05) 858e-860e
- 7 Janis JE, Dhanik A, Howard JH. Validation of the peripheral trigger point theory of migraine headaches: single-surgeon experience using botulinum toxin and surgical decompression. Plast Reconstr Surg 2011; 128 (01) 123-131
- 8 Poggi JT, Grizzell BE, Helmer SD. Confirmation of surgical decompression to relieve migraine headaches. Plast Reconstr Surg 2008; 122 (01) 115-122
- 9 Ascha M, Kurlander DE, Sattar A, Gatherwright J, Guyuron B. In-depth review of symptoms, triggers, and treatment of occipital migraine headaches (Site IV). Plast Reconstr Surg 2017; 139 (06) 1333e-1342e
- 10 Shauly O, Gould DJ, Sahai-Srivastava S, Patel KM. Greater occipital nerve block for the treatment of chronic migraine headaches: a systematic review and meta-analysis. Plast Reconstr Surg 2019; 144 (04) 943-952
- 11 Raposio G, Raposio E. Surgical therapy of occipital (Arnold) neuralgia: a case series. Ann Med Surg (Lond) 2022; 80: 104237
- 12 Raposio E, Caruana G. Tips for the surgical treatment of occipital nerve-triggered headaches. Eur J Plast Surg 2017; 40: 177-182
- 13 Knoedler L, Chartier C, Casari ME. et al. Relative pain reduction and duration of nerve block response predict outcomes in headache surgery: a prospective cohort study. Plast Reconstr Surg 2023; 152 (06) 1319-1327
- 14 Gfrerer L, Austen Jr WG, Janis JE. Migraine surgery. Plast Reconstr Surg Glob Open 2019; 7 (07) e2291
- 15 Lee M, Brown M, Chepla K. et al. An anatomical study of the lesser occipital nerve and its potential compression points: implications for surgical treatment of migraine headaches. Plast Reconstr Surg 2013; 132 (06) 1551-1556
- 16 Hatef DA, Gutowski KA, Culbertson GR, Zielinski M, Manahan MA. A comprehensive review of surgical treatment of migraine surgery safety and efficacy. Plast Reconstr Surg 2020; 146 (02) 187e-195e