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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(03): s00451806813
DOI: 10.1055/s-0045-1806813
Original Article

Ultrasound-guided continuous radiofrequency ablation of the proximal greater occipital nerve is effective in refractory occipital neuralgia: a retrospective cohort study

Suna Aşkın Turan 
1   University of Health Sciences, Mersin City Training and Research Hospital, Department of Pain Medicine, Mersin, Republic of Türkiye.
,
Şenay Aydın 
2   University of Health Sciences, Yedikule Chest Disease and Surgery Training and Research Hospital, Department of Neurology, Istanbul, Republic of Türkiye.
,
Ezgi Can 
3   University of Health Sciences, Ankara Etlik City Training and Research Hospital, Department of Pain Medicine, Ankara, Republic of Türkiye.
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Abstract

Background

Pain in occipital neuralgia (ON) originates from the upper cervical nerves converging with the trigeminal complex. Greater occipital nerve (GON) blocks and radiofrequency treatments can be used in refractory ON.

Objective

To assess the efficacy of ultrasound-guided proximal greater occipital nerve (PGON) continous radiofrequency ablation (CRFA) in ON throughout 1 year.

Methods

We analyzed data from medical records and headache diaries. Before the intervention and 1, 3, 6, and 12 months after the intervention, at each appointment we evaluated the headache intensity through the 11-point Numeric Rating Scale (NRS-11), the headache disability, through the Six-Item Headache Impact Test (HIT-6), as well as the headache days per month. Treatment efficacy was determined by NRS-11 score < 4 at 12 months.

Results

A total of 18 patients were analyzed. The mean initial NRS-11 score was of 8.78 ± 0.732. At least 50% of pain reduction was noted in all patients at 6 months, and in 66% patients at 12 months. The frequency of attacks was correlated to poor response (r = 0.598; p = 0.009). The efficacy of the diagnostic block was correlated to successful response (r = -0.789; p = 0.001). For the categorical variables, the electric shock pain was associated with NRS-11 score ≥ 4 (p = 0.041), and lancinating pain was associated with NRS-11 score < 4 at 12 months (p = 0.031).

Conclusion

Ultrasound-guided PGON CRFA in refractory ON significantly reduced pain for up to 1 year. The initial frequency of attacks, electric shock like pain, and reduced response to diagnostic block were associated with reduced response.

Keywords

Neuralgia - Headache - Radiofrequency Ablation - Nerve Block - Ultrasonography, Interventional - Pain Measurement - Treatment Outcome

Authors' Contributions

SAT: conceptualization, formal analysis, investigation, methodology, validation, writing – original draft, and writing – review & editing; EC: data curation, project administration, resources, software, and writing – review & editing; and SA: formal analysis, methodology, supervision, validation, and writing – review & editing.


Data Availability Statement

Data and materials are available from the corresponding author upon reasonable request and are subject to ethical review.


Editor-in-Chief: Hélio A. G. Teive.


Associate Editor: Mário Fernando Prieto Peres.




Publication History

Received: 31 October 2024

Accepted: 25 January 2025

Article published online:
02 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Suna Aşkın Turan, Şenay Aydın, Ezgi Can. Ultrasound-guided continuous radiofrequency ablation of the proximal greater occipital nerve is effective in refractory occipital neuralgia: a retrospective cohort study. Arq Neuropsiquiatr 2025; 83: s00451806813.
DOI: 10.1055/s-0045-1806813