Combined Interventional Treatment of Refractory Chronic Migraine

Abstract Migraine is one of the main causes disability in modern world. Treatment chronic refractory migraine (RCM) would be a challenge even for experienced physician. The aim this study was to analyze effect combination therapy RCM: greater occipital nerve’s (GON) pulsed radiofrequency (PRF) and botulinum toxin injections. We observed 6 female patients, suffering from RCM according European Headache Federation criteria. All patients had long history (5–44 years) with conservative treatment failure (at least three medication groups). Their could classified as period time (1–10 years). our passed PRF BTA injection consecutive 1-day treatments. Botulinum type A injections were done accordance PREEMPT protocol, followed by ultrasound-guided GONs bilateral. observation months after procedure. positive response all dramatic reduction pain intensity (from 7 ± 1 2 on NRS scale) significant decrease number headache days 22 5 4 4) during first month treatment. Two (30%) free until end observation. No adverse effects registered. Bilateral GON’s may useful option migraine. These interventional procedures are effective, minimally invasive, inexpensive, safe, well-tolerated can performed an outpatient basis.