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Botulinum Toxin A injection has emerged as a treatment with a conceptually lower side effect profile than many other techniques described here, with most recent trials demonstrating 50% or more improvement. [1] It remains a common practice to utilize a landmark-only approach when performing greater and lesser occipital nerve blocks.
Occipital nerve block is a procedure involving injection of steroids or anesthetics into regions of the greater occipital nerve and the lesser occipital nerve used to treat chronic headaches. These nerves are located in the back of the head near in the suboccipital triangle along the line between the inion and the mastoid process .
Local anesthetic is applied to the back of the neck and a Tuohy needle is advanced towards the location of the greater occipital nerve and lesser occipital nerve under fluoroscopic guidance. [8] [9] [10] When the location is confirmed, a temporary lead is placed through the needle before the needle is carefully removed.
Therapies acting on the vagus nerve (cranial nerve X) and the greater occipital nerve have both shown efficacy in managing cluster headache, but the specific roles of these nerves are not well-understood. [6] Two nerves thought to play an important role in cluster headaches include the trigeminal nerve and the facial nerve. [30]
Nerve block or regional nerve blockade is any deliberate interruption of signals traveling along a nerve, often for the purpose of pain relief. Local anesthetic nerve block (sometimes referred to as simply "nerve block") is a short-term block, usually lasting hours or days, involving the injection of an anesthetic, a corticosteroid, and other agents onto or near a nerve.
The greater occipital nerve is a nerve of the head. It is a spinal nerve , specifically the medial branch of the dorsal primary ramus of cervical spinal nerve 2 . It arises from between the first and second cervical vertebrae , ascends, and then passes through the semispinalis muscle .
A vestibular neurectomy is an operation that severs the vestibular nerve, which contributes to balance, while sparing the cochlear nerve, which contributes to hearing. The procedure has the potential to relieve vertigo, but may preserve the ability to hear. [7] It is important to note that this procedure will not reverse the effects of deafness.
A nerve decompression is a neurosurgical procedure to relieve chronic, direct pressure on a nerve to treat nerve entrapment, a pain syndrome characterized by severe chronic pain and muscle weakness. In this way a nerve decompression targets the underlying pathophysiology of the syndrome and is considered a first-line surgical treatment option ...