The effect of peripheral nerve block with local analgesic on the migraine disability assessment scale (MIDAS) in patients with chronic migraine

Objective: Migraine is a recurrent condition characterized by repeated attacks, often unresponsive to various pharmaceutical treatments, thereby increasing the burden on the healthcare system. In recent years, nerve blocks have gained popularity in the treatment of migraines, with numerous studies reporting positive outcomes. This study aims to evaluate the efficacy of nerve blocks in the treatment of chronic migraines. Materials and Methods: A total of 54 chronic migraine patients, including 23 receiving prophylactic treatment and 31 not receiving prophylactic treatment, who visited the Headache Clinic at Afyon Health Sciences University Faculty of Medicine Hospital between January 1, 2022, and September 1, 2022, were included in the study. Patients underwent Greater Occipital Nerve (GON), Supraorbital Nerve (SON) and Supratrochlear Nerve (STN) blocks with 1.5 ml of 2% lidocaine. The patients were grouped based on whether they received prophylactic treatment or not, and the changes in the number of painful days, pain intensity (VAS), Migraine Disability Assessment Scale (MIDAS) score, and the amount of analgesic used over time were examined. The evaluation times were set as pre-treatment, and the first and third months post-treatment. Results: No significant differences were found between the groups receiving prophylaxis and those not receiving prophylaxis in terms of the number of painful days, VAS score, MIDAS score, and analgesic usage. However, the time-dependent changes in these parameters within each group were found to be significant. In the group not receiving prophylaxis, the pre-treatment VAS score and the scores at the first and third months post-treatment were measured as (8.52±0.96), (4.84±1.59), and (3.16±1.71), respectively (p<0.001). In the group receiving prophylaxis, the pre-treatment VAS score and the scores at the first and third months post-treatment were measured as (8.74±1.29), (4.00±2.39), and (3.48±1.78), respectively (p<0.001). For the MIDAS score, the pre-treatment and the scores at the first and third months post-treatment were measured as (8.52±0.96), (4.84±1.59), and (3.16±1.71) in the non-prophylaxis group (p<0.001), and (3.70±0.56), (1.65±0.88), and (1.39±0.72) in the prophylaxis group (p<0.001). The monthly analgesic usage in the non-prophylaxis group was measured as (9.48±2.14), (4.00±2.37), and (2.00±1.77) pre-treatment and at the first and third months post-treatment, respectively (p<0.001). In the prophylaxis group, the monthly analgesic usage was measured as (9.65±2.37), (3.09±2.81), and (2.22±2.19) pre-treatment and at the first and third months post-treatment, respectively (p<0.001). Conclusion: In conclusion, the application of nerve blocks in the treatment of chronic migraine patients results in a significant reduction in pain intensity and analgesic medication consumption.