Effect of greater occipital nerve block on sympathic skin response in migraine patients

INTRODUCTION: Migraine is a common neurological disorder that affects daily life. This study aims to examine the effects of GON block, an alternative method in migraine treatment, on the sympathetic skin responses of patients. The study, carried out in the Neurology outpatient clinics of Abant İzzet Baysal University Training and Research Hospital, aims to understand the mechanism of blockade applied to patients diagnosed with migraine in migraine treatment and evaluate its effect on sympathetic skin responses. MATERIALS AND METHODS: In order to evaluate the mechanism of action of GON block and the importance of sympathetic skin response in follow-up, 20 voluntary migraine patients who needed GON block treatment were included. Six GON block treatments were applied to these patients, the first four at one week intervals and the next two at one month intervals. Three sympathetic skin response measurements were made: before the blockages, after the second blockade and after the sixth blockade. Migraine pain scales before and after treatment and their relationship were compared. RESULTS: In measurements performed during the migraine interval period, there was no significant difference between the latency and amplitude values before and after treatment, between the right and left sides. After treatment, significant decreases were observed in patients' monthly migraine frequency, visual pain scale, monthly analgesic use, monthly functional loss, MIDAS, and HIT-6 scales (p<0.001). Significant differences were observed in the variance analysis of B-SDY measurements performed in patients before treatment, at the 2nd session of treatment, and at the 6th session of treatment (p<0.05). The percentage (%) change rates of the amplitudes of the 1st and 3rd B-SDY measurements were compared in terms of correlation. The percentage (%) change in HIT-6 score was found to be correlated with both right and left B-SDY amplitudes (p<0.05), while no significant correlation was observed in other parameters (p>0.05). CONCLUSION: Our study supports the effectiveness of greater occipital nerve block. It indicates the need for this method to be more widely adopted. With the increasing number of studies investigating the relationship between migraine and the autonomic nervous system in recent years, it has become apparent that the mechanism of action of greater occipital nerve block in migraine treatment needs to be evaluated from the perspective of the autonomic nervous system as well. KEYWORDS: Migraine, Greater occipital nerve block, GON, Sympathetic Skin Response