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Omar M Tawfik - One of the best experts on this subject based on the ideXlab platform.
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repetitive occipital nerve blockade for Cervicogenic Headache expanded case report of 47 adults
Pain Practice, 2006Co-Authors: Zoher M Naja, Mariam Elrajab, Mohamad Altannir, Fouad Ziade, Omar M TawfikAbstract:Purpose: To evaluate the repetitive occipital nerve blocks using a nerve stimulator in the treatment of Cervicogenic Headache. Methods: This prospective noncomparative clinical interventional case-series study included 47 patients suffering from Cervicogenic Headache using a repetitive guided occipital nerve blockade. Results: Forty-one patients (87%) required more than one injection to achieve six-month pain-relief period. For every three years of Headache history, the outcomes demonstrated that a patient needed one additional injection to the basic injection. Conclusion: The repeated nerve stimulator-guided occipital nerve blockade is a treatment mode that may relieve Cervicogenic Headache with no recurrence for at least six months in addition to alleviation of associated symptoms.
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occipital nerve blockade for Cervicogenic Headache a double blind randomized controlled clinical trial
Pain Practice, 2006Co-Authors: Zoher M Naja, Mariam Elrajab, Mohamad Altannir, Fouad Ziade, Omar M TawfikAbstract:: Cervicogenic Headache is a chronic hemicranial pain, usually occurring daily. This randomized, double-blind, placebo-controlled trial evaluated the effectiveness of nerve stimulator-guided occipital nerve blockade in the treatment of Cervicogenic Headache. The reduction in analgesic consumption was the primary outcome measure. Fifty adult patients diagnosed with Cervicogenic Headache were randomly divided into two equal groups of 25 patients each. All patients in both groups received greater and lesser occipital blocks, whereas only 16 patients in each group received facial nerve blockade in association with the occipital blocks. The control group received injections of an equivalent volume of preservative-free normal saline. Pain was assessed using the visual analog scale (VAS) and the Total Pain Index (TPI). Forty-seven patients entered into the final analysis as three patients were lost to follow-up. Anesthetic block was effective in reducing the VAS and the TPI by approximately 50% from baseline values (P = 0.0001). Analgesic consumption, duration of Headache and its frequency, nausea, vomiting, photophobia, phonophobia, decreased appetite, and limitations in functional activities were significantly less in block group compared to control group (P < 0.05). The nerve stimulator-guided occipital nerve blockade significantly relieved Cervicogenic Headache and associated symptoms at two weeks following injection.
Gunnar Bovim - One of the best experts on this subject based on the ideXlab platform.
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Cervicogenic Headache migraine and tension type Headache pressure pain threshold measurements
Pain, 1992Co-Authors: Gunnar BovimAbstract:Pressure-pain threshold (PPT) measurements were performed with a pressure algometer, at 22 specified points in the head in patients with Cervicogenic Headache (n = 32), migraine (with and without aura) (n = 26) and tension-type Headache (n = 17). Comparisons were made with a group of healthy controls (n = 20). The average PPT differed significantly between the groups (ANOVA, F = 9.5, P < 0.0005), largely caused by the low threshold in Cervicogenic Headache patients. There were no significant differences between controls and the 2 other Headache groups. In the Cervicogenic Headache group, the lowest PPT was found in the occipital part of the head on the side with pain predominance. The ratio between the dominant and non-dominant sides (all 11 points on each side) was 0.85 in Cervicogenic Headache, whereas it was 0.99 in migraine patients with side preponderance of the pain. The present results support the view that the pathogenesis of Cervicogenic Headache differs from that of migraine and tension-type Headache. The results may further support the theory that fibres from the C2 level (innervating the occipital part of the head) may be included in the pathogenetic mechanism in Cervicogenic Headache.
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Intracutaneous sterile water injections do not relieve pain in Cervicogenic Headache
Acta Neurologica Scandinavica, 1992Co-Authors: Trond Sand, Gunnar Bovim, Grethe HeldeAbstract:Intracutaneous sterile water injections have been reported to relieve acute labor pain and cervical pain in whip-lash patients. A double blind cross-over trial has presently been conducted in 10 women with Cervicogenic Headache in order to investigate whether sterile water injections were effective in this disorder. No benefit was observed for either treatment (isotonic saline or sterile water), neither on pain during the first 14 days nor on neck mobility. We conclude that intracutaneous sterile water injections is not effective in Cervicogenic Headache
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Cervicogenic Headache migraine without aura and tension type Headache diagnostic blockade of greater occipital and supra orbital nerves
Pain, 1992Co-Authors: Gunnar Bovim, Trond SandAbstract:Abstract The diagnostic value of greater occipital and supra-orbital nerve blockades in patients with Cervicogenic Headache, migraine without aura, and tension-type Headache was investigated. The pain reduction after greater occipital nerve blockade was significantly more marked in the Cervicogenic Headache group than in the other categories. Moreover, pain reduction in the forehead was generally only found in the Cervicogenic Headache patients (77%). Pain reduction (in %) was significantly more marked following the greater occipital than the supra-orbital nerve blockade. The volume effect per se was evaluated by saline injection. This procedure did not result in distinct pain reduction. The effect obtained in Cervicogenic Headache is, accordingly, probably due to the local anaesthesia. The present results support the postulate that different pathogenetic factors probably are responsible for Cervicogenic Headache, tension-type Headache, and migraine without aura.
Ottar Sjaastad - One of the best experts on this subject based on the ideXlab platform.
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Cervicogenic Headache too important to be left un diagnosed
Journal of Headache and Pain, 2015Co-Authors: Torbjørn A Fredriksen, Fabio Antonaci, Ottar SjaastadAbstract:A comparison has been made between the Cervicogenic Headache criteria in the new IHS classification of Headaches (3rd edition- beta version) and The Cervicogenic Headache International Study Group’s (GHISG) criteria from 1998. In a more recent version, the CHISG criteria consist of 7 different items. While “core cases” of Cervicogenic Headache (CEH) usually fulfill all 7 criteria, the IHS classification - 3rd edition beta version- fulfills only 3 criteria. Although the new three beta version represents an improvement from the previous one, it does not quite seem to live up to the expectations for a diagnostic system for routine, clinical use.
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Cervicogenic Headache a real Headache
Current Neurology and Neuroscience Reports, 2011Co-Authors: Fabio Antonaci, Ottar SjaastadAbstract:Although theories regarding Headache originating in the neck have existed for more than 150 years, the term “Cervicogenic Headache” originated in 1983. Early descriptions pinpoint the characteristic symptoms as dizziness, visual disturbances, tinnitus, and “posterior” Headache, conceivably as a consequence of arthrosis, infliction upon the vertebral artery, or with a “migrainous” background and occurring in “advanced age.” Cervicogenic Headache (mean age of onset, 33 years) displays a somewhat different picture: unilateral Headache, starting posteriorly, but advancing to the frontal area, most frequently the main site of pain; usually accompanied by ipsilateral arm discomfort, reduced range of motion in the neck, and mechanical precipitation of exacerbations (eg, through external pressure upon hypersensitive, occipital tendon insertions). Treatment options in treatment-resistant cases include cervical stabilization operations and extracranial electrical stimulation. In a personal, population-based study of 1,838 individuals (88.6% of the population), a prevalence of 2.2% “core” cases was found.
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prevalence of Cervicogenic Headache vaga study of Headache epidemiology
Acta Neurologica Scandinavica, 2008Co-Authors: Ottar Sjaastad, Leiv S BakketeigAbstract:Objectives – To describe the prevalence and various clinical characteristics of Cervicogenic Headache (CEH) in the population at large. Methods – CEH was searched for in Vaga, Norway, where 1838 18 to 65-year-old citizens, i.e. 88.6% of this age group, underwent an interview/clinical examination. The Cervicogenic Headache International Study Group criteria include: (I) unilaterality of head pain, (II) reduction, range of movement, neck, (III/IV) ipsilateral shoulder/arm discomfort, (V/VI) mechanical provocation of similar pain, objectively or subjectively. Results – A prevalence of 4.1% was found. In 41 cases with the highest number of CEH criteria (‘core’ cases), there was a male preponderance (F/M: 0.71). While Cervicogenic traits (mechanical precipitation etc.) were frequently present in CEH, ‘migraine traits’, like nausea, vomiting, and throbbing seemed to be rarely present. In 97% of the cases, pain exacerbations began in the neck/occipital region. Conclusions – CEH may be one of the three large, recurrent Headaches. In this series, there was no female preponderance. Nuchal onset of pain is a characteristic trait.
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Coexistence of Cervicogenic Headache and migraine without aura (
Functional Neurology, 1999Co-Authors: Ottar Sjaastad, Fredriksen Ta, Juan A. Pareja, Stolt-nielsen A, Maurice B. VincentAbstract:It is well known that migraine with aura may coexist with various unilateral Headaches, like cluster Headache and chronic paroxysmal hemicrania. It may also coexist with Cervicogenic Headache. The diagnosis of migraine without aura ("common migraine") poses greater problems than the diagnosis of migraine with aura. Cervicogenic Headache diagnosis also poses problems when these two Headaches coexist, since they have symptoms in common. Therefore, the scientific demonstration of coexistence of migraine without aura and Cervicogenic Headache is bound to be a difficult task. In the present study, migraine without aura and Cervicogenic Headache seemed to coexist in 4 patients (3 F and 1 M, mean age 50). Attacks with migraine characteristics fulfilled the IHS and IASP migraine criteria. Out of a maximum of 13 migraine characteristics based on the IHS/IASP migraine criteria, such as unilaterality, aggravation on minor physical activity, etc., none of the patients presented less than 11, as opposed to a mean of < or = 4 of these criteria in the Cervicogenic type attacks. A similar system, based on criteria such as: reduction of range of motion in the neck, mechanical precipitation of attacks, etc., was also developed for Cervicogenic Headache. The mean number of Cervicogenic Headache criteria was 4.3 (out of a total of 5) in the "Cervicogenic part of the picture", as opposed to 1.5 (1.8 if laterality is considered, see text) in the "migraine part of the picture". Drug regimens and anaesthetic blocks also showed different results in the two different Headaches in the same patient. All in all, this study seems to support a coexistence of the two Headache types.
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Cervicogenic Headache. Long-term results of radiofrequency treatment of the planum nuchale
Functional Neurology, 1995Co-Authors: Ottar Sjaastad, Stolt-nielsen A, Blume H, Zwart Ja, Torbjørn A FredriksenAbstract:Seven female patients, all fulfilling the current criteria for Cervicogenic Headache, underwent radiofrequency treatment of the periosteum of the external surface of the occipital bone ("planum nuchale") on the symptomatic side, as described by Blume. The patients were followed up for approximately 4.5 years postoperatively. In three patients, the operation was considered completely successful (43%), whereas it was completely unsuccessful in two patients. In the two remaining patients, a considerable improvement (60-70%) was obtained. Thus, in 71% of the patients, an improvement of varying degree was obtained. In one of the patients who did not improve, a local effusion developed in the wake of the procedure. In the future, this procedure will probably be one of the therapeutic options for Cervicogenic Headache. These results provide further evidence establishing Cervicogenic Headache as a disorder, distinguishable from common migraine ("migraine without aura").
Zoher M Naja - One of the best experts on this subject based on the ideXlab platform.
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repetitive occipital nerve blockade for Cervicogenic Headache expanded case report of 47 adults
Pain Practice, 2006Co-Authors: Zoher M Naja, Mariam Elrajab, Mohamad Altannir, Fouad Ziade, Omar M TawfikAbstract:Purpose: To evaluate the repetitive occipital nerve blocks using a nerve stimulator in the treatment of Cervicogenic Headache. Methods: This prospective noncomparative clinical interventional case-series study included 47 patients suffering from Cervicogenic Headache using a repetitive guided occipital nerve blockade. Results: Forty-one patients (87%) required more than one injection to achieve six-month pain-relief period. For every three years of Headache history, the outcomes demonstrated that a patient needed one additional injection to the basic injection. Conclusion: The repeated nerve stimulator-guided occipital nerve blockade is a treatment mode that may relieve Cervicogenic Headache with no recurrence for at least six months in addition to alleviation of associated symptoms.
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occipital nerve blockade for Cervicogenic Headache a double blind randomized controlled clinical trial
Pain Practice, 2006Co-Authors: Zoher M Naja, Mariam Elrajab, Mohamad Altannir, Fouad Ziade, Omar M TawfikAbstract:: Cervicogenic Headache is a chronic hemicranial pain, usually occurring daily. This randomized, double-blind, placebo-controlled trial evaluated the effectiveness of nerve stimulator-guided occipital nerve blockade in the treatment of Cervicogenic Headache. The reduction in analgesic consumption was the primary outcome measure. Fifty adult patients diagnosed with Cervicogenic Headache were randomly divided into two equal groups of 25 patients each. All patients in both groups received greater and lesser occipital blocks, whereas only 16 patients in each group received facial nerve blockade in association with the occipital blocks. The control group received injections of an equivalent volume of preservative-free normal saline. Pain was assessed using the visual analog scale (VAS) and the Total Pain Index (TPI). Forty-seven patients entered into the final analysis as three patients were lost to follow-up. Anesthetic block was effective in reducing the VAS and the TPI by approximately 50% from baseline values (P = 0.0001). Analgesic consumption, duration of Headache and its frequency, nausea, vomiting, photophobia, phonophobia, decreased appetite, and limitations in functional activities were significantly less in block group compared to control group (P < 0.05). The nerve stimulator-guided occipital nerve blockade significantly relieved Cervicogenic Headache and associated symptoms at two weeks following injection.
J A Zwart - One of the best experts on this subject based on the ideXlab platform.
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the blink reflex in chronic tension type Headache migraine and Cervicogenic Headache
Cephalalgia, 1994Co-Authors: T Sand, J A ZwartAbstract:R1 and R2 blink reflex latencies were investigated blind in 10 patients with Cervicogenic Headache, 11 patients with chronic tension-type Headache, 11 patients with migraine, and 9 Headache-free controls. There were no R1 or R2 latency differences between the four groups. The latency of R1 increased significantly with Headache duration in tension-type Headache patients. Shorter R1 latencies were found on the symptomatic side than on the non-symptomatic side in Cervicogenic Headache patients. The results suggest that a state of hyperactivity may be present in the ipsilateral trigeminal nucleus in Cervicogenic Headache. Hypoactivity, however, may develop over time in tension-type Headache.
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The blink reflex in chronic tension‐type Headache, migraine, and Cervicogenic Headache
Cephalalgia, 1994Co-Authors: T Sand, J A ZwartAbstract:R1 and R2 blink reflex latencies were investigated blind in 10 patients with Cervicogenic Headache, 11 patients with chronic tension-type Headache, 11 patients with migraine, and 9 Headache-free controls. There were no R1 or R2 latency differences between the four groups. The latency of R1 increased significantly with Headache duration in tension-type Headache patients. Shorter R1 latencies were found on the symptomatic side than on the non-symptomatic side in Cervicogenic Headache patients. The results suggest that a state of hyperactivity may be present in the ipsilateral trigeminal nucleus in Cervicogenic Headache. Hypoactivity, however, may develop over time in tension-type Headache.