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Background <p>Multiple sclerosis (MS) is an autoimmune neurodegenerative disorder frequently associated with migraines, complicating management. Ultrasound-guided greater occipital nerve block (GONB) shows promise for migraine relief in MS, but its efficacy remains under investigation. The aim of this study was to assess the effectiveness of ultrasound-guided GONB in chronic, treatment-resistant migraines among MS patients, focusing on frequency, intensity, duration, quality of life, and potential predictors of response. In an uncontrolled single-arm pilot study, 20 MS patients with refractory migraines were selected from March to September 2024 and received ultrasound-guided GONB. Demographics, MRI findings, and migraine outcomes were recorded and assessed over 3 months, Follow-up assessments occurred at 2 weeks (for side effects), and then at 1-, 2-, and 3-months post-procedure.</p> Results <p>Participants (mean age 36.7, 70% female, 85% relapsing–remitting MS) showed initial reductions in migraine frequency, duration, intensity, and medication use. By 3 months, improvements in intensity (<i>p</i> = 0.001) and medication use (<i>p</i> = 0.002) persisted, while frequency and duration regressed. HIT-6 scores improved (<i>p</i> &lt; 0.001), but MIDAS scores did not. No predictors of response were identified. Although the single-arm design limits attribution of effects to the intervention.</p> Conclusion <p>Ultrasound-guided GONB provided short-term benefits in migraine outcomes, with lasting improvements in intensity, medication use, and quality of life, though long-term efficacy and predictors remain unclear. The type of the study with absence of a control group makes it difficult to establish the true effectiveness of GONB compared with other migraine therapies.</p>

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Treating refractory migraines in multiple sclerosis patients: a single-arm interventional study on ultrasound-guided occipital nerve block

  • 期刊论文

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  • 发表日期：

    2025年11月19日

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  • Nouran Mohamed Salah,
  • Rana Magdi Abdallah,
  • Sherien Mohamed Farag,
  • Salma Hamed Khalil,
  • Azza Abdelnasser Abdelaziz,
  • Doaa Abdallah Elaidy

摘要

Background

Multiple sclerosis (MS) is an autoimmune neurodegenerative disorder frequently associated with migraines, complicating management. Ultrasound-guided greater occipital nerve block (GONB) shows promise for migraine relief in MS, but its efficacy remains under investigation. The aim of this study was to assess the effectiveness of ultrasound-guided GONB in chronic, treatment-resistant migraines among MS patients, focusing on frequency, intensity, duration, quality of life, and potential predictors of response. In an uncontrolled single-arm pilot study, 20 MS patients with refractory migraines were selected from March to September 2024 and received ultrasound-guided GONB. Demographics, MRI findings, and migraine outcomes were recorded and assessed over 3 months, Follow-up assessments occurred at 2 weeks (for side effects), and then at 1-, 2-, and 3-months post-procedure.

Results

Participants (mean age 36.7, 70% female, 85% relapsing–remitting MS) showed initial reductions in migraine frequency, duration, intensity, and medication use. By 3 months, improvements in intensity (p = 0.001) and medication use (p = 0.002) persisted, while frequency and duration regressed. HIT-6 scores improved (p < 0.001), but MIDAS scores did not. No predictors of response were identified. Although the single-arm design limits attribution of effects to the intervention.

Conclusion

Ultrasound-guided GONB provided short-term benefits in migraine outcomes, with lasting improvements in intensity, medication use, and quality of life, though long-term efficacy and predictors remain unclear. The type of the study with absence of a control group makes it difficult to establish the true effectiveness of GONB compared with other migraine therapies.