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An occipital nerve block is a diagnostic and therapeutic procedure involving the injection of a local anesthetic, often combined with a corticosteroid, around the greater and/or lesser occipital nerves located at the posterior scalp near the occipital protuberance. It is commonly employed in the management of occipital neuralgia, cervicogenic headache, and certain primary headache disorders, such as cluster headaches or migraines with occipital involvement. The block can help confirm the nerve's role in the patient's pain and provide temporary to prolonged relief depending on the etiology and response to treatment.
A sphenopalatine ganglion (SPG) block is a minimally invasive procedure that involves applying local anesthetic to the sphenopalatine ganglion, a cluster of nerves located behind the nasal cavity near the sphenoid bone. The procedure is typically performed by inserting a thin catheter or cotton-tipped applicator soaked with lidocaine through the nostril to reach the ganglion, though it can also be done via injection through the greater palatine foramen. SPG blocks are primarily used to treat cluster headaches, which are severe, unilateral headaches that occur in cyclical patterns, as the sphenopalatine ganglion plays a key role in the trigeminal-autonomic reflex involved in these headaches.
Targeted prescriptionsfor headache relief.
FDA-approved preventive treatment.
Lifestyle and nutrition counseling for headaches focuses on identifying and modifying dietary triggers, hydration habits, sleep patterns, and stress management techniques that may contribute to headache frequency and severity. This individualized approach aims to promote long-term relief by supporting overall neurological and metabolic health through sustainable lifestyle changes
Abdominal migraine is a rare form of migraine that presents with abdominal pain instead of head pain. It predominantly affects children aged 5 to 9 years and is characterized by episodes of moderate to severe midline abdominal pain, often accompanied by nausea, vomiting, and pallor. It may precede the development of classic migraines in adolescence.
Cluster headaches are extremely painful, cyclical headaches that primarily affect men between the ages of 20 and 40. They occur in clusters or bouts, often at the same time each day, and can persist for weeks to months. Symptoms include severe unilateral pain, typically around the eye, with tearing, nasal congestion, and restlessness during attacks.
Exertional headaches are triggered by physical activity, such as strenuous exercise, sexual activity, coughing, or sneezing. These headaches are usually short-lived but intense, and can either be primary (benign) or secondary to underlying structural abnormalities such as aneurysms or Chiarimal formations.
Hemicrania continua is a rare, chronic headache disorder more frequently diagnosed in women. It presents as a continuous, one-sided headache without pain-free intervals and is often associated with autonomic symptoms (e.g., tearing, ptosis, nasal congestion). It responds remarkably well to indomethacin, making this medication both diagnostic and therapeutic.
Hemiplegic migraine is a rare and severe form of migraine that involves temporary paralysis or weakness on one side of the body, mimicking a stroke. It can occur with or without aura and often includes visual, sensory, and speech disturbances. The condition may be familial (genetic) or sporadic.
Also known as rebound headaches, MOH occurs due to the frequent use of headache relief medications, including analgesics, triptans, or opioids. Over time, the regular use of these medications causes the headaches to become more frequent and chronic, typically occurring daily or near-daily.
Menstrual migraines are closely linked to the fluctuation of estrogen levels in women and typically occur around menstruation, although they may appear at any time during the menstrual cycle. These migraines tend to be longer-lasting, more severe, and less responsive to standard treatments than non-menstrual migraines.
This form of migraine begins with a neurological warning phase (aura) that typically precedes the headache by 10 to 60 minutes. The aura may involve visual changes (zig-zag lines, blind spots), sensory disturbances, or speech difficulty, followed by a moderate to severe throbbing headache, often accompanied by nausea, photophobia, and phonophobia.
The most common type of migraine, migraine without aura presents with recurrent, throbbing headaches, typically on one side of the head, lasting 4–72 hours. Symptoms include nausea, sensitivity to light and sound, but no preceding aura. Triggers often include stress, hormonal changes, certain foods, and sleep disturbances.
NDPH is characterized by the sudden onset of daily, unremitting headache in a person with no prior headache history. The pain persists for more than 3 months, is often bilateral, and can resemble either a tension-type headache or migraine. The cause is often unknown, and the condition can be difficult to treat.
Paroxysmal hemicrania is a rare, short-lasting headache disorder featuring frequent attacks of severe, unilateral pain, usually around the eye. Attacks last 2 to 30 minutes, can occur multiple times per day, and are often accompanied by tearing and nasal congestion. Like hemicrania continua, it shows a dramatic response to indomethacin.
Children and adolescents can experience various types of headaches, including tension-type headaches, migraines (with or without aura), cluster headaches, and secondary headaches due to infections, trauma, or other underlying conditions. Evaluation often involves careful assessment of history, patterns, and any red flags for serious pathology.
Headaches can persist for weeks to months after recovery from COVID-19 and are part of the long COVID symptom complex. These headaches may resemble migraine or tension-type pain and are thought to result from neuroinflammation, vascular changes, or autonomic dysfunction triggered by the virus.
This headache develops after traumatic brain injury (TBI) and can present immediately or within 7 days post-injury. It may resemble migraine or tension-type headaches, and its duration can vary. Chronic post-traumatic headache can persist for months or even years, especially after concussions.
This type of headache occurs due to a leak of cerebrospinal fluid (CSF), typically after lumbar puncture or spontaneously. The pain is intensely positional, worsening when upright and relieved by lying down. Symptoms may also include neck stiffness, tinnitus, or vision changes.
Severe headaches are defined by intensity, not by type, and may be associated with underlying critical conditions, including subarachnoid hemorrhage, meningitis, or hypertensive crisis. These headaches often necessitate immediate medical attention and diagnostic imaging.
Severe migraines involve debilitating head pain, often accompanied by nausea, vomiting, and extreme sensitivity to light or sound. Affecting women more than men (3:1 ratio), severe migraines can interfere with daily functioning and may require abortive and preventive therapy for long-term control.
Tension-type headache is the most prevalent headache disorder globally. Characterized by mild to moderate, bilateral, non-pulsating pain, often described as a tight band around the head, it lacks the features of migraine such as nausea or aura. Stress and muscle tension are key contributing factors.
Typically every 3-6 months, depending on yourr, every 3-6 months, depending on your responses. First cycle treatment 1-2xweek for 6 weeks.
Mild tenderness(injection) or nasal numbness (SPG block) may occur.
Most plans cover nerve blocks for diagnosed headache disorders.
