PULSED RADIOFREQUENCE IN THE TRATMENT OF OCCIPITAL NEURALGIA: LITERATURE REVIEW AND SINGLE-CENTER EXPERIENCE

Abstract

Introduction: Even though various medications and procedures are used to treat occipital neuralgia, their effectiveness is sometimes limited. Radiofrequency pulsed therapy is a minimally invasive procedure in which the occipital nerves are treated with radiofrequency waves, a procedure that is effective, drug free and lasts for several months, often in excess of 6 months. Methods: We report three cases with occipital neuralgia, resistant to conservative therapies, who underwent pulsed radiofrequency therapy (PRF). Case Reports: Three Caucasian women presented with persistent headache, localized or originating in the occipital region. All three patients suffered from occipital neuralgia according the International Headache Society criteria for occipital neuralgia, 3^rd edition and complained of chronic tight headaches mainly located in the occipital region. Their diagnosis confirmed by undergoing an anesthetic nerve block. The initial onset of the symptoms was more than 10 years ago. Τhe patients had already tried anti-inflammatory drugs and muscle relaxants, gabapentin, pregabalin and tricyclic antidepressants (TCA) in appropriate doses and for a sufficient period of time without satisfactory response. On re-examination at 3 and 6 months respectively, pain as well as sensitivity to pressure and palpation of the occipital region was reduced to all of our patients and no adverse effects were observed. Subsequently, the treatment was repeated and we are waiting for the results. Conclusion: Although further studies including a larger number of patients with occipital neuralgia are needed, our findings showed that PRF in occipital nerves may be an effective therapeutic option for the control of refractory headache.