Predictors of GON Blockade Success in Migraine

Predictive Factors for the Success of Greater Occipital Nerve Block in Migraine: A Multicenter Prospective Study

This multicenter, prospective cohort study aims to identify clinical and demographic predictors that influence the success of greater occipital nerve (GON) block in patients with migraine.

Patients will be evaluated at baseline, on each injection day, and at one- and three-month follow-ups. Study parameters include demographics, migraine type and duration, comorbidities, headache characteristics, treatment history, and validated outcome measures such as the Numeric Rating Scale (NRS), Headache Impact Test-6 (HIT-6), and Global Rating of Change (GRoC).

The goal is to establish predictive factors of treatment success in order to optimize patient selection and contribute robust multicenter evidence to individualized migraine management

Inclusion Criteria:

• Diagnosis of migraine for at least 6 months, according to ICHD-3 criteria
• Age between 18 and 65 years
• Inadequate response to preventive therapy used regularly for at least 3 months
• Planned treatment with greater occipital nerve block (GONB) and provision of signed informed consent
• Receiving GONB treatment for the first time

Exclusion Criteria:

• Pregnancy or breastfeeding
• Presence of malignancy
• Coagulopathy or anticoagulant therapy
• Local infection, open wound, or history of surgery at the injection site preventing the procedure
• History of severe neurological or psychiatric disorders
• Receipt of interventional treatment (e.g., Botox, acupuncture, neural therapy, nerve blocks) within the last 3 months
• Use of steroids or immunosuppressive therapy
• Start of a new preventive therapy within the last 3 months
• Inability to comply with keeping a headache diary
• Known hypersensitivity or allergy to bupivacaine