ArticlePediatric neurology2014
Outcomes of greater occipital nerve injections in pediatric patients with chronic primary headache disorders.
Article in Pediatric neurology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 62 citations in OpenAlex.
- Greater and Lesser Occipital Nerve Blocks for Frequent and Severe Headaches in Children and Adolescents: A Protocolized Repetitive Intervention Study.Neurology and therapy · 2026Article
- Peripheral Nerve Blocks in Adolescents with Medically Refractory Migraine: A Retrospective Observational Study.Children (Basel, Switzerland) · 2026Article
- Gepants for headache prevention in children and adolescents: A multicenter chart review study.Headache · 2026Article
- Hallmarks of primary headache: part 4 - rare headache syndromes.The journal of headache and pain · 2025Review
- New Daily Persistent Headache in the Pediatric and Adolescent Population: An Updated Review.Life (Basel, Switzerland) · 2024Review
- Cluster Headache: Diagnosis, Management, and Treatment in Pediatric Headache.Journal of clinical medicine · 2024Review
- New Daily Persistent Headache (NDPH): Unraveling the Complexities of Diagnosis, Pathophysiology, and Treatment.Current pain and headache reports · 2023Review
- Trigeminal Autonomic Cephalalgias and Neuralgias in Children and Adolescents: a Narrative Review.Current neurology and neuroscience reports · 2023Review
- Article
- Outpatient Approach to Resistant and Refractory Migraine in Children and Adolescents: a Narrative Review.Current neurology and neuroscience reports · 2022Review
- Long COVID headache.The journal of headache and pain · 2022Review
- The Enigma of New Daily Persistent Headache: What Solutions for Pediatric Age?Current pain and headache reports · 2022Review
- Review of Interventional Therapies for Refractory Pediatric Migraine.Health psychology research · 2022Article
- Update of New Daily Persistent Headache.Current pain and headache reports · 2022Review
- Approach to Pediatric Intractable Migraine.Current neurology and neuroscience reports · 2021Review
- ED and Inpatient Management of Headache in Children and Adolescents.Current neurology and neuroscience reports · 2020Review
- New Daily Persistent Headache: a Diagnostic and Therapeutic Odyssey.Current neurology and neuroscience reports · 2019Review
- Treatment of disabling headache with greater occipital nerve injections in a large population of childhood and adolescent patients: a service evaluation.The journal of headache and pain · 2018Article
- Nerve Blocks in Pediatric and Adolescent Headache Disorders.Current pain and headache reports · 2017Review
- Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
backgroundChronic migraine is common in pediatrics and generally disabling. In adults, infiltration of the area around the greater occipital nerve can provide short- to medium-term benefit in some patients. This study reports the efficacy of greater occipital nerve infiltrations in pediatric patients with chronic primary headache disorders.
methodsRetrospective chart review of patients <18 years with a chronic primary headache disorder undergoing a first-time injection. Infiltrations were unilateral and consisted of a mixture of methylprednisolone acetate, adjusted for weight, and lidocaine 2%.
resultsForty-six patients were treated. Thirty-five (76%) had chronic migraine, 9 (20%) new daily persistent headache (NDPH), and 2 (4%) a chronic trigeminal autonomic cephalalgia. Medication overuse was present in 26%. Ages ranged from 7 to 17 years. Follow-up data were available for 40 (87%). Overall, 53% (21/40) benefitted, and 52% (11/21) benefitted significantly. Benefit onset ranged from 0 to 14 days, mean 4.7 (SD 4.3), with mean benefit duration of 5.4 (SD 4.9) weeks. In chronic migraine, 62% (18/29) benefitted, and 56% (10/18) significantly benefitted. In NDPH, 33% (3/9) benefitted; 33% (n = 1) significantly. Neither child with a chronic trigeminal autonomic cephalalgia benefitted. In logistic regression modeling, medication overuse, age, sex, and sensory change in the distribution of the infiltrated nerve did not predict outcome. There were no serious side effects.
conclusionsGreater occipital nerve injections benefitted 53% of pediatric patients with chronic primary headache disorders. Efficacy appeared greater in chronic migraine than NDPH. Given the benign side effect profile, a greater occipital nerve infiltration seems appropriate before more aggressive approaches.
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