PERIPHERAL NERVE BLOCK AS A SURGICAL TREATMENT FOR MEDICATION-OVERUSE HEADACHE: TWO CASE REPORT
DOI:
https://doi.org/10.53612/recisatec.v2i1.73Keywords:
overconsumption of medication, nerve block, Secondary headache disordersAbstract
Drug overuse headache (EMC) is a secondary headache that occurs for 15 or more days per month in patients with a pre-existing diagnosis of primary headache, which leads to regular overconsumption of symptomatic headache medications for 10 days in cases of ergotamine, trypthants, opioids and combinations of analgesics, or for more than 15 days in cases of non-opioid analgesics, paracetamol and non-steroidal anti-inflammatory drugs per month for more than 3 months. CEM is one of the disabling diseases that has had the most increased incidence since the 1990s. The main therapeutic measure is the withdrawal of the overused medicinal product. However, some patients do not fully respond to the withdrawal protocol and, in addition, those who showed improvement, still have monthly headaches, although enough not to be diagnosed with EMF. Anesthetic blocks are a resource for the management of different headaches, either as isolated or combined treatment, or for the treatment of rebound headache after drug withdrawal. Local anesthetics are able to reversively interrupt nerve impulse conduction by blocking voltage-dependent sodium channels through their non-ionized fraction, thus reducing cellular excitability. Thus, this study aimed to report the use of peripheral nerve block as an alternative and effective treatment for MOH.
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