Blockade of branches of the ophthalmic nerve in the management of acute attack of migraine.

The aim of this study was the evaluation of the blockade of branches of ophthalmic nerve in the management of the acute attack of migraine headache localized to the ocular region. The study included 70 female patients 23-60 years old who presented to the pain clinic at our hospital with an acute attack of migraine headache localized to the ocular and retro-ocular region. A targeted history and a neurologic examination were performed in all patients to confirm the diagnosis and at the same time to rule out life-threatening neurological dysfunction. The method applied was the blockade of the supraorbital and supratrochlear nerves which are branches of the ophthalmic nerve. By the use of a fine short needle 27G the nerves were sought for until paraesthesia is obtained and then 1 ml of lignocaine 2% with adrenaline 1:200,000 was injected in every one of the three sites of the nerves. The migraine acute attack was relieved in 58/70 patients (82%), while in 12/70 patients (18%) the results were poor. The pain relief started 3-4 min after the injection and was completed in 10-15 min. Our results support that the blockade of the branches of the ophthalmic nerve seems to be a safe and effective technique in the management of the acute attack of migraine localized to the ocular and retro-ocular region.