Role of anesthesiologic blockade in headache management.

Local anesthetic blocks have been used in a variety of ways in the management of headache. Some practitioners use blocks of the supraorbital and greater occipital nerves as a form of treatment. Although the effect of each block is limited in duration, a series of injections appears to provide sustained relief. However, no controlled studies have vindicated blocks as a tenable intervention. On the other hand, blocks can be used to diagnose cervical sources of headaches. When performed under controlled conditions, such blocks can identify cervical sources of pain in a substantial proportion of patients with headache after whiplash. Positive blocks also predict good outcome from radiofrequency neurotomy of the nerve blocked.