Alexander Sasha Dubrovsky1. 1. Pediatric Emergency Medicine, Montreal Children's Hospital - McGill University Health Center, 1001 Decarie Boulevard, Montreal, Quebec, H4A 3J1, Canada. sasha.dubrovsky@mcgill.ca.
Abstract
PURPOSE OF REVIEW: Peripheral nerve blocks of the scalp, mainly greater occipital nerve blocks, have received a renewed interest amongst pediatric providers as they offer an alternate option to provide both acute and chronic relief from the suffering of children with difficult to treat headaches. This narrative review will provide an in-depth discussion of the published pediatric-specific studies exploring the utility of nerve blocks for pediatric headache disorders. RECENT FINDINGS: A total of seven pediatric publications have been reported to date and reveal excellent therapeutic effectiveness of bilateral greater occipital nerve blocks on primary chronic headaches and post-traumatic headaches. Lidocaine is the preferred anesthetic choice and the value-added of concomitant steroids remains to be elucidated. It is important to ensure complete paresthesia of the blocked nerves to maximize effectiveness. The available studies suggest that peripheral nerve blocks of the scalp are an excellent tool that frontline clinicians can add to their armamentarium in treating pediatric headaches.
PURPOSE OF REVIEW: Peripheral nerve blocks of the scalp, mainly greater occipital nerve blocks, have received a renewed interest amongst pediatric providers as they offer an alternate option to provide both acute and chronic relief from the suffering of children with difficult to treat headaches. This narrative review will provide an in-depth discussion of the published pediatric-specific studies exploring the utility of nerve blocks for pediatric headache disorders. RECENT FINDINGS: A total of seven pediatric publications have been reported to date and reveal excellent therapeutic effectiveness of bilateral greater occipital nerve blocks on primary chronic headaches and post-traumatic headaches. Lidocaine is the preferred anesthetic choice and the value-added of concomitant steroids remains to be elucidated. It is important to ensure complete paresthesia of the blocked nerves to maximize effectiveness. The available studies suggest that peripheral nerve blocks of the scalp are an excellent tool that frontline clinicians can add to their armamentarium in treating pediatric headaches.
Authors: Roger Zemek; Nick Barrowman; Stephen B Freedman; Jocelyn Gravel; Isabelle Gagnon; Candice McGahern; Mary Aglipay; Gurinder Sangha; Kathy Boutis; Darcy Beer; William Craig; Emma Burns; Ken J Farion; Angelo Mikrogianakis; Karen Barlow; Alexander S Dubrovsky; Willem Meeuwisse; Gerard Gioia; William P Meehan; Miriam H Beauchamp; Yael Kamil; Anne M Grool; Blaine Hoshizaki; Peter Anderson; Brian L Brooks; Keith Owen Yeates; Michael Vassilyadi; Terry Klassen; Michelle Keightley; Lawrence Richer; Carol DeMatteo; Martin H Osmond Journal: JAMA Date: 2016-03-08 Impact factor: 56.272
Authors: Andrew Blumenfeld; Avi Ashkenazi; Uri Napchan; Steven D Bender; Brad C Klein; Randall Berliner; Jessica Ailani; Jack Schim; Deborah I Friedman; Larry Charleston; William B Young; Carrie E Robertson; David W Dodick; Stephen D Silberstein; Matthew S Robbins Journal: Headache Date: 2013-02-13 Impact factor: 5.887