Patterns of Use of Peripheral Nerve Blocks and Trigger Point Injections for Pediatric Headache: Results of a Survey of the American Headache Society Pediatric and Adolescent Section

• DOI: 10.1111/head.12939
• Publication Date: 2016-10-13T20:22:24Z
• Authors: Christina L. Szperka; Amy A. Gelfand; Andrew D. Hershey
• Keywords: Chronic Migraine; Occipital neuralgia; Specialty

Objective To describe current patterns of use nerve blocks and trigger point injections for treatment pediatric headache. Background P eripheral are often used to treat headaches in adults children, but the available studies practice data from adult headache specialists have shown wide variability diagnostic indications, sites injected, medication(s) used. The purpose this study was disorders. Methods A survey created REDCap, sent via email 82 members Pediatric Adolescent Section American Headache Society June 2015. queried about blocks, as well respondents' opinions regarding gaps evidence patient population. Results F orty‐one complete, five incomplete, three duplicate responses were submitted (response rate complete 50%). About 78% respondents identified their primary specialty Child Neurology, 51% certified medicine. Twenty‐six (63%) perform themselves, seven (17%) refer patients another provider blocks. Chronic migraine with status migrainosus most common indication (82%), though occipital neuralgia (79%), (73%), chronic without flare (70%), post‐traumatic new daily persistent (67%) also indications. commonly selected clinically meaningful response ≥50% reduction severity, while a decrease frequency at 4 weeks. Respondents inject following locations: 100% greater nerve, 69% lesser 50% supraorbital, 46% injections, 42% auriculotemporal, 34% supratrochlear. All local anesthetic, 12 (46%) corticosteroid (8 bupivacaine only, each lidocaine + bupivacaine, corticosteroid, 2 only). Conclusion Despite limited evidence, by specialists. There is considerable among clinicians injection site(s) medication selection, indicating substantial gap literature guide practice, supporting need further research area.