Peripheral Nerve Blocks in Adolescents with Medically Refractory Migraine: A Retrospective Observational Study

Objective: To evaluate the efficacy and safety of peripheral nerve blocks (PNB) in adolescents with medically refractory migraine. Materials and Methods: Twenty-eight adolescents with inadequate response to preventive therapy were included. Greater occipital nerve (GON) and/or lesser occipital nerve (LON) blocks were performed in three sessions at 8-week intervals. Pain severity was assessed using the Visual Analog Scale (VAS), and a structured questionnaire evaluated pain relief and functional outcomes. Results: A total of 84 procedures were performed. The results revealed that the mean monthly migraine frequency decreased from 14.4 to 4.7 days after the third session and the mean VAS score decreased from 7.7 to 3.3. Eighteen patients showed marked improvement, six had partial benefit, and four had no response. Questionnaire findings indicated improved pain control and patient-reported daily functioning. Adverse effects were mild and transient; no serious complications occurred. Conclusions: Peripheral nerve blocks, particularly GON and LON blockade, may be associated with reductions in headache frequency and severity in adolescents with refractory migraine and may contribute to improvements in patient-reported daily functioning. However, these findings should be supported by larger controlled studies.