Abstract
The article that was published in Nature Reviews/Neurology entitled Diagnosis and management of migraine in ten steps attracted our attention (1). What we realized is that in the non-pharmacological therapies section, there is no mention of greater occipital nerve blocks (GON) with local anesthetics. GON is an established practice supported by at least 8 randomized-control trials (2,3) 17 open label studies (2,3), 3 systematic reviews and meta-analyses (2–5), 2 narrative reviews and one critical review (2,3). These publications all show evidence that GON block may be a therapeutic option in migraine treatment.
In their concluding paragraph authors claim that ‘This consensus statement was developed by experts from Europe to provide generally applicable recommendations for the diagnosis and management of migraine to promote best clinical practice. The recommendations are based on published evidence and expert opinion and will be updated when new information and treatments emerge.’
We believe that promoting best clinical practice for management of migraine should take evidence of GON block into consideration which presents strong support for the treatment of migraine.
Footnotes
Declaration of conflicting interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
