Efficacy and safety of 121 injections of the greater occipital nerve in episodic and chronic cluster headache

Cephalalgia. 2012 Jun;32(8):630-4. doi: 10.1177/0333102412443335. Epub 2012 May 23.


Introduction: Infiltration of the greater occipital nerve (GON) with local anaesthetics and corticosteroids is a treatment option for cluster headache.

Methods: We retrospectively analysed the efficacy and safety of 121 GON injections in 60 patients with episodic or chronic cluster headache over a period of 4 years.

Results: Almost 80% of the infiltrations were at least partially effective (reduction of attack frequency, duration or severity) and 45% resulted in a complete response (no further attacks). The effect was maintained for 3.5 weeks on average in chronic cluster headache. In episodic cluster headache, the effect lasted for most of the bout. In 18 infiltrations, transient side effects were reported, such as local pain, steroid effects (facial oedema, sleeping disorders, acne), bradycardia or syncope.

Conclusion: Our data show that GON infiltration is a valuable and safe option in the clinical setting to treat patients suffering from cluster headache, especially for the episodic form of the disorder.

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Adrenal Cortex Hormones / adverse effects
  • Adult
  • Anesthetics, Local / administration & dosage*
  • Anesthetics, Local / adverse effects
  • Cluster Headache / drug therapy*
  • Cluster Headache / metabolism
  • Cluster Headache / pathology*
  • Edema / chemically induced
  • Female
  • Follow-Up Studies
  • Humans
  • Injections
  • Lidocaine / administration & dosage
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sleep Wake Disorders / chemically induced
  • Spinal Nerves / drug effects*
  • Spinal Nerves / metabolism
  • Treatment Outcome


  • Adrenal Cortex Hormones
  • Anesthetics, Local
  • Lidocaine