Ultrasound Guided Radiofrequency Ablation of the Occipital Nerve

Inclusion Criteria

• •Patients between the ages of 18-80 with a diagnosis of occipital neuralgia or migraine overlying the occipital region.
• •A diagnosis of occipital neuralgia will be based on the International Classification of Headache Disorders (ICHD), whose criteria include: paroxysmal stabbing pain in the distribution of the GON, tenderness over the affected nerve, and relief of pain for at least 3 hours after bupivacaine local anesthetic block of the affected nerve.
• •Patients may also be included if they have a diagnosis of migraine based on the ICHD criteria with predominance of pain over the occipital region that responded to occipital nerve block.
• •Patients must have failed oral medications including NSAIDs, opioids, and anticonvulsants for the management of their pain.
• •Failed treatment will be \<50% pain reduction with oral medication.
• •Patients must report headache frequency of at least 10 days per month.