Objective:To study the effectiveness and safety of great occipital nerve decompression in great occipital neurogenic intractable migraine.Methods:Fifty-one patients with great occipital neurogenic intractable migraine admitted to our hospital from December 2018 to December 2019 were chosen in our study. All patients were confirmed to be of great occipital neurogenic intractable migraine by blocked test and all patients underwent minimally invasive decompression of great occipital nerve. Preoperative and postoperative questionnaires were used to compare the severity of pain and frequency of pain episodes, and the prognoses of these patients were evaluated at the last follow-up.Results:Fifty-one patients were followed up for (12.02±3.36) months after surgery; at last follow-up, 10 patients were cured, 31 patients had obvious effect, 6 patients got improvement, 2 patients had poor effect, and 2 patients had no effect, with total effective rate of 80.40% (41/51). There were significant differences between before surgery and after surgery in the pain visual analog scale scores (7.47±0.76 vs.1.75±1.91) and frequency of pain episodes ([9.00±1.74] times/month vs. [2.82±2.47] times/month, P<0.05). Seven patients had temporary numbness at the surgical site after surgery, but 6 patients improved about 3 months after surgery and only one patient had persistent numbness. Conclusion:Great occipital nerve decompression is an effective and safe treatment method for great occipital neurogenic intractable migraine.

Migraine, as a chronic and highly disabled nervous system disease, has a great impact on the work and life of the patients, and also increases the burden on the social economy. At present, the treatment of migraine is mainly focused on drug treatment, but the high price of drugs, obvious side effects and other factors make the treatment rate of migraine is low. With the in-depth study of its pathogenesis and clinical manifestations, new ways of treating migraine such as peripheral nerve block, Botox A injection, nerve stimulation therapy, neurolysis, acupuncture and moxibustion have emerged, which bring new options for migraine patients. This article will introduce the current common non-drug treatment of migraine, and summarize the lack in research and development direction.

Objective:To study the therapeutic effect of botulinum toxin serotype A (BoNTA) in the treatment of chronic migraine (CM).Methods:A retrospective analysis was performed on 47 patients with CM admitted to the Department of Neurosurgery, Chengdu 363 Hospital from June 2018 to June 2019. All patients were treated with BoNTA. The severity of pain and the number of pain episodes per month were compared by preoperative and postoperative questionnaires.Results:The average pain incidence reported by the patients before operation was 12(9,16) times per month, but the average pain incidence reported by the patients after operation was reduced to 3(1,5) times per month. The mean pain score also decreased from 7(7,8) points before surgery to 1(1,5) points after injection. Eleven patients reported pain free after injection, 28 patients reported significant relief of pain, 3 patients reported effective relief of pain, and only 5 patients reported no significant postoperative improvement. The mean follow-up time was 11.06 months.Conclusion:BoNTA is a feasible and promising treatment for CM.