A.M. current address: Department of Neurology, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany.
Functional connectivity between trigeminal and occipital nerves revealed by occipital nerve blockade and nociceptive blink reflexes
Article first published online: 5 JUL 2005
Volume 26, Issue 1, pages 50–55, January 2006
How to Cite
Busch, V., Jakob, W., Juergens, T., Schulte-Mattler, W., Kaube, H. and May, A. (2006), Functional connectivity between trigeminal and occipital nerves revealed by occipital nerve blockade and nociceptive blink reflexes. Cephalalgia, 26: 50–55. doi: 10.1111/j.1468-2982.2005.00992.x
- Issue published online: 24 AUG 2005
- Article first published online: 5 JUL 2005
- Received 26 October 2004, accepted 18 March 2005
- Cluster headache;
- nerve block;
- nociceptive blink reflex;
- occipital nerve;
- trigeminal nerve
Headache syndromes often suggest occipital and neck involvement, although it is still unknown to what extent branches of segment C1-C3 contribute actively to primary headache. Pain within the occipital area may be referred to the trigeminal territory. However, a modulation of trigeminal transmission by affecting cervical input in humans has not been elucidated so far. A convergence of cervical and trigeminal input at the level of the caudal part of the trigeminal nucleus in the brainstem has been suggested due to anatomical and neurophysiological studies in animals. We examined the R2 components of the nociceptive blink reflex responses in 15 healthy subjects before and after unilateral nerve blockade of the greater occipital nerve with 5 ml prilocain (1%). R2 response areas (AUC) decreased and the R2 latencies increased significantly after the nerve blockade only on the side of injection. AUC and latencies on the non-injection side remained stable. Thresholds for sensory or pain perception did not differ significantly between the repeated measurements on both sides. Our findings extend previous results related to anatomical and functional convergence of trigeminal and cervical afferent pathways in animals and suggest that the modulation of this pathway is of potential benefit in primary headache disorders.