A Randomized Controlled Trial Comparing the Efficacy of Supratrochlear and Greater Occipital Nerve Blocks to Botulinum Toxin A in the Management of Chronic Migraine
The goal of this clinical trial is to determine whether nerve block injections (specifically, supratrochlear and greater occipital nerve injections) are as effective as Botulinum toxin A (Botox) injections in treating chronic migraine in adults. The main questions it aims to answer are: * Do nerve block injections reduce the number of monthly migraine days compared to baseline? * Are there any differences in the frequency of migraine-related symptoms between the nerve block and Botox treatment groups? * Which treatment leads to higher patient satisfaction and improved quality of life? Participants in this study will: * Receive either nerve block injections or Botox injections every 12 weeks. * Visit the clinic once every month for follow-ups and assessments. * Maintain a headache diary to record the frequency and severity of their migraines and any adverse effects experienced. * Researchers will compare the outcomes of the two groups to determine if one treatment is superior in terms of efficacy and patient satisfaction.
• Adults aged 18 to 65 years.
• Diagnosis of chronic migraine, defined as having headaches on 15 or more days per month for more than three months, with at least 8 of those days meeting criteria for migraine.
• Ability to provide informed consent and comply with study requirements.
• No changes in prophylactic migraine medications in the last 3 months.