Peripheral Nerve Block for the Management of Headache and Face Pain

  • Sherif CostandiEmail author
  • John Costandi
  • Dmitri SouzdalnitskiEmail author
  • Samer N. Narouze


Peripheral nerve blocks (PNBs) are valuable diagnostic and therapeutic tools in the management of headaches and face pain. These nerve blocks include supraorbital nerve, supratrochlear nerve, infraorbital nerve, inferior alveolar nerve, mental nerve, auriculotemporal nerve, glossopharyngeal nerve, and greater auricular nerve. Maxillary nerve, mandibular nerve, and occipital nerve blocks will be discussed in other chapters.

These PNBs are simple to perform and usually very safe; however, they can be catastrophic although very rarely. This chapter reviews clinically relevant anatomy, indications of different blocks, description of standard and novel ultrasound-guided techniques, feared complications, and pearls about how to perform these procedures safely and efficiently.


Herpes Zoster Nerve Block Mental Foramen Inferior Alveolar Nerve Infraorbital Nerve 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Headache Classification Committee. The International Classification of Headache Disorders, 2nd edition. Cephalalgia. 2004;24:1–160.Google Scholar
  2. 2.
    Blumenfeld A, Ashkenazi A, Napchan U, Bender SD, Klein BC, Berliner R, Ailani J, Schim J, Friedman DI, Charleston 4th L, Young WB, Robertson CE, Dodick DW, Silberstein SD, Robbins MS. Expert consensus recommendations for the performance of peripheral nerve blocks for headaches-a narrative review. Headache. 2013;53(3):437–46.PubMedCrossRefGoogle Scholar
  3. 3.
    Evans RW, Pareja JA. Expert opinion: supraorbital neuralgia. Headache. 2009;49:278–81.PubMedCrossRefGoogle Scholar
  4. 4.
    Tsui BCH, Dullane D, Funicane BT. Neural blockade for the surgery to the head and neck. Chronic pain. In: Cousins MJ, Carr DB, Horlocker TT, Bridenbaugh PO, editors. Cousins and Bridenbaugh’s neural blockade in clinical anesthesia and pain medicine. 4th ed. Philadelphia: LWW; 2009. p. 486–91.Google Scholar
  5. 5.
    Levin M. Nerve blocks in the treatment of headache. Neurotherapeutics. 2010;7:197–203.Google Scholar
  6. 6.
    Spinner D, Kirschner JS. Accuracy of ultrasound-guided superficial trigeminal nerve blocks using methylene blue in cadavers. Pain Med. 2012;13(11):1469–73.PubMedCrossRefGoogle Scholar
  7. 7.
    Tsui BC. Ultrasound imaging to localize foramina for superficial trigeminal nerve block. Can J Anaesth. 2009;56(9):704–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Nguyen A, Girard F, Boudreault D, et al. Scalp nerve blocks decrease the severity of the pain after craniotomy. Anesth Analg. 2001;93:1272–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Osborne I, Sebeo J. “Scalp block” during craniotomy: a classic technique revisited. J Neurosurg Anesthesiol. 2010;22:187–94.CrossRefGoogle Scholar
  10. 10.
    Voronov P, Suresh S. Head and neck blocks in children. Curr Opin Anaesthesiol. 2008;21:317–22.PubMedCrossRefGoogle Scholar
  11. 11.
    Suresh S, Young NM, et al. Does a preemptive block of the great auricular nerve improve postoperative analgesia in children undergoing tympanomastoid surgery? Anesth Analg. 2004;98:330–3.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Pain ManagementCleveland ClinicClevelandUSA
  2. 2.Oral and Maxillofacial Surgery DepartmentColumbia University Medical CenterNew YorkUSA
  3. 3.Center for Pain MedicineSumma Western Reserve HospitalCuyahoga FallsUSA
  4. 4.Center for Pain Medicine, Western Reserve HospitalCuyahoga FallsUSA

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