Does performing peripheral nerve (greater occipital, auriculotemporal, or supraorbital) blocks at the same visit as Botox injections for migraine treatment provide greater benefit than at different visits?

To my knowledge, there has never been a study to provide an answer to this question, so it remains unknown. I have performed nerve blocks and Botox injections in the same visit. I administer nerve blocks to most patients at a frequency of every 4-6 weeks. When a nerve block is scheduled within a few days of a Botox visit, I combine the two procedures. I perform nerve blocks first to take advantage of local anesthesia, which reduces the pain associated with Botox injections. However, I am not aware of any research that demonstrates that this combination has made the Botox treatment more effective than those performed without a nerve block procedure.