Migraine and Headache Treatment with Sphenopalatine Ganglion Block

Sphenopalatine Ganglion Block (SPG)

What do you do when your electronics aren’t working? Common wisdom is to unplug it and plug it back in. The Sphenopalatine Ganglion Block is the same concept. The difference is that what is not working correctly is your nervous system, and what your unplugging and plugging back in is a ball of nerve cells called the Sphenopalatine Ganglion. The SPG is a non-invasive, no needles, minor office procedure that can be done in 10 minutes with patients getting up to 6 months of relief from headaches and migraines.

What kind of headaches and migraines does the SPG work for?

Patients have experienced relief from chronic migraines, episodic migraines, acute migraines, cluster headaches, trigeminal neuralgia, post concussive headaches, pregnancy migraine, post dural puncture migraine, MS migraine, Chiari migraine, and others.

What does the research say?

Acute Migraine

In a 2018 study done by researchers from Bahrain, they performed SPG blocks using the Sphenocath device on 55 patients with a moderate to severe acute migraine headache lasting between 4 and 72 hours. The patients were not responsive to abortive medications. After performing the SPG block 71% of patients were completely migraine free at 15 minutes, 78% were migraine free at 2 hours, and 70% were migraine free at 24 hours. An additional 27%, 20%, and 22% reported that they had at least 50% relief.

Status Migrainosus (lasting more than 72 hours)

In 2019 a study done by USA researchers and published in the scientific journal Headache, SPG blocks were performed on 88 consecutive patients with a migraine attack lasting more than 72 hours who had already failed 2 or more abortive medications. The researchers found that on average patients experienced 67.2% relief from their migraine in 30 minutes. In this study the patients received their SPG block with a needle injection, a much more invasive procedure than Dr. Smitherman performs with the Sphenocath device.

Chronic Migraine

In 2015 researchers from Missouri published a study in the journal Headache where they compared repetitive SPG blocks with an anesthetic vs saline for chronic migraines. 28 patients in the anesthetic group received twice weekly SPG blocks for 6 weeks. In this study the anesthetic treatment group had less days with headache, less average pain, less headache impact, and lower medication use than the saline group. This study supplied evidence on the effectiveness of the SPG block for chronic migraine sufferers.

Chronic Cluster Headache

In a 2017 study form a united team of researchers from Germany, Denmark, Spain, Belgium, and the United States, researchers performed sphenopalatine ganglion stimulation to patients over a 24 months period. The researchers found that the treatment patients had a “clinically relevant reduction of attack frequency”.

How does this quick and effective headache and migraine treatment work?

  1. The patient lays on they’re back
  2. A numbing cream is applied to the patients nostril
  3. Dr. Smitherman inserts a specially designed catheter called the Sphenocath into the nasal cavity. Placing it in a very specific position.
  4. An anesthetic called 2% lidocaine is pushed through the catheter into the back of the nasal cavity where it pools in what is essentially a cup shaped area.
  5. The lidocaine drains from the cup shaped area along a canal that leads to the sphenopalatine ganglion
  6. When the lidocaine arrives it numbs the sphenopalatine ganglion, and gives it a reset. In essence unplugging and resetting a part of your nervous system that can result in significant headache and migraine relief.

Can I get an SPG block while on my other medications?

Yes. There are typically no interactions with an SPG and migraine medications. Each patient is evaluated on an individual basis by Dr. Smitherman.

Does insurance cover the SPG Block

Dr. Smitherman accepts many insurance plans. Dr. Smitherman will bill your insurance company for your office visit, and any trigger point injections given at the time of your appointment. However, insurance companies do not currently cover the SPG block. 

If you think you could benefit from working with Dr. Smitherman please book a free 15 minute consultation or appointment online.

References

  • Binfalah M, Alghawi E, Shosha E, Alhilly A, Bakhiet M. Sphenopalatine Ganglion Block for the Treatment of Acute Migraine Headache. Pain Res Treat. 2018;2018:2516953. Published 2018 May 7. doi:10.1155/2018/2516953
  • Mehta, D., Leary, MC., Yocoub, HA., El-Hunjul, M. et al. The Effects of Regional Anesthetic Sphenopalatine Ganglion Block on Self-Reported Pain in Patients with Status Migrainosus. Headache. 2019 Jan;59(1):69-76. doi: 10.1111/head.13390. Epub 2018 Jul 25.
  • Cady, RK., Saper, J., Dexter, K., Cady, RJ., Manley, HR. Long-term efficacy of a double-blind, placebo controlled, randomized study for repetitive sphenopalatine blockade with bupivacaine vs. saline with the Tx360 device for treatment of chronic migraine. Headache. 2015 Apr;55(4):529-42. doi: 10.1111/head.12546. Epub 2015 Mar 31.
  • Jurgens, TP., Barloese, M., May, A., Lainez, JM., Schoenen, J., Gaul, C., Goodman, AM., Caparso, A., Jensen, RH., Long Term effectiveness of sphenopalatine ganglion stimulation for cluster headache. Cephalagia 2017 Apr;37(5):423-434. doi: 10.1177/0333102416649092. Epub 2016 May 9.
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