A new case report (pubmed abstract below) was just published in Headache, March 2016 Hemicrania Continua discusses a case report of a sufferer responding to repetitive sphenopalatine ganglion blocks. The typical treatment is indomethacin a powerful non-steroidal that many patients do not tolerate.
The patient was a 52 year old with a 7 year history of problems.
SPG Blocks (Sphenopalatine Ganglion Blocks) have been shown to be effective for many headaches including tension headache, chronic daily headache, cluster headache and all of the autonomic cephalgias. While it is not universally effective it is miraculous results for many patients.
This patient was treated twice a week for for 6 weeks but utilizing self administration on a daily or twice daily basis would probably give far better results. Self administration is also extremely inexpensive (less than $1.00 /per application and it puts the patient in charge of their pain.
The beauty of the SPG Block is that it can be done whenever pain begins and it is also effective for depression, anxiety and many other problems.
The Sphenopalatine Ganglion is also called the Pterygoid Ganglion or Meckels Ganglion
Headache. 2016 Mar;56(3):573-9. doi: 10.1111/head.12783. Epub 2016 Mar 1.
Hemicrania continua may respond to repetitive sphenopalatine ganglion block: A case report.
Michelle Androulakis X1, Krebs KA1, Ashkenazi A2.
Hemicrania continua (HC) is a chronic headache disorder characterized by a continuous, strictly unilateral head pain accompanied by cranial autonomic symptoms, which completely responds to indomethacin; however, few alternative treatment options exist for the patients with this disorder who cannot tolerate indomethacin. Sphenopalatine ganglion (SPG) block has been used for the treatment of various headaches, with the strongest evidence for efficacy in cluster headache.
A 52-year-old woman with a 7-year history of HC was evaluated in our clinic for management of her headaches after she had stopped using indomethacin due to a bleeding gastrointestinal ulcer. After failing multiple pharmacologic therapies, she was treated with repetitive SPG blocks using bupivacaine (0.6 mL at 0.5%) twice a week for 6 weeks and followed by maintenance therapy. This treatment protocol resulted in significant improvement in her headaches, mood, and functional capacity.
SPG block using a local anesthetic may be an effective treatment for patients with HC, specifically for those who cannot tolerate indomethacin, or when this drug is contraindicated.
© 2016 American Headache Society.
chronic migraine; cranial autonomic symptoms; hemicrania continua; indomethacin; sphenopalatine ganglion block; trigeminal autonomic cephalagias