SHINGLES RELIEF: Sphenopalatine Ganglion (SPG) Blocks Offers Fast Relief for Herpes Zoster as does Stellate Ganglion Blocks. Includes Literature Review & Citations.

SHINGLES RELIEF SPG BlocksAutonomic Blocks:  Sphenopalatyine Ganglion Blocks and Stellate Ganglion Blocks can give amazing relief from the pain of a Herpes Zoster Episode.  These episodes may occur decades after the original  varicella-zoster virus which caused  Chicken Pox is reactivated.

SASPGB: Self-Administered SPG Blocks offer exceptional patient controlled pain relief especially for Trigeminal Nerve Pain of Herpes Zoster including Eye Pain!

This may safely be considered as a First Line Treatment for alleviating pain of Shingles especially affecting the head and neck.

Sphenopalatine Ganglion Blocks have been utilized to treat pain since 1908 when it was first described by Dr Greenfield Sluder to treat Sluders Neuralgia.  His textbook “NASAL NEUROLOGY:  HEADACHES AND EYE DISORDERS ” was the state of the art for many years.  Dr Sluder was Chair of Otolaryngology at Washington University School of Medicine is St Louis.  He purposely titeld the book “Nasal Neurology” due to importance of Sphenopalatine Ganglion Blochs in all cases of head, neck and eye pain due to tyhe Sympathetic and Parasympathetic nerves that travel with the Trigeminal Nerve.

On page 104 of Sluder’s book is a case observed by W. M. C. Bryan where anesthetic (cocaine) to the Sphenopalatine Ganglion stopped intense Herpes pain in the Eyeball and in the maxillary division of the Trigeminal nerve.  His text has 80 pages of case histories treated by Ganglion Blocks including Acute Blindness, Vacumn Frontal Headaches, Anterior Ethmoidal Neuralgia, Asthma, and Vidian Neuralgia to mention just a few.

Shingles is a result of reactivation of the Herpes Zoster viral infection of the varicella-zoster virus. It is usually extremely painful and pain is the first presenting symptom.   Shingles is usually  self-limited to follow nerve pathways or dermatomes, often causing a dermatomal rash.

Symptoms typically begin with pain along the affected dermatome by  and are then followed by a vesicular eruption 3-5 days later.  According to Mayo Clinic the Symptoms include:

“The signs and symptoms of shingles usually affect only a small section of one side of your body. These signs and symptoms may include:

  • Pain, burning, numbness or tingling
  • Sensitivity to touch
  • A red rash that begins a few days after the pain
  • Fluid-filled blisters that break open and crust over
  • Itching

Some people also experience:

  • Fever
  • Headache
  • Sensitivity to light
  • Fatigue”

There are numerous studies on the use of Autonomic Blocks for treating Shingles, recurrent Herpes Zoster outbreaks. Combined stellate ganglion and sphenopalatine ganglion block in acute herpes infection.  https://pubmed.ncbi.nlm.nih.gov/8358137/

Neuromuscular dentistry and the role of the autonomic nervous system: Sphenopalatine ganglion blocks and neuromodulation. An International College of Cranio Mandibular Orthopedics (ICCMO) position paper.
Ira L Shapira DDS, D,AAPM, D,ABDSM, FICCMO, MICCMO 

Abstract

The Sphenopalatine Ganglion (SPG) is known to play an integral role in the pathophysiology of a wide variety of orofacial pains involving the jaws, sinuses, eyes and the trigeminal autonomic cephalalgias. It supplies direct parasympathetic innervation to the trigeminal and facial nerves. Sympathetic innervation from the superior sympathetic chain passes thru the SPG to the trigeminal and facial nerves.This paper reviews relevant and significant literature on SPG Blocks and Neuromodulation published in peer reviewed medical and dental journals. Neuromuscular Dentistry employs ULF-TENS to relax musculature and simultaneously provide neuromodulation to the ganglion.Conclusion: The effects of ULF-TENS on the autonomic nervous system acts on the Limbic System and Hypothalamus (H-P-A) to address Axis II issues during neuromuscular dental procedures. It also directly affects the autonomic component of the trigeminal nerve involved in almost all headaches and migraines as well as the Myofascial and Joint disorders of TMD.

Keywords: Neuromuscular Dentistry; Sphenopalatine Ganglion (SPG) Block; Sphenopalatine Ganglion (SPG) Neuromodulation; Trigeminal Autonomic Nervous system; ULF-TENS.

Stellate block for trigeminal herpes zoster  E R OlsonH B Ivy   

J Headache Pain. 2017; 18(1): 118.
Sphenopalatine ganglion: block, radiofrequency ablation and neurostimulation – a systematic review  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5745368/
J Pain Res. 2017; 10: 2815–2826.
Ganglion blocks as a treatment of pain: current perspectives   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734237/
The Clinical Journal of Pain: June 1993 – p 135-13
Abstract:  A total sympathetic block of head and neck by a combination of stellate ganglion and sphenopalatine ganglion block is described as a therapeutic modality in a 55-year-old woman with postherpetic neuralgia involving the opthalmic division of the trigeminal nerve with complete pain relief.
There are over 1400 citations on Pub Med for Herpes Zoster and the Eye including pain, Herpes zoster ophthalmicus: acute keratitis
https://pubmed.ncbi.nlm.nih.gov/?term=herpes+zoster+eyes
Herpes zoster involving the abducens and vagus nerves without typical skin rash: A case report and literature review

Abstract:   Herpes zoster is characterized by unilateral vesicular eruption and it most often affects the trigeminal nerve. We would like to report a rare case of abducens and vagus nerves palsy caused by varicella zoster virus (VZV) without the typical vesicular rash.

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