Sphenopalatine Ganglion Block Treatment
How Sphenopalatine Ganglion block brings about Migraine and Headache relief :
The sphenopalatine ganglion (SPG) is a nerve bundle located deep in the face, behind the root of the nose. It is part of the autonomic nervous system. It supplies the lacrimal gland, paranasal sinuses, glands of the mucosa of the nasal cavity and pharynx, the gingiva, and the mucous membrane and glands of the hard palate. It is not involved in feeling or movement.
Sometimes after a nerve is sensitized by trauma, infection or other causes, the sympathetic activity can cause pain. Blocking the sympathetic activity by anesthetizing the SPG may stop the pain. A sphenopalatine ganglion block treatment is done to:
- Diagnose the cause of pain in the face and head
- Manage the pain of certain types of chronic headaches
- Manage sympathetically maintained facial pain
For over 100 years, the SPG has been a clinical target to treat severe headaches (Sluder 1908). Since Sluder first described the application of cocaine or alcohol to the SPG, the SPG has been a site for the treatment of severe headache pain, mainly applying lidocaine and other agents to the SPG to achieve a nerve block (Kudrow, Kudrow et al. 1995; Maizels, Scott et al. 1996; Maizels and Geiger 1999).
Recently, acute stimulation of the SPG was tested in patients with migraine (Tepper, Rezai et al. 2009) and cluster headache (Ansarinia, Rezai 2010). In these studies, acute stimulation of the SPG with good anatomical and physiological placement led to rapid termination of severe headache pain.
Sphenopalatine Ganglion Block Technique
The sphenopalatine ganglion (SPG) is a collection of nerves (sympathetic, parasympathetic and some sensory). It lies in a bony cavity called the pterygopalatine fossa, which is deep in the midface.
The Sphenopalatine Ganglion Block Procedure
During a sphenopalatine ganglion block treatment, pain-relieving medicine is injected to the region where the ganglion lies. This may reduce the release of the chemical norepinepherine activating the pain sensitive nerves and reduce the pain.The patient is usually sedated, and using X-ray (fluoroscopy) guidance, a fine needle is placed near the SPG and anesthetic is injected. The patient will not feel numbness in the face. Pain relief may also not be immediate. A pain diary is used following the procedure to track the response.