If you suffer from migraine headaches, cluster headaches, trigeminal neuralgia, tension headaches that are severe, Indy Vital has a procedure just for you. We understand how debilitating and hard it is to have severe headaches that may be associated with other symptoms such as facial pain, numbness and tingling involving the scalp or face, flashing lights and irritability.
The SGB Procedure
The Sphenopalatine Ganglion Block Procedure (SGB) consists in inserting a special kind of catheter, called Spheno Cath in the nostril and advance the catheter inside the nose cavity to a specific location where a bundle of nerves called shenopalatine ganglion resides. This location is just behind the nose cavity. To assure that the injection of local anesthetic is delivered in the exact location, the procedure is done under x-ray guidance using a machine called fluoroscopy C-Arm. This procedure has been FDA cleared and the Spheno Cath is now available for physicians to provide patients with this procedure. It is usually recommended in patients that have moderate to severe headaches. There are no needles involved in this procedure.
Patients that have recurrent headaches over a period of six months or longer and who had failed traditional treatment with medications. At Indy Vital, patients may opt to treat their headaches with SGB in trying to avoid the use of strong medication such as anti-seizure drugs, narcotics and other forms of pharmacological therapy that could produce a significant amount of side effects and may cost more than the SGB procedure.
Sphenopalatine Ganglion Block Frequently Asked Questions
What is the Sphenopalatine ganglion block procedure?
In case you suffer from severe migraine headaches or cluster headaches, you may opt to have the sphenopalatine ganglion block procedure. The procedure is non-invasive and requires no anesthesia. It consists in advancing a catheter over the nasal cavity under the guidance of an x-ray machine called fluoroscopy and then injecting local anesthetic with the use lidocaine 4% at an area behind the nasal cavity called the sphenopalatine ganglion nerve.
When is the Sphenopalatine ganglion block procedure indicated? Who can have this method of treatment?
If you suffer from significant migraine or cluster headache that is debilitating, you are a candidate for the sphenopalatine ganglion block procedure. Occasionally, doctors may reserve this procedure for patients that are not responding to conventional treatment with oral medications, but in our opinion, the decision is ultimately made by the patient. In case you are a patient who does not take medications well, have significant side effects, or you do not like taking oral medications, you may opt to have the Sphenopalatine Ganglion Block Procedure as your first line of therapy for migraine headaches.
How long it takes to do the procedure?
The procedure is done relatively quickly. Between the preparation and the insertion of the catheter and the nasal cavity followed by the injection of 4% lidocaine over the area of the Sphenopalatine Ganglion nerves, takes approximately 15 minutes. We ask every patient to remain under observation for an additional 10 minutes after the procedure is completed to monitor for signs of nosebleed. Nosebleeds are uncommon, happening and less than 10% of the procedures performed, but maybe annoying and require additional attention.
Does the procedure require the use of needles? Is this procedure painful?
No, the procedure does not require needles and is virtually painless. There is a sensation of mild discomfort upon advancing the Spheno Catheter through the nasal cavity. To minimize this effect, we utilized lidocaine gel inside the nasal cavity before proceeding the Spheno Catheter under the x-ray fluoroscopy over the nasal cavity.
What are the risks associated with the sphenopalatine ganglion block procedure?
The procedure is a very low-risk procedure. Severe complications have not been reported in the medical literature. The most common complication is a minor problem associated with irritation of the mucosa due to the use of the Spheno Catheter. This irritation may cause nosebleed that is usually self-limited and uncomplicated. This complication happens and less than 10% of the cases.
After the procedure, can I stopped my migraine headache medication?
We recommend that you discontinue the use of other medications unless you have been prescribed anticonvulsant or antiseizure medicines for the control of your migraines. In this case, we will send you back to your neurologist or the prescribing physician, for his input and opinion in the matter.
When may I expect my headaches to improve?
In 80% of the cases, most patients achieve headache remission immediately after the procedure is completed. The procedure has a very high success rate.
How frequently do I need to have the sphenopalatine ganglion block procedure?
It varies, occasionally patient obtains a permanent remission after one procedure using the sphenopalatine ganglion block technique. We recommend that a few her headaches are severe that he return for the procedure every 3-4 months. The use of SGB may prevent relapse of your migraine headaches.
In general the procedure is very well tolerated but a sensation of numbness in your troth may develop due to the injection of the local anesthetic. The anesthetic may drip from behind the nasal cavity to your pharynx. Less common, is the development of cough or low blood pressure. This side effects are temporary and should result spontaneously after 30 minutes to a maximum of 2 hours.
In general, this procedure is very well tolerated and the complications are usually minor and may involve the development of nosebleeds. For this reason, it is recommended that patients be observed for one or two hours after the procedure. Very rarely, With only a few reported cases, patients may lose a sensation of the soft palate after this procedure. Epistaxis (Nosebleeds) may happen in up to 10% of patients.
At Indy Vital, we offer SBG procedures for headache. The process consists of inserting a small catheter called Spheno Catheter in the nostrils and move the catheter to an area behind the nose cavity under the use of fluoroscopy x-ray imaging. Once the catheter is placed in the adequate location, a small amount of concentrated local anesthetic is delivered to the area blocking the sphenopalatine ganglion and trigeminal nerve causing the headache to subside for a prolonged time, possibly months. The procedure is overall very well tolerated and may resolve your headache entirely or decrease the intensity and frequency of new episodes. During the procedure, the patient may view that he needs to sneeze, and there may be minor discomfort or irritation and a quick burning sensation when the anesthetic is applied to the area. The side effects are usually small and temporary and include numbness of the troth, low blood pressure, and rarely nausea. This numbness sensation should last only a few hours.