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.
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.
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.
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.
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.
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.
In 80% of the cases, most patients achieve headache remission immediately after the procedure is completed. The procedure has a very high success rate.
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.