Patient report – SPG nerve block for treatment resistant paroxysmal hemicrania (PH)

Paroxysmal hemicrania (PH) treated with SPG Nerve Block.

A 69-year-old woman is treated for treatment resistant  paroxysmal hemicrania that was not responding to indomethacin and other treatment options. Nerve blocks have produced a positive outcome and treatment for the patient with headaches.

“Our patient, who was drug resistant, showed a clear clinical improvement with an SEGB. The use of endoscopy certainly facilitates the identification of the ana- tomical region corresponding to the pterygopalatine fossa, thus making it possible to inject the target site directly. The SPG is located in the pterygopalatine fossa”

“The patient came to our Headache Centre complain- ing of headaches of increasing intensity occurring over a period of 13 months. Nothing particularly significant showed up in her medical history, and no recent trauma was referred. The patient had never suffered from headaches before, and there was no family history of head- aches. The pain was described as severe, unilateral, localized to orbital and supraorbital areas, accompanied by….  rhinorrhoea, eyelid oedema, forehead and facial sweating and ptosis, lasting 5–20 min. The episodes had a frequency of 8–10 per day.”

Unilateral – Pain on only one side of the head or face

Orbital – Around the eye

Supraorbital – Above the eye

Rhinorrhoea – Runny nose

Eyelid oedema – Puffy eyelid

Ptosis – Drooping eyelid