Chronic migraine treated with SPG nerve block

SPG is an abréviation for the “Sphenopalatine Ganglion”. The SPG is a large intersection of nerves situated on each side of the face, just below and behind the eye. The SPG is labeled in the diagram below.

Simple and safe treatment of the SPG with local anaesthetic, was published in 2014 “Headache“, on behalf of the American Headache Society.

In the study 41 Chronic migraine patients  between 18 – 80 years old, were enrolled at two migraine centres in the USA, and went through a 28 day period of monitoring before receiving SPG Nerve Block treatment for migraine.

The patients were randomly assigned to two groups, and the SPG block was administered with different substances for each group. The SPG block is administered by injection.

In the first group local anaesthetic was injected in to the SPG, (0.5% bupivacaine) and in the second group, a placebo of salt water (0.5% saline) was injected.

The is one SPG located on each side of the face immediately behind and below the eye. Both sides of the face were injected twice a week for six weeks. Thereafter, patients had to report their migraine experiences before treatment, and 15 minutes, 30 minutes, and 2 hours after treatment, using a numeric scale.

38 Patients completed the study.

The group that received local anaesthetic had a significant decrease in pain scores compared to the placebo (saline) group, at all time points on the numeric scale.

Scores relating to the intensity of the headaches were also decreased in the local anaesthetic group after treatment, compared to before treatment. The saline group showed no difference in pain intensity scores before and after treatment.

Sphenopalatine Ganglion: The point at which the three branches of the trigeminal nerve converge. The trigeminal nerve sends and receives information about pain and sensation to the head and face. The Sphenopalatine Ganglion is found behind and below the eye.

Bupivacaine: Is a local anaesthetic.

View the original Sphenopalatine Ganglion Block migraine treatment at this link: A Double-Blind, Placebo-Controlled Study of Repetitive Transnasal Sphenopalatine Ganglion Blockade With Tx360® as Acute Treatment for Chronic Migraine

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