Cluster Headache treated with SPG Nerve Block.

Sphenopalatine Ganglion (SPG): A group of nerve cells that are linked to the trigeminal nerve- the nerve which sends information about sensation, such as pain, to the face. The Sphenopalatine Ganglion is found behind the eye and nose.

Endoscopic Sphenopalatine Ganglion Block (SPGB): a procedure which uses anaesthetics or other numbing drugs to block the group of nerves behind the eye and nose and thus stop communication between these nerves and the trigeminal nerve. This technique has been found to alleviate head and facial pain.


This article is an evaluation of an endoscopic sphenopalatine ganglion block technique developed and performed 5 years before the release of the present article. The study involved 15 patients who were diagnosed with prolonged cluster headache that were untreatable by medications. Before the treatment patients experienced an average of 7.8 migraine attacks daily. Before the endoscopic procedure patients were given an anaesthetic and a drug to numb the area. The drugs were applied in the nostrils and left for 10-15 minutes. The needle was inserted through the nostrils to administer the drugs into the lower part of the sphenopalatine ganglion. To block the sphenopalatine ganglion the following blocking drugs were administered triamcinolone acetonide (40 mg), bupivacaine 1% (4 ml) and mepivacaine 2%. One person performed all the procedures.

At the end of the procedure the headaches stopped completely in 8 (54%) patients. 3 patients continue to experience a decrease in the number of attacks between 8-28 months. The other patients experienced different periods of no attacks (1, 2 months) or 1 month of no attacks and 3 months of 3 attacks per week. 1 of the 15 patients experienced zero attacks for 5 months. Another one experienced a reduction in attacks of 4 attacks per week throughout 6 months. The level of pain during the attacks was also reduced. 6 patients said that they didn’t benefit from the procedure and didn’t have an attack free period of at least 15 days. 6 patients had no differences in symptoms before and after the procedure. Patients who had good results for a long period were allowed to repeat the procedure. While 3 patients reported complications after the procedure.


View the original Sphenopalatine Ganglion Block migraine treatment at this link: Sphenopalatine endoscopic ganglion block in cluster headache:
a reevaluation of the procedure after 5 years

  • ” Most important the fact that 3/15 patients (20%) avoided neurostimulation and its correlated risks, makes this approach a valuable addition to the therapeutic options.”
  • “One patient experienced an only partial benefit for 6 months with four attacks per week and a marked reduction of intensity of the headache.”
  • “the second-longest remission period (18 months) suffered from bilateral CH and had already been treated on both sides 12 months earlier and had experienced complete remission for 12 months.”

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