Select Sphenopalatine Ganglion (SPG) Block Scientific Articles
Refractory primary and secondary headache disorders that dramatically responded to combined treatment of ultrasound-guided percutaneous suprazygomatic pterygopalatine ganglion blocks and non-invasive vagus nerve stimulation: a case series
This article focuses on a case series where patients with severe, treatment-resistant headaches experienced significant relief after receiving ultrasound-guided percutaneous suprazygomatic sphenopalatine ganglion (SPG) blocks.
Key Takeaways:
Challenging Headaches Addressed: The patients had long-standing primary headaches (such as migraines and cluster headaches) and secondary headaches (like postdural puncture headaches) that did not respond to other treatments.
Innovative Treatment:
SPG Block: This technique targets a specific nerve cluster in the head to block pain signals. It is considered safe, with minimal side effects like temporary numbness.
Results: The patients experienced immediate and long-lasting headache relief. This was significant because standard therapies had previously failed for these individuals.
Mechanism: The SPG block may work by disrupting pain pathways and reducing inflammation in the nerves connected to the brain, helping to prevent the occurrence of headache episodes.
Conclusion:
The study highlights SPG block as a potential first- or second-line treatment for chronic and difficult-to-treat headaches, offering promising outcomes for those who have not found relief with other therapies.
Sphenopalatine ganglion block a jack of all trades
The article explains the importance and versatility of the sphenopalatine ganglion block (SPG block) in pain management. This block targets the sphenopalatine ganglion (a nerve cluster in the head) to relieve different types of pain, particularly various headaches.
Key Points:
Location and Role: The SPG is located outside the skull but close to the brain, making it accessible for interventional pain treatments. It is involved in processing both sensory and autonomic signals that affect pain and headache mechanisms.
Pain Relief Mechanism:
The SPG block interrupts nerve pathways that transmit pain and autonomic symptoms.
It modulates sensory signals in the trigeminal nerve system, which plays a central role in headaches and facial pain.
It can also block sympathetic nerve activity that contributes to pain, such as in post-herpetic neuralgia and facial pain.
Applications: SPG blocks are effective for treating conditions like migraines, cluster headaches, tension headaches, trigeminal neuralgia, and even pain associated with cancer and post-surgical recovery.
Procedure Benefits: Due to its unique anatomical position and connections to higher brain centers, the SPG block is effective for a range of pain syndromes and is relatively easy to access for medical procedures.
This block is often used when standard headache treatments fail and can provide significant pain relief with minimal invasiveness.
Sphenopalatine Ganglion Block in the Management of Chronic Headaches
This article discusses the use of the sphenopalatine ganglion block (SPG block) in managing chronic headaches. The SPG is a nerve cluster in the head associated with transmitting pain and autonomic signals related to headaches.
Key Points:
SPG Anatomy: The SPG is located near the trigeminal nerve and is involved in sensory and autonomic functions. It can contribute to pain signals in headaches and other facial pain conditions.
Role in Headaches: The SPG block targets the nerve cluster to disrupt pain signals and reduce headache symptoms. It is particularly considered for treating headaches that have autonomic symptoms, such as cluster headaches and migraines.
Effectiveness:
Studies show that SPG blocks can provide pain relief, but the effectiveness varies based on the technique used and the agents applied (e.g., lidocaine, bupivacaine).
Some methods are invasive (e.g., using needles or radiofrequency ablation), while others are non-invasive, like applying medication intranasally.
Clinical Findings:
Various clinical trials and reports indicate that SPG blocks can help reduce headache frequency and intensity.
Techniques range from simple intranasal applications to more complex procedures involving radiofrequency to produce lasting relief.
Results show different degrees of success, and more research is needed to identify the most effective methods.
Conclusion:
The SPG block is considered a safe and potentially effective treatment for chronic headaches, including cluster headaches and migraines. While promising, further studies are recommended to optimize techniques and improve results.
Percutaneous sphenopalatine ganglion block: an alternative to the transnasal approach
This article reviews an alternative method for performing a sphenopalatine ganglion (SPG) block for treating certain headaches, particularly postdural puncture headaches (PDPH). Here’s a simplified summary:
Key Points:
Why the SPG Block? The SPG block is used to alleviate headaches by targeting a nerve cluster involved in pain transmission. Blocking this ganglion reduces pain by decreasing nerve activity that causes blood vessel dilation in the brain.
Traditional vs. New Method:
Transnasal Approach: This conventional method uses a cotton swab with local anesthetic placed in the nasal cavity. However, it has inconsistent results, challenges in accurate placement, and can cause discomfort.
Percutaneous (Needle) Approach: The article advocates for a newer, needle-based approach that uses ultrasound to guide the needle above the cheekbone (zygomatic arch). This method delivers anesthetic directly and effectively, showing higher success rates and better patient tolerance.
Benefits of the New Method:
More precise delivery of the anesthetic to the target area.
Minimizes the discomfort associated with the transnasal method.
Lower risk of complications compared to other invasive techniques.
Safety and Effectiveness: This technique has been performed extensively at the University of Florida with over 1,500 procedures and minimal complications, limited to minor skin bleeding at the needle insertion site.
Conclusion:
The percutaneous SPG block is presented as a safer, more effective alternative to the transnasal approach for headache relief, especially in cases where traditional methods are ineffective. The study encourages further exploration to confirm its benefits and potential broader application.
Assessment of craniofacial hyperhidrosis and flushing by sphenopalatine blockade - a randomized trial
This article details a study exploring the use of sphenopalatine ganglion (SPG) block for treating craniofacial hyperhidrosis (CFH) (excessive facial sweating) and flushing. Here’s a summary for easier understanding:
Main Points:
Why This Study? CFH and facial flushing can severely affect people's social lives and comfort due to excessive sweating and redness. These conditions stem from the nervous system and often don’t respond well to typical treatments. The study aimed to test if blocking the SPG, a nerve cluster involved in autonomic functions, could help.
Methods:
Participants: 25 patients with CFH were split into two groups: one receiving topical lidocaine applied to the SPG area, and the other receiving an SPG injection with lidocaine.
Duration: Effects were monitored for 6 months to assess how well these methods controlled symptoms and impacted quality of life.
Findings:
Results for CFH: Patients who received the injection showed significant improvement in their symptoms, lasting up to 6 months. The topical method did not provide the same level of relief.
Flushing: The treatment had less success for facial flushing, showing no significant improvement.
Safety: The procedures were generally safe, with minor side effects like temporary nosebleeds or mild eye irritation.
Conclusions:
SPG injections can be an effective, safe treatment for CFH, providing relief for months.
Further research is needed to confirm these findings and explore why flushing did not respond as well.
This study sheds light on SPG blocks as a potential new treatment for managing stubborn cases of craniofacial sweating, though not as effective for facial flushing.