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Diagnostic Imaging

Diagnostic Imaging

Central Scheduling Phone: 603-663-2180

Sphenopalatine Ganglion (SPG) Block- Migraine and Cluster Headache Treatment

The Sphenopalatine Ganglion (SPG) is a cluster of complex nerve cells which acts as a “way station” for nerve impulses. Blocking the SPG with numbing medicine (SPG block) is a 100 year old procedure for treatment of head and neck pain and headaches.

The Procedure:

Sphenocath is a minimally invasive Xray guided procedure (in most cases) with no needles. Sphenocath is a small flexible tube which is passed up behind the nose bone through the nostrils, and a small amount of Xray dye is injected, ensuring the tube is in the right place and the flow of dye is correct. Then a small amount of concentrated local anesthetic (like novocaine) is injected, which fills a small notch in the back of the nasopharynx, anesthetizing and resetting the sphenopalatine ganglion. Numbing the SPG essentially reboots the ganglion so that head, face and neck stimuli are interpreted correctly and the sensation of headache and facial pain is decreased or eliminated. Migraines, migraine variations, sinus and cluster headaches are treatable. Facial pain syndromes like trigeminal neuralgia, occipital and spinal headaches, and even morning sickness have been treated successfully.

Experienced Physicians:

In our hands, and we’ve been doing SPG with sphenocath longer than anyone in northern New England, we have success rates approaching 90% with very few and minor side effects (an occasional nosebleeds or lightheadedness/dizziness). Results commonly last weeks to months and relief for years is not uncommon. It can be repeated as often as needed and with repeated procedures often the results last longer and longer. Like any procedure, it is not 100% predictable and it doesn’t always work. Often, if it fails, repeating it will help.

What to Expect:

Spg BlockThe procedure from start to finish takes about 30 minutes. The actual injection takes less than 1 minute; you rest on your back for 10-15 minutes, and then you are done. While slightly unpleasant - patients have described it as having water up your nose – it is not painful. Most patients can drive themselves home although we prefer you have a driver. Results are often immediate, rarely take a few days to improve, and are usually fairly durable, meaning if it works for a few days it will usually work for an extended period of time, and most patients report that when their headaches start to recur, they are less frequent, less intense, and easier to treat with more basic medications.