What is a Sphenopalatine Ganglion Block, or SPGB?
The SPGB is a procedure in which medication (lidocaine) is used to “reset” a ganglion, or nerve bundle, at the back of the nasal passages that is known to be involved in many migraines and cluster headaches. This procedure has been shown to provide long term relief of many migraines and cluster headaches.
How is the procedure performed?
This procedure is performed in the Imaging Department at the hospital. The nasal passages are numbed with a spray, then a small, flexible catheter is inserted into your nostrils (one side at a time) while you lay on your back with your head tipped back. Special x-ray equipment will be used to see that the catheter is in the right position so that the medication is placed right onto the area where the ganglion is. This is verified by putting a small amount of x-ray contrast through the catheter, then following that with a small amount of lidocaine. The lidocaine will be absorbed through your nasal tissues to “reset” the sphenopalatine ganglion.
How do I know if this procedure is right for my headaches?
Patients who have migraines that include nausea, light sensitivity, or sensitivity to sound, or who suffer from cluster headaches often experience relief from this procedure. It is important for your regular medical provider (doctor, physician assistant, or nurse practitioner) to make sure that your headaches are not caused by another, more serious, condition.
Are there any conditions that would prevent me from getting having this procedure done?
Any condition that would prevent the lidocaine from absorbing through the nasal tissues in the area of the sphenopalatine ganglion could prevent the procedure from being completely effective. These would include sinus infections, allergies or other conditions where there is a lot of sinus/nasal drainage, and nasal polyps or tumors in the area where the ganglion is located.
How safe are the medications used in this procedure?
The medications have been around for many years and are known to be very safe in the amounts that are used for this procedure. If you are allergic to injectable iodine-containing x-ray contrast or lidocaine, you should discuss the pretreatment options with your regular medical provider.
What do I need to do to prepare for this procedure?
You will need to remove your earrings, necklaces, and any other jewelry above the shoulders for the procedure. Pony tails or other hair accessories on the back of the head should also be avoided, for comfort while laying on your back for the procedure. You may continue to take your regular medications, including those that you take to prevent or treat your migraines and continue your regular caffeine intake. Most patients will be able to resume their normal activities within 15-20 minutes after the procedure is completed.
How will I know if this procedure works for my migraines?
If you have a migraine during the time of the procedure, you may experience immediate relief from that migraine. If you do not have a migraine at the time of the procedure, but experience them at regular time intervals (for example, two to three times per week, during weather changes, along with your menstrual period, etc.), you may notice that you get through those times without suffering from a migraine.
How long can I expect this procedure to last?
This procedure has been found to be effective for anywhere from a couple of weeks to over a year. It has also been shown to have a cumulative effect, where you may get longer relief each time you have the procedure done, up to a certain point. On average, patients will need to have the procedure repeated 3-4 times per year.
When should I have it repeated?
Let your regular medical provider know as soon as you have your first migraine after you have been treated. They can then schedule you for your next SPGB procedure.
