Can SPG Nerve Blocks Stop Migraine Pain in Its Tracks?

Any migraine sufferer knows that migraines are more than just headaches – they are disabling, painful episode that impacts their daily life. 38 million Americans suffer from migraines each year. Many people living with migraines try to manage their symptoms with over the counter medications, maintenance prescription medications, and other self-care treatments. Some patients are turning to interventional medicine for treatments like sphenopalatine ganglion nerve blocks administered by a SphenoCath catheter, in hopes of treating their migraines and ending their pain.

Migraines are neurological attacks characterized by severe and often debilitating head pain on one or both sides of the head and can include vomiting, light sensitivity, and blurred vision. Many migraine patients have sound and smell sensitivity during attacks, and some also experience visual disturbances called auras while having an episode. Migraine attacks can last four hours or more, and in some cases as long at 72 hours.

The cause of migraines was originally thought to be blood vessels dilating in the head and pressing against the brain. New research has found that the dilation of the blood vessels may not be the cause of the pain, but happen as a response to activity occurring with the trigeminal nerve.

The trigeminal nerve is the largest and most complex nerve in the cranium, and supplies feeling to the face and head. It also provides the motor function needed for chewing. The trigeminal nerve is made up of both sensory and autonomic nerves. Autonomic nerves are responsible for involuntary reactions in the face in response to stimuli, like the tearing of the eyes. Recent studies have found that when the trigeminal nerve becomes stimulated, it triggers the blood vessels in the brain’s covering to dilate as a response. Some researchers suggest that migraine causing stimuli include smells, bright lights and changes in barometric pressure.

As the blood vessels dilate and blood pulses through them, the trigeminal nerve translates these pulses as pain. These feelings of pain pass through the sphenopalatine ganglion, or SPG located right behind the nose, causing headaches and migraines.

Blocking pain from being transmitted through the SPG and causing a migraine can be done by using a nerve block delivered by a SphenoCath. A SphenoCath is a thin and flexible catheter that is inserted into the nasal cavity to deliver an anesthetic to the SPG. This anesthetic blocks the SPG from transmitting pain signals to the rest of the brain. One or both nostrils may be treated, depending on where the patient has pain.

The SphenoCath SPG Block is a minimally invasive, outpatient procedure. A topical anesthetic nasal spray is administered to numb the area, and the SphenoCath is inserted through the nostril. The anesthetic for the block is dripped into the nasal cavity. It Is then absorbed through the bone and into the SPG.

The SphenoCath can deliver the anesthetic in about two to three minutes, but the entire procedure takes about 15 to 20 minutes. The SPG nerve block using the SphenoCath is performed by an interventional radiologist in an office or clinic. Dr. Michael Budler, M.D., is an interventional radiologist who performs SphenoCath on migraine patients in his Grand Island, Nebraska, practice. Budler explains why the SphenoCath is a great treatment migraine sufferers, “The SphenoCath is a is very thin and flexible. It can be comfortably inserted into the nasal cavity and quickly deposit the blocking agent. This quick procedure can immediately bring relief to patients suffering migraine pain.”

Risks and complications of SphenoCath are short-lived and include slight discomfort during the procedure, soreness after the procedure, numbness or bitter taste in the mouth and nosebleeds.

The SPG nerve block can last several months, but Budler recommends patients return for additional treatments at least four times a year. “Because the anesthetic will eventually wear off, patients should return for reapplication once every three to four months,” he says.