EHMTI-0191. A novel approach for the treatment of cluster headache – onabotulinumtoxina block of the sphenopalatine ganglion

Background

Blockade of the sphenopalatine ganglion with OnabotulinumtoxinA injections (SphenoBlock) represents a novel approach for treating intractable chronic cluster headache (iCCH).

Aim

The aim of this pilot study was to explore the safety aspects and therapeutic potential of SphenoBlock.

Method

After signing written confirmed consent ten patients with iCCH were injected with 25 U (n=5) or 50 U (n=5) onabotulinumtoxinA towards the sphenopalatine ganglion in an observational study, approved by the Institutional Review Board, with 6 months follow-up. The procedure was performed with a novel image-guided technique. The primary endpoint was to evaluate safety of the procedure, but change in attack frequency from baseline to week 4, 12 and 24 was also registered.

Results

Data for the first 5 patients are presented. One patient experienced intermittent ipsilateral visual deficits lasting 4 weeks. Patient number 5 was a failed injection. Four patients were defined as frequency responders (>50% reduction from baseline) in week 4, 3 patients responded in week 12, and 2 patients in week 24 (Figure 1). Complete study data will be presented at the meeting.

Figure 1

Conclusion

SphenoBlock in iCCH shows promising preliminary results and give reasons for cautious optimism for further studies on this low-cost alternative treatment of iCCH.