Table 3 Studies of SPG block for cluster headache
From: Sphenopalatine ganglion: block, radiofrequency ablation and neurostimulation - a systematic review
Cluster headache | ||||||||
|---|---|---|---|---|---|---|---|---|
Author | Year | Medical problems | Approach | Imaging | Medication | Number of cases | Study design | Outcome |
Devoghel et al. [52] | 1981 | Cluster headache | Needle injection. Supra-zygomatic approach | None | Pure alcohol | 120 | Case series | 85.8% had complete relief |
Barre et al. [7] | 1982 | Cluster headache | Cotton swab. Applied to sphenopalatine foramen. Self-application if responded to treatment | None | 50 mg of cocaine flakes, then 10% and 5% cocaine solution | 11 | Case series | 10 out of 11 had 50-100% abortion rate in spontaneous headache |
Kittrelle et al. [8] | 1985 | Cluster headache | Lidocaine directly dropped into the nostrils | None | 4% lidocaine | 5 | Case series | 4 of 5 patients obtained relief of nitrate-induced cluster headaches |
Costa et al. [6] | 2000 | Cluster headache (nitroglycerin induced) | Cotton tipped applicator, transnasal approach | None | 10% cocaine or 10% lidocaine | 6 episodic CH, 9 chronic CH | Double-blind, placebo-controlled, | All patients with induced pain responded to cocaine after 31.3 min and lidocaine after 37 min |
Felisati et al. [9] | 2006 | Chronic cluster headache | Endoscopic needle injection that approaches the pterygopalatine fossa by way of the lateral nasal wall | None | Triamcinolone acetonide, 1% bupivacaine and 2% mepivacaine with adrenaline | 21 | Case series | 11 out of 21 have improvement in symptoms |
Yang et al. [53] | 2006 | Chronic cluster headache | Transnasal needle | Fluoroscopy | 0.2% Ropivacaine and triamcinolone | 1 | Case report | 60% pain relief |
Pipolo et al. [10] | 2010 | Drug-resistant chronic cluster headache | Needle into the inferior portion of the sphenopalatine foramen (transnasal endoscopic technique-prasanna 1993 | None | 40 mg triamcinolone acetonide, 1% bupivacaine, 2% mepivacaine with adrenaline | 15 | Case series | 55% experience complete subsidence of CH symptoms |
Zarembinski et al. [54] | 2014 | Drug-resistant chronic cluster headache, with Jacob’s disease | Sphenopalatine ganglion block via mandibular notch, then radiofrequency oblation. | Fluoroscopy, CT | 0.25% bupivacaine and 10 mg/ml dexamethasone | 1 | Case report | Pain significantly improved. |
Kastler et al. [55] | 2014 | Cluster headache (14), persistent idiopathic facial pain (10), and other types of facial pain (18) | Infrazygomatic approach | CT | Absolute alcohol | 14 | Case series | 76.5% of patients have 50% pain relief at 1 month |