Skip to main content

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