Do you suffer from chronic migraines? If so, you know that they can take over your entire life – trying to prevent them before they start, and fruitlessly searching for something to alleviate the pain once they hit. Soon, you may have another option!
There’s exciting new research supporting a simple radiology treatment to relieve some of the pain. The procedure is called “image-guided, intranasal sphenopalatine ganglion (SPG) blocking,” and, despite its difficult name, is quick and easy.
A simple procedure
First, the provider sprays a topical numbing lidocaine solution inside a patient’s nose. Then, using fluoroscopy, the doctor threads a small catheter up one nostril to the back of the nose and injects a very small amount (2 mL) of concentrated (4%) lidocaine hydrochloride into a bundle of nerves just behind the nose called the sphenopalatine ganglion while the patient inhales. The doctor then repeats the injection via the other nostril. The entire procedure takes only about 15 or 20 minutes and is painless for most patients.[1]
Patients experience ongoing relief
In a study of this new procedure, patients experience ongoing relief after the procedure and were able to reduce their consumption of pain medication.[2] 112 patients with severe migraines were studied; their average migraine severity on a visual analogue scale (VAS) of 1-10 began at an average of 8.25 (with scores greater than 4 at least 15 days per month). The day after the SPG block procedure, patients’ VAS scores averaged 4.10, and the relief lasted: thirty days after the procedure, patients reported an average score of 5.25, a 36 percent decrease from pretreatment. 88 percent of patients also indicated that they required less migraine medication for ongoing relief than before the procedure or even none at all.
“Administration of lidocaine to the sphenopalatine ganglion acts as a ‘reset button’ for the brain’s migraine circuitry,” explained Kenneth Mandato, M.D., the study’s lead researcher and an interventional radiologist at Albany Medical Center. “When the initial numbing of the lidocaine wears off, the migraine trigger seems to no longer have the maximum effect that it once did. Some patients have reported immediate relief and are making fewer trips to the hospital for emergency headache medicine.”
When will this be available?
Although the SPG procedure isn’t a cure for migraines, the indications are that patients could have it repeated multiple times as needed because it’s minimally invasive and lidocaine is an established, relatively safe drug. The adverse effects observed in the Albany study were few and minimal: one patient reported a stomachache when subsequently swallowing medicine, and another experienced a sinus flare-up.
Nerve blocks, including applications of lidocaine to the SPG, have been successfully used to treat migraine pain for decades, but using fluoroscopy for more targeted injection of the drug is a new frontier.[3] Researchers will continue tracking this study’s patients, and more studies must be done, but this line of research opens a promising new door for migraine relief.
Iowa Radiology, with locations in downtown Des Moines, Lakeview, Clive, and Ankeny, is committed to providing our patients the latest in radiologic technology and superior care.
{{cta(‘da466015-7a1f-4afb-89c2-34c29760155d’)}}
The information contained in the Iowa Radiology website is presented as public service information only. It is not intended to be nor is it a substitute for professional medical advice. You should always seek the advice of your physician or other qualified healthcare provider if you think you may have a medical problem before starting any new treatment, or if you have any questions regarding your medical condition.
Iowa Radiology occasionally supplies links to other web sites as a service to its readers and is not in any way responsible for information provided by other organizations.
[1] http://www.medscape.com/viewarticle/841013
[2]http://www.sciencecodex.com/imageguided_treatment_shown_to_break_the_migraine_cycle-151821
[3] http://www.medscape.com/viewarticle/841013
Recent Comments