The SPG is a collection of nerve cells located behind the nose and is closely linked to the trigeminal nerve, the nerve mainly involved with headache disorders. The SPG has connections to a part of the brain called the brainstem, where migraine headaches and cluster headaches are presumed to originate from. Blocking the nerves in the SPG has been shown to block pain transmission in the nerves. In an SPG block, an anesthetic agent, such as lidocaine or bupivacaine is injected in the area surrounding the ganglion. Until recently, it was an invasive procedure done by a trained doctor by inserting a needle from the side of the head in front of the ear. However, more recently, newer and less invasive techniques have been developed that can inject the medicine safely through the nose sing a catheter.
This procedure can be done easily in the office and does not require any surgical expertise. A special applicator is inserted through the nose and the medication is delivered right in the SPG foramen.
Thiscan provide instant headache relief, often within a few minutes of the injection. In many patients, the headache relief can be quite sustained. The procedure does not require any sedation and takes less than a minute.