Nitin Sharma*
Background: The Sphenopalatine ganglion (SPG), a parasympathetic ganglion in the pterygopalatine fossa, is involved in the activation of trigemino autonomic reflex, a pathway responsible for the symptoms of migraine and other primary headaches. Excessive touchiness of the SPG might be answerable for the raising aggravation and rehashed assaults in headache. Hindering the Sphenopalatine ganglion might bring about cutting short of an intense headache assault as well as decline the recurrence of resulting assaults by diminishing extreme touchiness of the SPG.
Method: An open, prospective interventional study was planned on 42 patients who fulfilled ICHD3 beta criteria of Migraine. A single, bilateral transnasal Sphenopalatine ganglion block was administered to patients with moderate to severe headache, using cotton tip applicator soaked with 4% lidocaine. VAS (Visual Analog Scale) was recorded before the procedure and 15 minutes, 2 hours and 24 hours after the procedure. The frequency of headache before and after a single SPG block was also noted. Statistical Analysis was performed using SPSS software version 23.0. P value of <0.05 was considered significant.
Results: 30 patients completed the study. The mean duration of illness in the group was 33.40 ± 15.89months. The pre procedure VAS was 6.53 ± 1.01. The mean VAS after fifteen minutes and 2 hours was 2.27 ± 0.69 and 1.37 ± 0.67 respectively. This relief continued till the next day. Mean Frequency of migraine episodes decreased from 10.33 ± 2.84 to 7.90 ± 2.38 after the block (p< 0.001). Twenty three patients had recurrence in the second week of intervention and 7 in the third week.
Conclusion: A solitary trans nasal Sphenopalatine block is a compelling, painless approach to cutting short an intense episode of headache alongside causing a decline in recurrence of additional assaults for upto a month.
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