I am very pleased to be speaking on this topic at the Moscow International College of CranioMandibular Orthopedics (ICCMO) Meeting.
I have a paper on the Role of the
Sphenopalatine Ganglion and the use of SPG Blocks and Neuromodulation in Neuromuscular Dentistry Scheduled for publication in the May 2019 issue of Cranio, The Journal of CranioMandibular and Sleep Practice.
New article on Cluster Headache, The title is quoted from the article.
Sphenopalatine Ganglion Blocks have been used since 1908.
Amazingly safe and effective for wide range of disorders. Self-Administration makes SPG Blocks even more effective.
Self-Administration of bilateral trans-nasal SPG blocks is a simple and minimally invasive way to administer effective treatment of Cluster Headache, Migraine, TACs and and other chronic and episodic headaches.
https://www.reddit.com/r/SPGBlocks/
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Abstract from PubMed:
Neurol Sci. 2019 Mar 16. doi: 10.1007/s10072-019-03796-5. [Epub ahead of print]
Cluster headache: crosspoint between otologists and neurologists-treatment of the sphenopalatine ganglion and systematic review.
Rosso C1, Felisati G2,3, Bulfamante A1, Pipolo C4.
Author information
Abstract
Among cephalgias, cluster headache (CH) is the rarest and the most disabling, explaining the appellation of “suicide headache.” Up to 20% of chronic CH reveals to be resistant to pharmacological treatments, in which case interventional procedures should be considered. Many reports evaluated invasive approaches and a wide strand of research is dedicated to the sphenopalatine ganglion. Our paper will now be focused on providing an overview on modern applications on the sphenopalatine ganglion (SPG), their outcomes, and their feasibility in terms of risks and benefits. The group reviewed the international literature systematically for procedures targeting the sphenopalatine ganglion and its branches for episodic and chronic CH, including block, stimulation, radiofrequency, stereotactic radiosurgery, and vidian neurectomy. Seventeen articles fixed our inclusion criteria.********************* Comparing the outcomes that have been analyzed, it is possible to notice how the most successful procedure for the treatment of refractory chronic and episodic CH is the SPG block, which reaches respectively 76.5% and 87% of efficacy. *******************************Radiofrequency has a wide range of outcomes, from 33 to 70.3% in CCH. Stimulation of SPG only achieved up to 55% of outcomes in significant reduction in attack frequency in CCH and 71% in ECH. Radiosurgery and vidian neurectomy on SPG have also been analyzed. Generally, ECH patients show better response to standard medical therapies; nevertheless, even this more manageable condition may sometimes benefit from interventional therapies mostly reserved for CCH. First results seem promising and considering the low frequency of side effects or complications, we should think of expanding the indications of the procedures also to those conditions. Outcomes certainly suggest that further studies are necessary in order to understand which method is the most effective and with less side effects. Placebo-controlled studies would be pivotal, and tight collaboration between neurologists and otorhinolaryngologists should also be central in order to give correct indications, which allow us to expect procedures on the SPG to be an effective and mostly safe method to control either refractory ECH or CCH.
KEYWORDS:
Cephalgia; Cluster headache; Endoscopic transnasal approach; Refractory headache; Sphenopalatine ganglion
Neurol Sci. 2019 Mar 16. doi: 10.1007/s10072-019-03796-5. [Epub ahead of print]
Cluster headache: crosspoint between otologists and neurologists-treatment of the sphenopalatine ganglion and systematic review.
Rosso C1, Felisati G2,3, Bulfamante A1, Pipolo C4.
Author information
Abstract
Among cephalgias, cluster headache (CH) is the rarest and the most disabling, explaining the appellation of “suicide headache.” Up to 20% of chronic CH reveals to be resistant to pharmacological treatments, in which case interventional procedures should be considered. Many reports evaluated invasive approaches and a wide strand of research is dedicated to the sphenopalatine ganglion. Our paper will now be focused on providing an overview on modern applications on the sphenopalatine ganglion (SPG), their outcomes, and their feasibility in terms of risks and benefits. The group reviewed the international literature systematically for procedures targeting the sphenopalatine ganglion and its branches for episodic and chronic CH, including block, stimulation, radiofrequency, stereotactic radiosurgery, and vidian neurectomy. Seventeen articles fixed our inclusion criteria. Comparing the outcomes that have been analyzed, it is possible to notice how the most successful procedure for the treatment of refractory chronic and episodic CH is the SPG block, which reaches respectively 76.5% and 87% of efficacy. Radiofrequency has a wide range of outcomes, from 33 to 70.3% in CCH. Stimulation of SPG only achieved up to 55% of outcomes in significant reduction in attack frequency in CCH and 71% in ECH. Radiosurgery and vidian neurectomy on SPG have also been analyzed. Generally, ECH patients show better response to standard medical therapies; nevertheless, even this more manageable condition may sometimes benefit from interventional therapies mostly reserved for CCH. First results seem promising and considering the low frequency of side effects or complications, we should think of expanding the indications of the procedures also to those conditions. Outcomes certainly suggest that further studies are necessary in order to understand which method is the most effective and with less side effects. Placebo-controlled studies would be pivotal, and tight collaboration between neurologists and otorhinolaryngologists should also be central in order to give correct indications, which allow us to expect procedures on the SPG to be an effective and mostly safe method to control either refractory ECH or CCH.
KEYWORDS:
Cephalgia; Cluster headache; Endoscopic transnasal approach; Refractory headache; Sphenopalatine ganglion
Two addiitional articlees on Sphenopalatine Ganglion Blocks published in March 2019.
Emerging treatments for cluster headache: hopes and disappointments.
Some aspects on the pathophysiology of migraine and a review of device therapies for migraine and cluster headache.
Ira L Shapira DDS, D,ABDSM, D,AAPM, FICCMO
Past Chair, Alliance of TMD Organizations
Diplomat, Academy of Integrative Pain Management
Diplomate, American Board of Dental Sleep Medicine
Diplomate, American Board Sleep and Breathing
Regent, Master & Fellow, International College of CranioMandibular Orthopedics
Board Eligible, American Academy of CranioFacial Pain
Dental Section Editor, Sleep & Health Journal
Member Cranio Editorial Board, Journal of Craniomandibular and Sleep Practice
Member, American Equilibration Society
Member, Academy of Applied Myofunctional Sciences
Member, Academy of Cosmetic Dentistry
Life Member, American Dental Association
www.ThinkBetterLife.com
www.DelanyDentalCare.com
www.NorthShoreSleepDentist.com
www.IHateCPAP.com
www.iHateHeadaches.org
www.SleepandHealth.com
www.SphenopalatineGanglionBlocks.com
https://www.youtube.com/channel/UCk9Bfz6pklC7_UluWFHzLrg