Regional anesthetic suprazygomatic sphenopalatine ganglion (SPG) block may quickly and effectively relieve status migrainosus, according to a study published in Headache.
Although it is known that the SPG plays a critical role in the transmission of pain and other autonomic responses associated with migraine, the current treatment of migraine with SPG block via transnasal lidocaine was found to provide only moderate relief and to be poorly tolerated.
The study included participants with a diagnosis of migraine, based on the International Headache Society criteria, who had been diagnosed with status migrainosus, had failed to respond to ≥2 abortive medications, and had received a suprazygomatic SPG block (n=88). Participants rated their pain using a 1 to 10 Likert scale before and 30 minutes after the injection. The 88 participants received a total of 252 suprazygomatic SPG block procedures after traditional medications failed to relieve their symptoms.
There were no significant adverse events or complications after injections; 1 participant developed a transient cranial nerve VI palsy, which resolved completely after 6 hours.
Mehta D, Leary MC, Yacoub HA, et al. The effect of regional anesthetic sphenopalatine ganglion block on self-reported pain in patients with status migrainosus [published online July 25, 2018]. Headache.