CANANDAIGUA – The Diagnostic Imaging Department at UR Medicine’s Thompson Hospital is now offering an innovative treatment found to offer sustained relief to many of those who suffer from chronic migraines and cluster headaches.
Called an intranasal sphenopalatine ganglion (SPG) block, the image-guided procedure is minimally invasive and involves no needles. “It’s a very unique alternative,” stated Dr. Devang Butani, an interventional radiologist specializing in pain management who performs the procedure at both Thompson and Strong Memorial Hospital.
According to the American Migraine Foundation, 36 million Americans – about 12 percent of the population – suffer from migraines, which can cause people to miss work and can make them more likely to have depression, anxiety, sleep disorders, other pain conditions and fatigue.
There is no cure for migraines. Typically, Dr. Butani said, the first line of treatment for reducing frequency and severity is medication, including over-the-counter pain relievers. When that doesn’t help, some patients resort to narcotics, but those can be addictive.
Research on the image-guided intranasal SPG block, which Dr. Butani called “a new take on an old procedure,” was presented earlier this year at the annual scientific meeting of the Society of Interventional Radiology. According to Endovascular Today, the study’s lead investigator – Dr. Kenneth Mandato of the Albany Medical Center – referred to the treatment as “breakthrough” and said it has the potential to quickly improve quality of life.
During the procedure, a thin catheter is inserted through the nasal passages to administer lidocaine. The procedure takes approximately 20 minutes, and according to Dr. Butani, it involves minimal risks. Those include minor bleeding if the nasal passages are dry.
Prior to the development of the image-guided procedure, Dr. Butani said, a needle was used to break through the cheekbone.
Dr. Butani said patients who receive an SPG block often feel some relief within a few hours, with relief improving over the course of the next few days.
At the SIR conference earlier this year, Dr. Mandato explained the administration of the lidocaine acts as a “reset button” for the brain’s migraine circuitry, so when the initial numbing of the lidocaine wears off, the migraine trigger has less effect than it did previously. According to Dr. Butani, the procedure can also benefit patients with facial distribution pain syndromes such as trigeminal neuralgia and persistent pain over the upper and lower jaws after root canals.
No referral is needed for a minimally invasive SPG block, and Dr. Butani said most insurances cover the procedure.
To schedule a consult at Thompson, call Interventional Radiology at the DI nurses’ station, (585) 396-6701.