Introducing SphenoBlock for Pain

SphenoBlock is a minimally invasive procedure designed to temporarily block a collection of nerves (the sphenopalatine ganglion – SPG), effectively delivering pain relief. The SPG lies in a bony cavity which is deep in the midface nasal cavity and is related to a variety of facial pain conditions, such as migraines, cluster headaches and atypical facial pain.

A sphenopalatine ganglion block is done to:

  • Diagnose the cause of pain in the face and head
  • Manage the pain of certain types of chronic headaches
  • Manage sympathetically maintained facial pain

During a SphenoBlock, pain-relieving medicine is injected to the region where the ganglion lies, sometimes with the use of a fine needle (the SphenoCath). This may reduce the release of the chemical norepinepherine activating the pain sensitive nerves and reduce the pain with long-lasting effects.

Patient will not feel numbness in the face.

Procedure is painless.

Requires no X-rays.

Takes about 30 minutes in the office.

Most insurance companies, as well as Medicare, cover the procedure.

SphenoBlock can often give immediate relief to an ongoing pain episode and/or help to give longer term relief by “resetting” this group of nerves (SPG).

If you’re currently taking medicine for migraines or other chronic facial pain, this simple procedure may over time replace the need for narcotics or other pain medications. It fits into the overall treatment plan with regards to medications, Botox injections and surgery for migraines.

Migraines: Can Dementia, Stroke, or Heart Attack Be Next?

July 15, 2013

Content provided by the Faculty of the Harvard Medical School
New Harvard research confirms some links, rejects others.

Two new studies from Harvard examine the possible associations between migraine headaches and other conditions. One study offers encouraging news: the headaches will not hurt thinking skills. Another study suggests a warning: the headaches, when accompanied by aura, may signal an increased risk of heart attacks and stroke. “After high blood pressure, migraine with aura was the second strongest single contributor to the risk of heart attacks and strokes,” says study author Dr. Tobias Kurth, adjunct associate professor of epidemiology at the Harvard School of Public Health. “It was followed by diabetes, family history, smoking, and obesity.”


A migraine is a throbbing headache that begins mainly on one side of the head, often accompanied by nausea. It can last from four to 72 hours, and it can be made worse by loud noise and bright light. Sometimes people who get migraines see pulsating lights or black spots or have blurry, distorted vision shortly before the headache kicks in. That’s called migraine with aura.
While we don’t completely understand what causes migraines, we do know that they are associated with an increase in tiny or “silent” brain lesions, which can be a risk factor for dementia and cognitive decline. “This led us to question if migraine headache is a progressive brain disease,” says Dr. Pamela Rist, lead author of one study and a research fellow at the Harvard School of Public Health. But after analyzing data on more than 6,300 women, Dr. Rist and her team determined that migraines, with or without aura, do not appear to lead to cognitive decline. They published their research recently in BMJ. “It is reassuring news for people with migraines,” says Dr. Rist.


The other Harvard study, presented at the American Academy of Neurology meeting in March, focused on more than 27,000 women, of whom 1,400 had migraine with aura (MA). Researchers found that MA was a strong contributor to the risk of developing major cardiovascular events such as heart attack or stroke.

While the study does not prove that MA is causing vascular events, Dr. Kurth says MA is a warning sign. “It should be considered a factor that could indicate increased risk of cardiovascular disease.” There is currently no evidence that treating or preventing migraine reduces future risks of heart attack and stroke.


Just because you have MA, it doesn’t mean you’ll have a heart attack or stroke. If you’re concerned about your risk, you can reduce it the same way everyone can: by controlling blood pressure, quitting smoking, exercising, and maintaining a healthy weight.

If you do have migraines and cardiovascular disease, be sure to talk to your doctor about which drugs you can use to stop migraine attacks. Dr. Kurth says some drugs used to treat migraine can cause blood vessels to contract, which may restrict blood flow and cause complications for people with existing heart disease or a high risk of stroke. The drugs include triptans, such as sumatriptan (Imitrex), almotriptan (Axert), and frovatriptan (Frova), as well as ergotamines, such as dihydroergotamine (DHE-45) and ergotamine tartrate plus caffeine (Cafergot).

Last Annual Review Date: May 1, 2013 Copyright: Copyright 2013 Harvard Health Publications

Botox for Chronic Migraines

July 15, 2013

Content provided by the Faculty of the Harvard Medical School
Excerpted from a Harvard Special Health Report

Botulism is a rare but serious paralytic illness caused by a nerve toxin produced by the bacterium Clostridium botulinum. People usually contract botulism after eating food contaminated with the toxin, which binds to nerve endings, essentially paralyzing motor nerves.

Yet the toxin is better known as a wrinkle-buster, since injecting tiny amounts above the eyes and over the bridge of the nose relaxes small areas of muscles, smoothing crow’s feet and frown lines. But onabotulinumtoxinA Injection (Botulinum Toxin Type A, Botox) has more than just cosmetic applications — it’s also approved for the treatment of cross-eye, abnormal squinting and eyelid twitching, neck and shoulder muscle spasms, and severe sweating.

In the mid-1990s, a number of anecdotal reports suggested people who got Botox injections to fight wrinkles also had fewer migraine headaches, spurring a flurry of clinical trials to test that idea. But the results have been disappointing. A review of 11 clinical trials concluded that Botox was “probably ineffective” as a treatment for episodic migraine and chronic tension headache.

However, Botox may benefit people with chronic migraine, a form of chronic daily headache in which people have headaches at least 15 days per month, at least eight of which are migraine. About 2% of adults are plagued by this crippling condition, which leaves many unable to hold down a job, do housework, or have any semblance of a normal social life.

In a two-part clinical trial, nearly 1,400 people received up to five courses of Botox into specific head, neck, and shoulder muscles every 12 weeks. After 24 weeks, people treated with Botox had fewer days with a migraine than those who received placebo injections. During the second phase, all participants received Botox for an additional 32 weeks. At the end of the study, nearly 70% of patients treated with Botox had at least half as many days with migraine. The most common side effects (neck pain and muscle weakness) were mild and short-lived, according to the study, which was published in the journal Headache in 2010 — the same year Botox was approved to treat chronic migraine in the United States.

If you are a potential candidate for this therapy, be sure to find a physician with experience doing the injections. According to headache experts, doctors require extensive training to properly administer the required 31 injections in seven different locations on the head and neck.

Last Annual Review Date: Jan 1, 2011 Copyright: Copyright Harvard Health Publications

Common Migraine Triggers

So you know your migraine triggers?

Trigger identification and management is an integral part of Migraine management. Some triggers can be avoidable, allowing us to avoid some Migraines. Other triggers can’t be avoided, but knowing that we have those triggers is still helpful in our efforts to have fewer Migraines. Another consideration is that triggers can be “stackable” or “cumulative.” This means that some triggers might not bring on a Migraine if we counter just one, but “stack” two or more together, and they bring on a Migraine.

Read the entire article here…

12 Tips for Living Well with Migraines

Do you know what your Migraine triggers are? Trigger identification and management are a vital part of Migraine disease management. If certain foods are triggers for you, you can avoid them. If messed up sleep patterns or missed meals are triggers for you, you can do something about them.

  • Evaluate your medical team
  • Review your treatment regimen
  • Identify those triggers
  • Plan better nutrition
  • Don’t forget good hydration
  • Find and adopt an acceptable level of activity
  • Improve your organization
  • Learn to delegate
  • Dump the guilt
  • Take some “Me Time” each day
  • Seek and offer support
  • Remember, you can be in control

Read More…