Migraines

An estimated 12 percent of the U.S. population suffers from migraines – recurring attacks of throbbing or pulsing moderate to severe pain. A subset of these patients, along with those who suffer from other types of headaches, do not respond to treatment. During a migraine, people are often very sensitive to light, sound and may become nauseated or vomit. Migraines are three times more common in women than in men. Currently there is very little to offer the chronic migraine headache patient. Nearly two thirds of patients discontinue prescription medications due to inadequate relief and side-effects. However, two novel therapies have shown to be effective: ketamine therapy and SPG block.

Ketamine Therapy

A recent study that almost 75 percent of patients experienced an improvement in their migraine intensity after a three- to seven-day course of inpatient treatment with ketamine. The study concluded that ketamine holds promise as a treatment for migraine headaches in patients who have failed other treatments. While the study focused on short-term relief, it can help patients long-term.

SPG block

The sphenopalatine ganglion (SPG) blocks have time-tested efficacy when it comes to serious chronic and episodic migraines pain. The block is performed by navigating a cotton tip applicator through the nasal passages, which is placed there for 15-20 minutes. Sphenopalatine ganglion (SPG) is located just deep to the nasal mucosa posterior to the middle nasal turbinate. The SPG can be blocked by diffusion of local anesthetic through the overlying mucosa. Sensory, sympathetic and parasympathetic fibers pass through or synapse in the SPG, making it a key structure in various types of cephalgia. Temporarily blocking function of the SPG can provide prompt, and sometimes sustained, relief of pain.

SPG block is quick and safe to perform, it is well tolerated by patients with minimal risk of complications, and it does not require the use of needles. The course of treatment for migraines consisting of SPG blocks is twice a week for 6 weeks (total of 12 treatments). SPG blocks are used for both short- and long-term treatment of headaches and migraines, and most patients feel relief after the first few treatments.

The combination of ketamine and SPG block therapies provides the best chance of achieving quick and long-lasting relief from migraine pain.