Cluster headache: crosspoint between otologists and neurologists—treatment of the sphenopalatine ganglion and systematic review

Rosso, Cecilia; Felisati, Giovanni; Bulfamante, Antonio Mario; Pipolo, Carlotta

doi:10.1007/s10072-019-03796-5

Cited by 11 publications

(7 citation statements)

References 43 publications

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“…SPG may absorb local anesthetic via the middle turbinate and lateral nasal mucosa from a cotton-tipped applicator, the so-called "intranasal approach" (33). SPGB has been reported in the management of cluster headache (37), migraine (38), trigeminal neuralgia (39), herpes zoster involving the ophthalmic nerve (40), paroxysmal hemicrania (41), and neck cancer pain (42), atypical facial pain (43), complex regional pain syndrome (CRPS) (44), temporomandibular disorder (45), nasal contact point headache (46), and vasomotor rhinitis (47).…”

Section: Discussionmentioning

confidence: 99%

Peripheral Nerve Blocks for Postdural Puncture Headache: A New Solution for an Old Problem?

Giaccari

Aurilio

Coppolino

et al. 2021

In Vivo

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Background/Aim: Postdural puncture headache (PDPH) is one of the earliest recognized complications of regional anesthesia after inadvertent dural puncture. Epidural blood patch (EBP) is the "gold standard" for the treatment of PDPH. Several alternatives have been suggested as peripheral nerve blocks. The aim of this systematic review was to find out the potential efficacy and safety of peripheral nerve blocks for the treatment of PDPH. Materials and Methods: The main databases were systematically searched in September 2020 for studies examining regional anesthesia and PDPH. Results: Nineteen studies were identified, including a total of 221 patients. Sphenopalatine ganglion block, greater occipital nerve block, and lesser occipital nerve block were performed. All participants reported a numeric rating scale (NRS) <4 after peripheral nerve blocks at 1, 24 and 48 h. Only patients with PDPH after diagnostic lumbar puncture reported NRS ≥4 after 48 h. No major adverse events were reported. Approximately, 17% of patients underwent a second or more peripheral nerve blocks. In 30 participants, EBP was required. Conclusion: To our knowledge, this is the first systematic review on the use of peripheral nerve blocks to treat PDPH. Peripheral nerve blocks can be considered as analgesic options in the management of PDPH.

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Section: Discussionmentioning

confidence: 99%

Peripheral Nerve Blocks for Postdural Puncture Headache: A New Solution for an Old Problem?

Giaccari

Aurilio

Coppolino

et al. 2021

In Vivo

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show abstract

“…The SPG may absorb local anesthetic via the middle turbinate and lateral nasal mucosa from a cotton-tipped applicator, the so-called "intranasal approach". 30 SPGB has been reported to threat cluster headache, 33 migraine, 34 trigeminal neuralgia, 35 herpes zoster involving the ophthalmic nerve, 36 paroxysmal hemicrania, 37 head and neck cancer pain, 38 atypical facial pain, 39 complex regional pain syndrome (CRPS), 40 temporomandibular disorder, 41 nasal contact point headache, 42 and vasomotor rhinitis. 43 The greater occipital nerve (GON) is the sensory branch of the posterior ramus of the C2 spinal nerve.…”

Section: Discussionmentioning

confidence: 99%

Regional Anesthesia For Postdural Puncture Headache (PDPH): A New Solution For An Old Problem? A Systemic Review.

Giaccari¹,

Coppolino²,

Aurilio³

et al. 2020

Preprint

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Background: Postdural puncture headache (PDPH) is one of the earliest recognized complications of regional anesthesia. It is a common complication after inadvertent dural puncture. When conservative management is ineffective, the Epidural Blood Patch (EBP) is the “gold standard” for the treatment of PDPH. Due to the potential complications of EBP, several alternatives have been promoted as peripheral nerve blocks.A systematic review of the use of regional anesthesia for PDPH is needed to identify an alternative method of pain management.Objectives: To systematically review literature to establish the efficacy and applicability of regional anesthesia used in the treatment of PDPH in the hospital setting.Methods: Embase, MEDLINE, Google Scholar and Cochrane Central Trials Register were systematically searched in May 2020 for studies examining regional anesthesia for PDPH. The methodological quality of the studies and their results were appraised using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist and specific measurement properties criteria, respectively.Results: Nineteen studies evaluating peripheral nerve blocks for PDPH were included for a total of 221 patients. Sphenopalatine ganglion block (SPGB), greater occipital nerve block (GONB) and lesser occipital nerve block (LONB) were performed. All participants reported NRS lower than 4 after peripheral nerve blocks at 1, 24 and 48 hours. Only patients who experienced PDPH after diagnostic lumbar puncture reported NRS ≥ 4 after 48 hours. No adverse event was reported after the execution of nerve blocks, except an occasionally discomfort related to the insertion of cotton-tip applicators intranasally for SPGB. 17% of patients underwent a second or more peripheral nerve block due to uncontrolled pain. In 30 participants, EBP was required; none of cases followed spinal anesthesia.Conclusion: Peripheral nerve blocks can be considered as analgesic options in the management of PDPH, as not all cases require EBP for successful treatment. Treatment of PDPH with peripheral nerve blocks seems to be a minimal invasive, easy and effective method, which can offer to patients when conservative management is ineffective.

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“…The involvement of an SPG approach is really interesting and we have also been involved in several of the past SPGneuromodulation trials. 1,4 We agree that an external block has many advantages as it is quick, cheap, and the side effects are minimal, but we find it very important that patients can self-administer the acute therapy. It would be very interesting to see if it has a consistent effect in CH; however, comparing a manual block and a nasal spray may additionally cause blinding difficulties, a well-known issue in CH.…”

Section: Intranasal Treatment Of Cluster Headache: a Responsementioning

confidence: 99%

Intranasal treatment of cluster headache: A response

et al. 2022

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Cluster headache: crosspoint between otologists and neurologists—treatment of the sphenopalatine ganglion and systematic review

Cited by 11 publications

References 43 publications

Peripheral Nerve Blocks for Postdural Puncture Headache: A New Solution for an Old Problem?

Peripheral Nerve Blocks for Postdural Puncture Headache: A New Solution for an Old Problem?

Regional Anesthesia For Postdural Puncture Headache (PDPH): A New Solution For An Old Problem? A Systemic Review.

Intranasal treatment of cluster headache: A response

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