SUNCT Syndrome: A Treatment Option with Local Opioid Blockade of the                     Superior Cervical Ganglion? A Case Report

Sabatowski, Rainer; Huber, Michael; Meuser, Thomas; Radbruch, L

doi:10.1046/j.1468-2982.2001.00180.x

Cited by 32 publications

(28 citation statements)

References 21 publications

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“…Sabatowski et al [30] reported a case of SUNCT that had responded quite well to superior cervical ganglion blockade by local opioid injection. In addition, Mays et al [36] performed stellate nerve block using local opioid injections in patients with chronic headache and reported the effectiveness of this treatment.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, Mays et al [36] performed stellate nerve block using local opioid injections in patients with chronic headache and reported the effectiveness of this treatment. Maier et al [37], suggested that blockade of the superior cervical ganglion would be effective in different types of painful conditions of the head and face [30]. In the literature, there has been no study of superior cervical ganglion blockade with a local anesthetic agent in patients with TTH.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Local Lidocaine Application on Anxiety and Depression and Its Curative Effect on Patients with Chronic Tension-Type Headache

et al. 2013

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Background: Tension-type headache (TTH) is a primary headache disorder. In this study, the efficacy of local lidocaine application on anxiety and depression and its curative effect in patients with chronic TTH was investigated. Methods: Forty-eight patients (24 local lidocaine injection, 24 local saline injection group) with chronic TTH were enrolled in our study. Injections were applied to the trigger points of the muscles that are innervated by C1-C3 and the trigeminal nerve, exit points of the fifth cranial nerve, and around the superior cervical ganglion. Each patient underwent one session every 3 days. Patients were evaluated before and 3 months after the treatment. Results: In both groups, the number of painful days in a month, visual analogue scale values, amount of analgesic use in a month, Hamilton depression score, and Hamilton anxiety score decreased after the treatment. As a result, all of the parameters were found to have improved in both groups (p < 0.05), the results were statistically significant, and the lidocaine group's response to the treatment was better than the placebo group (p < 0.001). Conclusion: Our findings suggest that local lidocaine administration can be an effective method in the treatment of chronic TTH.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of Local Lidocaine Application on Anxiety and Depression and Its Curative Effect on Patients with Chronic Tension-Type Headache

et al. 2013

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“…Im Hinblick auf die niedrige Fallzahl scheint die Wirkung einer GLOA am GCS jedoch auch durch diese Untersuchung nicht grundsätzlich bewiesen. Andere Autoren wie Fine u. Ashburn [7], Wassef [17] sowie Sabatowski et al [14] berichten über eine erfolgreiche initiale GLOA-Behandlung bei einzelnen Patienten, bei denen andere Therapiemaßnahmen nicht geholfen hatten. Für die Injektionen wurden Fentanyl (0,05-0,1 mg) und Buprenorphin in einer Dosis von 0,03 mg verwendet.…”

Section: Initiale Wirkungunclassified

Opioidwirksamkeit am Ganglion cervicale superius

Elsner

Radbruch²,

Gaertner³

et al. 2006

Schmerz

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The efficacy of ganglionic local opioid analgesia (GLOA) at the superior cervical ganglion (SCG) was retrospectively investigated in 74 consecutive patients with neuropathic pain in the head and face region. It was possible to retrospectively analyze the short-term and medium-term treatment results in 64 of 74 patients. The long-term effect was subsequently determined using a standardized questionnaire. The short-term analgesic effect of the first blockade by GLOA was significant with a mean pain reduction of 52% (p < 0.001). Within a span of 20 min the mean pain intensity decreased from 65 to 28 on a visual analogue scale. A clinically relevant pain reduction (> or = 30%) was observed in 73% of the patients. The proportion of responders (pain reduction > or = 50%) was 59% after the first blockade. Patients with zoster or trigeminal neuralgia experienced greater pain relief than patients with atypical facial pain or longer lasting postzoster neuralgia. During the course of the blockade series with an average duration of 33 days, a significant medium-term pain reduction of 30% was noted. In the first 3 treatment days, the level of continuous pain declined from 6.3 to 4.3 on a numerical rating scale. Short-term responders reported a better medium-term pain reduction than nonresponders. After 3 years (range: 5 months to 6 years), 21% of 52 patients remained free of pain. The other patients reported often only minimal residual pain or a decrease of pain severity and duration. According to these results, GLOA at the SCG can represent a suitable and simple treatment option for neuropathic facial pain.

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“…There have been re p o rts of impro v ement upon the use of amitriptyline, carbamazepine, gabapentin, prednisone, topiramate 5 , lamotrigine 6 , nifedipine and sumatriptan 4 . Anesthetic blockades do not work very well, although there have been re p o rts of improvement following the local opioid blockade of the superior cervical ganglion 7 . There have also been re p o rts of surgical pro c e d u res that worked eff e c t i v e l y 5 while others re p o rts have indicated a lack of response to such procedures 8 .…”

mentioning

confidence: 99%

SUNCT syndrome associated with pituitary tumor: case report

Filho

Galvão

Teixeira

et al. 2006

Arq. Neuro-Psiquiatr.

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-For twelve years, the subject of this report, a 38-year-old man, presented a clinical condition compatible with the SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing) syndrome. He presented a stabbing and intense daily pain located in the left pre-auricular and temporal regions. Each of these intense pain attacks lasted around one minute and presented a f requency of two to eight times per day. The pain was associated with ipsilateral lacrimation, conjunctival injection and rhinorrhea. MRI revealed a pituitary tumor with little suprasellar extent. The subject's serial assays of prolactin, GH, TSH and ACTH were within normal levels. Following transsphenoidal hypophysect o m y, with complete removal of the tumor, the subject no more presented pain. The pathological diagnosis was non-secreting adenoma. Fourteen months after the surgery, he remains symptom-free.KEY WORDS: SUNCT, pituitary tumor, surgery, ultra-shorting headaches.Síndrome SUNCT associada a tumor de hipófise: relato de caso RESUMO -O paciente relatado neste artigo apresentou uma condição clínica compatível com síndro m e SUNCT (cefaléia de curta duração, unilateral, neuralgiforme com hiperemia conjuntival e lacrimejamento). Ele referia dor diária, intensa, em facada, localizada na região pré-auricular e temporal esquerd a s . Cada ataque de dor permanecia por cerca de um minuto, com freqüência de duas a oito vezes por dia. A dor se acompanhava de lacrimejamento ipsolateral, congestão conjuntival e rinorréia. A RM mostrou um tumor de hipófise com pouca extensão suprasselar. Dosagens de prolactina, GH, TSH e ACTH estavam em níveis normais. Foi então submetido a hipofisectomia transesfenoidal com remoção completa do tumor após o que a dor cessou completamente. O diagnóstico anátomo-patológico foi adenoma não secre t o r. Quatorze meses após a cirurgia, o paciente permanecia livre de dor. PALAVRAS-CHAVE: SUNCT, tumor de hipófise, cirurgia, cefaléia de curta duração. s y n d rome is the poor response to pharm a c o l o g i c a l t re a t m e n t s 3 , 4 . There have been re p o rts of impro v ement upon the use of amitriptyline, carbamazepine, gabapentin, prednisone, topiramate 5 , lamotrigine 6 , nifedipine and sumatriptan 4 . Anesthetic blockades do not work very well, although there have been re p o rts of improvement following the local opioid blockade of the superior cervical ganglion 7 . There have also been re p o rts of surgical pro c e d u res that worked eff e c t i v e l y 5 while others re p o rts have indicated a lack of response to such procedures 8 .This syndrome has been listed in the second edition of The International Classification of Headache D i s o rders together with trigeminal autonomic cephaThe SUNCT syndrome (short-lasting unilateral neur a l g i f o rm headache attacks with conjunctival injection and tearing) is an uncommon headache characterized by moderate to severe pain. Usualy, the locations with the most severe pain are the ocular/periocular regions and the fronta...

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SUNCT Syndrome: A Treatment Option with Local Opioid Blockade of the Superior Cervical Ganglion? A Case Report

Cited by 32 publications

References 21 publications

Efficacy of Local Lidocaine Application on Anxiety and Depression and Its Curative Effect on Patients with Chronic Tension-Type Headache

Efficacy of Local Lidocaine Application on Anxiety and Depression and Its Curative Effect on Patients with Chronic Tension-Type Headache

Opioidwirksamkeit am Ganglion cervicale superius

SUNCT syndrome associated with pituitary tumor: case report

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