Skip to main content
Top
Published in: Pain and Therapy 3/2022

Open Access 06-07-2022 | Computed Tomography | Original Research

Long-Term Follow-Up Safety and Effectiveness of CT-Guided Radiofrequency Thermocoagulation of Sphenopalatine Ganglion in Refractory Headache Treatment

Authors: Bingyue Xin, Keyue Xie, Ge Luo, Ming Yao

Published in: Pain and Therapy | Issue 3/2022

Login to get access

Abstract

Objective

The purpose of this study was to evaluate the effectiveness and safety of computed tomography (CT)-guided radiofrequency thermocoagulation (RFTA) of the sphenopalatine ganglion (SPG) for patients with refractory headache.

Methods

A total of 14 patients with refractory migraine and 10 patients with cluster headache (CH) who underwent CT-guided SPG RF between May 2019 and August 2021 at the Jiaxing First Hospital, located in Jiaxing City, Zhejiang Province, China, were included and analyzed in this retrospective cohort study. Pain score, sleep quality scores, and treatment effects were observed before operation as well as 1 day and 1, 3, 6, 12, and 24 months after surgery. Also, the incidence of facial numbness at different timepoints after operation was evaluated.

Results

The frequency and duration of attacks decreased after treatment in patients with migraine, and the shortening of the cluster period and the prolongation of the remission period after treatment in patients with CH indicated that the treatment was effective. The numeric rating scale (NRS) ranged from 0 to 10, where 0 meant no pain and 10 meant the worst imaginable pain. The NRS of patients at 1 day and 1, 3, 6, 12, and 24 months after surgery was significantly lower than before operation (P < 0.05). The treatment of patients with migraine and CH was effective. The overall incidence of numbness in patients with migraine and the total incidence of numbness in patients with CH was recorded. The total incidence of numbness decreased gradually, but no significant difference was detected in the incidence of numbness between the two groups (P > 0.05). No serious adverse reactions, such as orthostatic hypertension, intracranial infection, and visual disturbance, occurred in the patients after operation.

Conclusion

CT-guided RFTA of the SPG significantly relieves headache symptoms in patients with refractory migraine and CH. It has the advantages of rapid onset, long duration, and a safe and reliable treatment process, making it worthy of clinical application.
Literature
1.
go back to reference Robbins MS. Diagnosis and management of headache: a review. JAMA. 2021;325(18):1874–85.CrossRef Robbins MS. Diagnosis and management of headache: a review. JAMA. 2021;325(18):1874–85.CrossRef
2.
go back to reference Goadsby PJ, Lipton RB and Ferrari MD. Migraine--current understanding and treatment. N Engl J Med. 2002; 346: 257–70. Goadsby PJ, Lipton RB and Ferrari MD. Migraine--current understanding and treatment. N Engl J Med. 2002; 346: 257–70.
3.
go back to reference Lipton RB, Silberstein SD. Episodic and chronic migraine headache: breaking down barriers to optimal treatment and prevention. Headache. 2015;55(Suppl 2):103–26.CrossRef Lipton RB, Silberstein SD. Episodic and chronic migraine headache: breaking down barriers to optimal treatment and prevention. Headache. 2015;55(Suppl 2):103–26.CrossRef
4.
go back to reference Robbins MS, Starling AJ, Pringsheim TM, et al. Treatment of cluster headache: the American Headache Society evidence-based guidelines. Headache. 2016;56:1093–106.CrossRef Robbins MS, Starling AJ, Pringsheim TM, et al. Treatment of cluster headache: the American Headache Society evidence-based guidelines. Headache. 2016;56:1093–106.CrossRef
5.
go back to reference Hoffmann J, May A. Diagnosis, pathophysiology, and management of cluster headache. Lancet Neurol. 2018;17:75–83.CrossRef Hoffmann J, May A. Diagnosis, pathophysiology, and management of cluster headache. Lancet Neurol. 2018;17:75–83.CrossRef
6.
go back to reference Rozen TD, Fishman RS. Cluster headache in the United States of America: demographics, clinical characteristics, triggers, suicidality, and personal burden. Headache. 2012;52:99–113.CrossRef Rozen TD, Fishman RS. Cluster headache in the United States of America: demographics, clinical characteristics, triggers, suicidality, and personal burden. Headache. 2012;52:99–113.CrossRef
7.
go back to reference Nilsson Remahl AI, Laudon Meyer E, Cordonnier C, et al. Placebo response in cluster headache trials: a review. Cephalalgia. 2003;23:504–10.CrossRef Nilsson Remahl AI, Laudon Meyer E, Cordonnier C, et al. Placebo response in cluster headache trials: a review. Cephalalgia. 2003;23:504–10.CrossRef
8.
go back to reference Schulman EA, Lake AE 3rd, Goadsby PJ, et al. Defining refractory migraine and refractory chronic migraine: proposed criteria from the refractory headache special interest section of the American Headache Society. Headache. 2008;48(6):778–82.CrossRef Schulman EA, Lake AE 3rd, Goadsby PJ, et al. Defining refractory migraine and refractory chronic migraine: proposed criteria from the refractory headache special interest section of the American Headache Society. Headache. 2008;48(6):778–82.CrossRef
9.
go back to reference Silberstein SD, Dodick DW, Pearlman S. Defining the pharmacologically intractable headache for clinical trials and clinical practice. Headache. 2010;50(9):1499–506.CrossRef Silberstein SD, Dodick DW, Pearlman S. Defining the pharmacologically intractable headache for clinical trials and clinical practice. Headache. 2010;50(9):1499–506.CrossRef
10.
go back to reference D’Antona L, Matharu M. Identifying and managing refractory migraine: barriers and opportunities? J Headache Pain. 2019;20(1):89.CrossRef D’Antona L, Matharu M. Identifying and managing refractory migraine: barriers and opportunities? J Headache Pain. 2019;20(1):89.CrossRef
11.
go back to reference Robbins MS, Robertson CE, Kaplan E, et al. The sphenopalatine ganglion: anatomy, pathophysiology, and therapeutic targeting in headache. Headache. 2016;56:240–58.CrossRef Robbins MS, Robertson CE, Kaplan E, et al. The sphenopalatine ganglion: anatomy, pathophysiology, and therapeutic targeting in headache. Headache. 2016;56:240–58.CrossRef
12.
go back to reference Narouze S, Kapural L, Casanova J, et al. Sphenopalatine ganglion radiofrequency ablation for the management of chronic cluster headache. Headache. 2009;49:571–7.CrossRef Narouze S, Kapural L, Casanova J, et al. Sphenopalatine ganglion radiofrequency ablation for the management of chronic cluster headache. Headache. 2009;49:571–7.CrossRef
13.
go back to reference Yarnitsky D, Goor-Aryeh I, Bajwa ZH, et al. 2003 Wolff Award: possible parasympathetic contributions to peripheral and central sensitization during migraine. Headache. 2003;43:704–14.CrossRef Yarnitsky D, Goor-Aryeh I, Bajwa ZH, et al. 2003 Wolff Award: possible parasympathetic contributions to peripheral and central sensitization during migraine. Headache. 2003;43:704–14.CrossRef
14.
go back to reference Zhu J, Luo G, He Q, et al. Evaluation of the efficacy of unipolar and bipolar spinal dorsal root ganglion radiofrequency thermocoagulation in the treatment of postherpetic neuralgia. Korean J Pain. 2022;35:114–23.CrossRef Zhu J, Luo G, He Q, et al. Evaluation of the efficacy of unipolar and bipolar spinal dorsal root ganglion radiofrequency thermocoagulation in the treatment of postherpetic neuralgia. Korean J Pain. 2022;35:114–23.CrossRef
15.
go back to reference Dones I, Messina G, Nazzi V, et al. A modified visual analogue scale for the assessment of chronic pain. Neurol Sci. 2011;32(4):731–3.CrossRef Dones I, Messina G, Nazzi V, et al. A modified visual analogue scale for the assessment of chronic pain. Neurol Sci. 2011;32(4):731–3.CrossRef
16.
go back to reference Penarrocha-Diago M, Boronat A, Penarrocha-Oltra D, et al. Clinical course of patients with episodic cluster headache treated with corticosteroids inproximity to the sphenopalatine ganglion: a preliminary study of 23 patients. Med Oral Patol Oral Cir Bucal. 2012;17:e477–82.CrossRef Penarrocha-Diago M, Boronat A, Penarrocha-Oltra D, et al. Clinical course of patients with episodic cluster headache treated with corticosteroids inproximity to the sphenopalatine ganglion: a preliminary study of 23 patients. Med Oral Patol Oral Cir Bucal. 2012;17:e477–82.CrossRef
17.
go back to reference Ansarinia M, Rezai A, Tepper SJ, et al. Electrical stimulation of sphenopalatine ganglion for acute treatment of cluster headaches. Headache. 2010;50:1164–74.CrossRef Ansarinia M, Rezai A, Tepper SJ, et al. Electrical stimulation of sphenopalatine ganglion for acute treatment of cluster headaches. Headache. 2010;50:1164–74.CrossRef
18.
go back to reference Devoghel JC. Cluster headache and sphenopalatine block. Acta Anaesthesiol Belg. 1981;32:101–7.PubMed Devoghel JC. Cluster headache and sphenopalatine block. Acta Anaesthesiol Belg. 1981;32:101–7.PubMed
19.
go back to reference Chua NH, Vissers KC, Wilder-Smith OH. Quantitative sensory testing may predict response to sphenopalatine ganglion pulsed radiofrequency treatment in cluster headaches: a case series. Pain Pract. 2011;11:439–45.CrossRef Chua NH, Vissers KC, Wilder-Smith OH. Quantitative sensory testing may predict response to sphenopalatine ganglion pulsed radiofrequency treatment in cluster headaches: a case series. Pain Pract. 2011;11:439–45.CrossRef
20.
go back to reference Garcia-Isidoro S, Castellanos-Sanchez VO, Iglesias-Lopez E, et al. Invasive and non-invasive electrical neuromodulation in trigeminal nerve neuralgia: a systematic review and meta-analysis. Curr Neuropharmacol. 2021;19(3):320–33.CrossRef Garcia-Isidoro S, Castellanos-Sanchez VO, Iglesias-Lopez E, et al. Invasive and non-invasive electrical neuromodulation in trigeminal nerve neuralgia: a systematic review and meta-analysis. Curr Neuropharmacol. 2021;19(3):320–33.CrossRef
21.
go back to reference Maniam R, Kaye AD, Vadivelu N, et al. Facial pain update: advances in neurostimulation for the treatment of facial pain. Curr Pain Headache Rep. 2016;20:24.CrossRef Maniam R, Kaye AD, Vadivelu N, et al. Facial pain update: advances in neurostimulation for the treatment of facial pain. Curr Pain Headache Rep. 2016;20:24.CrossRef
22.
go back to reference Schmidt RF, Theofanis TN, Lang MJ, et al. Sphenopalatine ganglion stimulation is a reversible and frequency-dependent modulator of the blood–brain barrier. Brain Res. 2019;1718:231–41.CrossRef Schmidt RF, Theofanis TN, Lang MJ, et al. Sphenopalatine ganglion stimulation is a reversible and frequency-dependent modulator of the blood–brain barrier. Brain Res. 2019;1718:231–41.CrossRef
23.
go back to reference Baker TS, Robeny J, Cruz D, et al. Stimulating the facial nerve to treat ischemic stroke: a systematic review. Front Neurol. 2021;12:1–15.CrossRef Baker TS, Robeny J, Cruz D, et al. Stimulating the facial nerve to treat ischemic stroke: a systematic review. Front Neurol. 2021;12:1–15.CrossRef
Metadata
Title
Long-Term Follow-Up Safety and Effectiveness of CT-Guided Radiofrequency Thermocoagulation of Sphenopalatine Ganglion in Refractory Headache Treatment
Authors
Bingyue Xin
Keyue Xie
Ge Luo
Ming Yao
Publication date
06-07-2022
Publisher
Springer Healthcare
Published in
Pain and Therapy / Issue 3/2022
Print ISSN: 2193-8237
Electronic ISSN: 2193-651X
DOI
https://doi.org/10.1007/s40122-022-00401-0

Other articles of this Issue 3/2022

Pain and Therapy 3/2022 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine