Indirect Cost of Migraine

Abstract

Glycerol gangliotomyGlycerol, radiofrequency thermocoagulation, and gamma knife have been used for gasserian ganglio rhizolysis in patients with trigeminal neuralgia and chronic intractable cluster headache with variable success. Radiofrequency lesions of cervical (C2) g-angw were reported to be helpful in patients with "cervicogenic" hkadache, instead of more invasive surgical procedures.In the November 1998 issue of CephalaZgk, Ludwig/and associates reported the morphological changes and the time course of those changes after injection of glycerol in the cervical ganglion in rats. They conch&xl that the immediate "nerve block" effect may be due to the effect of glycerol on neuronal membrane and the permanent effects are due to degenerative changes in the glial as well as neuronal and myelin morphology. They did not confirm the old notion that glycerol selectively affects pamcarryingfibers. * Clinical application of glycerol gangliolysis in cervicogenic headache remains to be explored. Overall, in trigeminal neuralgia and cluster headache, analgesia obtained by glycerol is not as effective as radio fr=F==yorgam= knife lesions. 7 in determining the dose