Sphenopalatine Ganglion Block Successfully Treats Migraines in a Type 1 Arnold Chiari Malformation Pregnant Patient: A Case Report

Abstract

A 32-year-old woman at 36 weeks gestation with a medical history of corrected Type 1 Arnold Chiari malformation presented with an intractable headache. When methylprednisolone and morphine treatment provided no relief, we performed 2 topical transnasal sphenopalatine ganglion blocks by applying 4% lidocaine drops into each nostril via a cotton-tipped applicator. The patient's symptoms significantly improved, and she was discharged home the same day. She has been without relapse of headaches during the 6 months of follow-up by our pain service.

Topical Sphenopalatine Ganglion Block Compared With Epidural Blood Patch for Postdural Puncture Headache Management in Postpartum Patients

“…33 What remains unexplained is the ability of a short-acting agent, such as lidocaine to permanently turn off the PDPH symptoms even after the pharmacological effect of the medication wears off, but interestingly, this block appears to have a similar permanent effect in the treatment of migraines. 34,35 Unlike the EBP, the SPGB is not associated with severe morbidity. Adverse effects that have been reported so far were transient and not serious, such as bitter taste, nostril burning, and oropharyngeal numbness, which all resolve within 20 minutes.…”

Sphenopalatine Ganglion Block Relieves Chronic Abdominal Wall Pain!

“…However, all of these treatments provided only minimal relief. Considering that the sphenopalatine ganglion block had previously been shown to relieve pain of various etiologies, we offered this treatment option to this patient [3][4][5][6][7].…”