Transnasal blockage of the Sphenopalatine Ganglion is probably the safest approach to treatment of both acute and chronic migraines, cluster headaches and many othe r disorders.
There is virtually no contraindications other than allergy to lidocaine or other anesthetic. This article discusses a single application but self administered Sphenopalatine Ganglion Blocks puts patients in control of their pain control. Slef-Administration is an extremely safe and cost effective approach to headache and migraine management.
From Neurology Advisor:
“Transnasal sphenopalatine ganglion block
A modality that is gaining interest is the use of transnasal sphenopalatine ganglion (SPG) block for migraine, cluster headache, and trigeminal neuralgia because it is not invasive.2 Neurologist Mohamed Binfalah, MD, ABPN, from the University Medical Center, King Abdullah Medical City, in Adliya, Bahrain, and colleagues tested the technique in 55 patients (mean age, 37.9 years; 72.7% women) with the use of a sphenopalatine catheter filled with 2 mL of 2% lidocaine administered via each nostril.2
A total of 70.9%, 78.2%, and 70.4% of patients reported being free of headache 15 minutes, 2 hours, and 24 hours, respectively, after the procedure.2 The great majority of patients (98.1%) reported feeling “very good” or “good” 2 and 24 hours after the intervention, as assessed with the Patient Global Impression of Change scale. Adverse events were mild and lasted less than 24 hours, but patients reported throat numbness, nausea (10.9%), dizziness (10.9%), vomiting (1.8%), and nasal discomfort (18.2%).2
“I don’t believe we have clear guidelines on the proper timing for using interventions in headache management,” remarked Dr Binfalah. “Some experts recommend using these interventions for refractory cases, but I think that it is reasonable to use interventions such as SPG blocks early in specific circumstances such as acute migraines not responding to analgesics, status migrainosus, migraine in pregnancy, acute cluster headaches, and in patients with low compliance or specific contraindications for oral or injectable analgesics and prevention medications.””