What is the Procedure?

The sphenopalatine ganglion (SPG) block is a medical procedure used to manage various types of pain and autonomic nervous system dysfunctions, including headaches, migraines, cluster headaches, new daily persistent headache, orofacial pain, and craniofacial hyperhidrosis (excessive facial sweating). This procedure involves administering an anesthetic and steroid to the sphenopalatine ganglion, a collection of nerve cells located in the pterygopalatine fossa, which is situated behind the nose and above the roof of the mouth. We use the ultrasound machine to pinpoint the target location for ease and safety

Read more about the science here.

What Conditions Are Treated

• Migraine

• Cluster Headache

• Tension Headache

• New Daily Persistent Headache

• Orofacial pain

• Excessive Facial Sweating

How Does It Work?

The SPG block works by targeting the autonomic nervous system, specifically the parasympathetic nerve fibers that influence pain and other autonomic functions. Here's a simplified explanation of the biology involved:

1. Nerve Anatomy: The SPG is part of a larger network that includes the trigeminal nerve, which is responsible for facial sensations and certain autonomic functions.

Blocking the SPG can reset & reduce the parasympathetic outflow, which is often associated with conditions like headaches and hyperhidrosis.

2. Mechanism: The anesthetic blocks the transmission of nerve signals, which can reduce pain and other symptoms.

For headaches, the block can lead to vasoconstriction (narrowing of blood vessels) and reduced blood flow, which helps alleviate pain caused by vasodilation (widening of blood vessels).

Procedure Overview

 Before Treatment:  Fill out an intake form and have a consultation with Dr. Ko  Next, review and sign the consent form. Continue taking your medications as usual. Plan for someone to drive you home post-treatment.

-  During Treatment:  Relax in a comfortable chair while we administer a local anesthetic to the targeted areas. The procedure uses Butterfly IQ3+ ultrasound guidance with color doppler flow to ensure accuracy and is completed within 30-45 minutes.

-  After Treatment:  You will be monitored in the clinic for a short time period. Please expect to experience minor, temporary side effects like numbness of the mouth, jaw, and face, & difficulty chewing. These effects indicate the procedure's success and resolve within 4-8 hours. Other effects like mild soreness & swelling at the injection site may occur but are easily manageable.

Benefits and Safety

Pain Relief: May be effective in treating various types of headaches, including migraines and cluster headaches.

Reduced Sweating: May significantly decrease facial sweating in patients with craniofacial hyperhidrosis.

Minimal Invasiveness: The procedure is relatively quick, safe, and can be done in our office.

Risks and Side Effects

Discomfort: Some discomfort at the site of injection or application is common.

Minor Bleeding/Swelling: Slight bleeding and/or swelling at the injection site may occur.

Infection: As with any procedure involving needles, there is a small risk of infection.

Transient Symptoms: Temporary side effects such as facial numbness, nasal congestion, altered taste, & difficulty chewing for up to 4-8 hours.

How much does SPG Block Cost?

Here is the link for the SPG Block pricing sheet.