New image-guided treatment acts as ‘reset button’ for migraine pain

An innovative and minimally invasive procedure is effective at instantly treating migraine headaches while reducing their frequency and intensity long after the initial treatment, according to a study presented at the Society of Interventional Radiology’s (SIR) Annual Scientific Meeting.

The treatment, known as image-guided, intranasal sphenopalatine ganglion (SPG) blocks, is performed by administering lidocaine to a bundle of nerves associated with migraine pain via a spaghetti-sized catheter inserted through the nose. “Intranasal [SPG] blocks are image-guided, targeted, breakthrough treatments,” said Kenneth Mandato, MD, lead author of the study and interventional radiologist with Albany Medical Center, in a statement. “They offer a patient-centered therapy that has the potential to break the migraine cycle and quickly improve patients’ quality of life.”

The researchers studied 112 patients who suffered from migraine or cluster headaches by assessing the severity of pain prior to and following treatment with SPG blocks using the standard 1-10 visual analog scale (VAS).

Before the initial treatment, an average VAS score of 8.25 was reported by the patients studied, who also estimated having at least 15 days a month with a VAS score higher than 4. Less than one day after receiving SPG blocks, patients reported their pain had been cut in half, registering VAS scores averaging 4.1. Patients also reported sustained relief over time, with an average VAS score of 5.25 after 30 days. Most patients—88 percent—reported substantially reduced or no use of headache medication in the weeks following treatment.

The treatment has a unique effect on the targeted nerve bundle, according to Mandato. “Administration of lidocaine to the sphenopalatine ganglion acts as a ‘reset button’ for the brain’s migraine circuitry,” he said. “When the initial numbing of the lidocaine wears off, the migraine trigger seems to no longer have the maximum effect that it once did.”

Though patients participating in the study reported fewer trips to the hospital and less reliance on emergency headache medications, the researchers stress that the use of SPG blocks should not be considered a cure for migraines. However, because of the minimally invasive nature of the procedure, they believe the treatment can be repeated by patients suffering from chronic headache pain.