Sphenopalatine Ganglion (SPG) block

Sphenopalatine Ganglion (SPG) blocks are a safe, effective, and well-tolerated treatment for difficult-to-treat headaches, particularly those located in the forehead, frontal, or sinus regions of the head. They are often used when standard medications have not provided sufficient relief or when a severe headache episode will not resolve. This can occur in patients with migraine and is known as status migrainosus.

SPG blocks target a different branch of the trigeminal nerve than traditional nerve blocks and are performed without the use of a needle, focusing on the sphenopalatine ganglion.

During the procedure, a cotton-tip applicator coated with viscous lidocaine is gently inserted into one or both nostrils. The sensation may feel similar to a flu or COVID test, but any discomfort typically fades quickly as the numbing effect of the lidocaine begins. The applicator is positioned adjacent to the location of the sphenopalatine ganglion, allowing the medication to anesthetize it.

This produces an effect similar to a nerve block but targets a different portion of the trigeminal nerve and does so without the use of injections.