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A prospective case series of sphenopalatine ganglion pulsed radiofrequency therapy for refractory chronic cluster headache
Author(s) -
Lazzari Z. T.,
Palmisani S.,
Hill B.,
AlKaisy A.,
Lambru G.
Publication year - 2020
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14176
Subject(s) - medicine , refractory (planetary science) , cluster headache , pulsed radiofrequency , ganglion , percutaneous , surgery , anesthesia , pain relief , physics , migraine , astrobiology , anatomy
Background and purpose The management options for chronic cluster headache (CCH) are limited and a significant proportion of patients become refractory to pharmacological treatments. Pulsed radiofrequency (PRF) of the sphenopalatine ganglion (SPG) may present an efficacious, minimally invasive treatment modality for patients with refractory CCH. We describe the clinical outcomes of 14 patients with refractory CCH treated with PRF of the SPG. Methods Patients with medically refractory CCH who underwent percutaneous SPG‐PRF treatment between January 2016 and April 2019 were included in this report. Patients obtaining at least 30% reduction in weekly cluster attacks for at least 3 months were defined as responders. Treatment‐related side effects were collected. Results A total of 14 patients were included in this report (nine males). At a median follow‐up of 6.5 (range 6–13) months post‐procedure, eight patients (57.1%) were defined as responders to the treatment. Six patients were non‐responders and reported either a reduction in frequency and severity of attacks for <3 months (2/6), no improvement (2/6) or temporary worsening of symptoms (1/6). The majority of patients (63.6%, n = 7/11) treated with >45 V were responders compared with responders treated with 45 V (33.3%, n = 1/3). Five patients (35.7%) experienced post‐procedural side effects. Conclusion This case series suggests that PRF targeting the SPG might offer a safe, minimally invasive and effective treatment for medically refractory CCH. Given the small number of cases and the short follow‐up, larger and more robust studies will be needed to confirm our findings.