Nervous System Diseases

Symptoms and General Pathology

All Conditions

Mouth and Tooth Diseases

Neoplasms

Skin and Connective Tissue Diseases

Rare Diseases

Neuralgia

Headache

Trigeminal Neuralgia

Ganglion Cysts

Synovial Cyst

Headache Disorders

Cysts

Pain

Neurologic Manifestations

Peripheral Nervous System Diseases

Neuromuscular Diseases

Mucinoses

Connective Tissue Diseases

Trigeminal Nerve Diseases

Facies

Facial Neuralgia

Facial Nerve Diseases

Mouth Diseases

Stomatognathic Diseases

Cranial Nerve Diseases

Brain Diseases

Central Nervous System Diseases

All Drugs and Chemicals

Vasodilator Agents

Botulinum Toxins

Botulinum Toxins, Type A

abobotulinumtoxinA

Acetylcholine

Cholinergic Agents

Neurotransmitter Agents

The patients will be injected with 25 IU of Botulinum Toxin Type A towards the sphenopalatine ganglion in the affected side (ipsilateral to the pain)

Botulinum Toxin Type A

Erling A Tronvik, PhD, MD

Trigeminal neuralgia is one of the strongest pains known to humans. Some patients do not have enough effect with the available pharmaceutical treatments and are offered surgery. There are different types of procedures and most of them are complex with a risk for complications. The researchers want to start a pilot study on 10 patients with a new surgical technique using neuronavigation. The target will be a neural structure (sphenopalatine ganglion) which has an important role in facial pain. There have been a few trials trying to block this structure in trigeminal neuralgia, but none using this new approach with botulinum toxin. The researchers technique requires local anesthesia only (awake patient). The researchers believe that this treatment can become a "low threshold"-treatment for patients who do not have enough effect with pharmacological treatment and a better alternative to other complex surgical approaches. Using this new neuronavigation system the researchers can reach this neural structure with high precision.

Botulinum Toxin Type A Block of the Sphenopalatine Ganglion in Trigeminal Neuralgia. Safety Issues.

Number of adverse events. Registration of any adverse events categorized by probable relationship to drug or the procedure. Data obtained from the headache diaries as well as open questions during consultations.

expressed as score on Visual analogue scale (VAS) for pain

St. Olavs Hospital

Norwegian University of Science and Technology

Post-Dural Puncture Headache

Anti-Arrhythmia Agents

Channel Blockers

Central Nervous System Depressants

Central Nervous System Stimulants

Analgesics

Respiratory System Agents

Other Dietary Supplements

Lidocaine

Anesthetics

Caffeine

Theophylline

patients will be performed transnasal sphenopalatine block and conservative treatment ( iv hydration, analgesic agents, caffeine or theophylline)

patients will receive standard supportive treatment ( Conservative treatments are iv hydration, analgesic agents, caffeine or theophylline)

the intervention will be performed on sitting position. Lidocaine 2% viscous (0.5ml) will be apply on cotton swab sticks and one will be gently inserted into nostril, along the floor of the nose. Stick will be used to insert it as far as it goes with the intention to reach the nasopharyngeal wall (posterior wall of the nose). At that position the swab stick will be left undisturbed for 20 minutes.

sphenopalatine ganglion block

Conservative treatments are iv hydration, analgesic agents, caffeine or theophylline

conservative treatment

mehmet yilmaz

This study evaluates effect of sphenopalatine ganglion block in post dural puncture headache. Half of participants will receive standard supportive treatment and other half of patients will be performed sphenopalatine ganglion block.

Spinal anesthesia is known subarachnoid block also commonly used regional anesthesia technic. Spinal anesthesia is frequently performed in obstetric patients undergoing cesarian section, which has several advantages including less deep vein thrombosis incidence, low opioid requirement, early mobilization and early lactation also has some complications too. Postdural headache is one of the most known complications of spinal anesthesia.

The etiology of the postspinal headache remains unclear. Severeness of the symptoms and amount of the cerebrospinal fluid leakage have been found positive correlating. The cerebrospinal fluid supports brain with it's mass effect. When a leakage of the fluid occurs, support of the brain decreases and pain sensitive structures of the brain gets more sensitive. In this condition 5 th 9th and 10 th cranial nerves, falks cerebelli, tentorium and blood vessels are affected most. Decreased cerebrospinal fluid volume causes decreased brain volume and compensatory mechanisms lead to cerebral venous dilatation. Conservative treatments are iv hydration, analgesic agents, caffeine or theophylline. Epidural blood patch is the gold standard for the treatment . However epidural blood patch is an invasive technic and has some complications such as dural puncture, infection and neurologic trauma.

Sphenopalatine ganglion is one of the four parasympathetic thin ganglion in skull. Parasympathetic fibers innervates cerebral and meningeal blood vessels which cause vasodilatation and stimulate nociceptor activation on meninges. Consequently headache is related with sensory cortex.

Transnasal SPG block is performed successfully in chronic pain syndromes including migraine, cluster headaches and atypic face pain. Likewise the SPG block is performed in acute treatment of postspinal headache. However gold standard of the treatment is epidural blood patching which is interventional and has many risks. Several studies enrolled limited participants offer SPG block primarily in the literature.

Is Sphenopalatine Ganglion Block Treatment Effective on Postspinal Headaches

Effect of the Sphenopalatine Ganglion Block for Post Spinal Headache Treatment: A Prospective Randomized Controlled Study

VAS score will be asked to the patients. Visual analog scale (VAS) from 0 to 10. 0(= no anxiety), 10(= highest level of anxiety)

Derince Training and Research Hospital

Principle investigator

Glycerol

Protective Agents

The patients will be injected with glycerol using a new neuronavigation-based technique in the trigeminal ganglion.

Trigeminal neuralgia is one of the strongest pains known to humans. Some patients do not have enough effect with the available pharmaceutical treatments and are offered a type of surgery, which involves the injection of glycerol in a nerve structure called trigeminal ganglion. The researchers will do a pilot study on 10 patients with a new surgical technique using neuronavigation. The researchers believe that this new neuronavigation-based system can improve the precision of the technique and reduce the risk for complications.

Glycerol Block of the Trigeminal Ganglion in Trigeminal Neuralgia Using a New Neuronavigation-based Surgical Technique

Number of adverse events and number of participants with adverse events after glycerol injection in the trigeminal ganglion and severity of adverse events by the method used. Registration of any adverse events categorized by probable relationship to drug or the procedure. Data obtained from the headache diaries as well as open questions during consultations.

expressed by means of patient global impression of change questionnaire (PGIC)

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Botulinum Toxin Type A Block of the Sphenopalatine Ganglion in Trigeminal Neuralgia. Safety Issues.	NCT02662972	Trigeminal Neur... Headache Disord...	Botulinum Toxin...	18 Years - 80 Years	Norwegian University of Science and Technology
Botulinum Toxin Type A Block of the Sphenopalatine Ganglion in Trigeminal Neuralgia. Safety Issues.	NCT02662972	Trigeminal Neur... Headache Disord...	Botulinum Toxin...	18 Years - 80 Years	Norwegian University of Science and Technology
Is Sphenopalatine Ganglion Block Treatment Effective on Postspinal Headaches	NCT03512977	Headache Disord... Central Nervous...	sphenopalatine ... conservative tr...	18 Years - 45 Years	Derince Training and Research Hospital
Glycerol Block of the Trigeminal Ganglion in Trigeminal Neuralgia Using a New Neuronavigation-based Surgical Technique	NCT02624661	Trigeminal Neur... Headache Disord...	Glycerol	18 Years - 80 Years	Norwegian University of Science and Technology
Glycerol Block of the Trigeminal Ganglion in Trigeminal Neuralgia Using a New Neuronavigation-based Surgical Technique	NCT02624661	Trigeminal Neur... Headache Disord...	Glycerol	18 Years - 80 Years	Norwegian University of Science and Technology

Spots Global Cancer Trial Database for headache disorders