Intra-arterial Sphenopalatine Ganglion Block for Patients With Refractory Headache
Chronic Migraine, Cluster Headache, Trigeminal Neuralgia
About this trial
This is an interventional treatment trial for Chronic Migraine
Eligibility Criteria
Inclusion Criteria:
- Established diagnosis of one of the three following headache or facial pain disorders as defined by the ICHD-329 [chronic migraine, cluster headache, trigeminal neuralgia] and failure to respond to two or more preventive therapies
A. Chronic migraine
Failure to respond to two or more preventive therapies including Onabotulinumtoxin A, erenumab, fremanezumab, galcanezumab, topiramate, valproic acid, metoprolol, propranolol, timolol, atenolol, nadolol, amitriptyline, nortriptyline, venlafaxine, duloxetine.
This will include status migrainosus.
B. Cluster headache
Failure to respond to Verapamil, AND one other preventive treatment including Prednisone, Dexamethasone, galcanezumab, lithium, valproic acid, topiramate, external vagus nerve stimulation
C. Trigeminal neuralgia
Failure to respond to two or more preventive therapies, including: Oxcarbazepine or carbamazepine, and One of the following: gabapentin, pregabalin, baclofen, lamotrigine, phenytoin
Exclusion Criteria:
- Patients with malignant neoplasm of the pterygopalatine fossa
- Pregnancy, lactation
- Severe allergic reaction to Dexamethasone
- Severe allergic reaction to NSAID
- Renal failure
- Active systemic infection or fever
- Known cerebral vascular disease
- Drug or alcohol abuse
- Opioid dependency (stable doses ok)
- Triptans within 48 hours from the procedure
Sites / Locations
- Weill Cornell Medicine
Arms of the Study
Arm 1
Experimental
Intra-Arterial Delivery of Ketorolac and Dexamethasone