Intranasal Catheter Treatment Shows Promise for Relieving Chronic Migraine Symptoms

March 1, 2015—The Society of Interventional Radiology (SIR) announced the presentation of research on an innovative treatment for chronic migraine patients that provides sustained relief of headaches. The study is being being presented at SIR.15, the society’s 40^th annual scientific meeting in Atlanta, Georgia.

According to SIR, clinicians at Albany Medical Center in Albany, New York and the State University of New York’s Empire State College in Saratoga Springs, New York used image-guided, intranasal sphenopalatine ganglion (SPG) blocks to give patients enough ongoing relief that they required less medication to relieve migraine pain. The study’s lead investigator is Kenneth Mandato, MD, an interventional radiologist at Albany Medical Center.

In SIR’s press release, Dr. Mandato stated, “Migraine headaches are one of the most common, debilitating diseases in the Unites States, and the cost and side effects of medicine to address migraines can be overwhelming. Intranasal SPG blocks are image-guided, targeted, breakthrough treatments. They offer a patient-centered therapy that has the potential to break the migraine cycle and quickly improve patients’ quality of life.”

As summarized by SIR, the investigators conducted a retrospective analysis of 112 patients with migraine or cluster headaches. Patients reported the severity of their headaches on a visual analogue scale (VAS), ranging from 1–10, to quantify the degree of debilitation experienced from the migraine. During the treatment, a catheter is inserted through the nasal passages to administer 4% lidocaine to the SPG.

The investigators found that before treatment, patients reported an average VAS score of 8.25 with scores > 4 at least 15 days per month. The day after the SPG block, patients’ VAS scores were cut in half to an average of 4.10. Thirty days after the procedure, patients reported an average score of 5.25, a 36% decrease from before treatment. Additionally, 88% of patients indicated that they required less or no migraine medication for ongoing relief.

Dr. Mandato explained, “Administration of lidocaine to the sphenopalatine ganglion acts as a ‘reset button’ for the brain’s migraine circuitry. When the initial numbing of the lidocaine wears off, the migraine trigger seems to no longer have the maximum effect that it once did. Some patients have reported immediate relief and are making fewer trips to the hospital for emergency headache medicine.”

Dr. Mandato advised that although patients reported relief from their migraines, SPG blocks are not a cure for migraines; they are a temporary solution, as are other current treatment options for chronic headaches. Because of the minimally invasive nature of the treatment and the medication’s safety profile, Mandato believes patients can have the SPG block repeated, if needed.

The investigators will conduct follow-up at 6 months to learn how the 112 patients have continued to respond to the treatment. Dr. Mandato is also considering conducting a double-blind, prospective study to more rigorously evaluate the effectiveness of SPG blocks in treating chronic migraines, stated SIR.