Abstract
The sphenopalatine ganglion—also known as pterygopalatine ganglion, Meckel’s ganglion, Sluder’s ganglion and nasal ganglion—is the largest of the four parasympathetic ganglia associated with the trigeminal nerve. It is considered one of the largest neuron collection in the head outside of the brain, being exposed to the environment via the nasal mucosa. Classically, refractory head and face pain were treated with a series of ineffectual medications with intolerable side effects – cycling from one to the next based on trial and error. Although the sphenopalatine ganglion is a little-known region in the face, pain management specialists believe that it is very effective in the treatment of many conditions. It is a life changing, safe and established procedure that offers the pain sufferers an immediate relief from their pain. Dextrose 5% concentration in a neutral pH sterile water solution treats the neurogenic inflammation and stops the neuropathic pain by blocking the TRPV1 ion channels. In this paper, a 32 years old lady was suffering from severe headache, with an impaired vision of the left eye. The Visual Evoked Potential (VEP) showed an attack of optic neuritis. After 5 sessions of treatment with buffered dextrose in 5% concentration, the VEP showed a resolved attack of optic neuritis.
Conclusion: Buffered Dextrose in 5% concentration gave marvelous results in the treatment of headache and optic neuritis, and helped the patient to regain her vision.
Keywords: Sweet nasal treatment, Lyftogt perineural injection treatment, optic neuritis, headache, dextrose.
References
- Gray’s Anatomy Drawing of Sphenopalatine or Pterygopalatine ganglion, as presented on Wikipedia. http://en.wikipedia.org/wiki/Pterygopalatine_ganglion.
- Manahan AP, Malesker MA, Malone PM. Sphenopalatine ganglion block relieves symptoms of trigeminal neuralgia: a case report. Nebr Med J. 1996; 81:306-9
- Peterson JN, Schames J, Schames M, King E. Sphenopalatine ganglion block: a safe and easy method for the management of orofacial pain. Cranio. 1995; 13:177-81
- Stechison MT, Brogan M. Transfacial transpterygomaxillary access to foramen rotundum, sphenopalatine ganglion, and the maxillary nerve in the management of atypical facial pain. Skull Base Surg. 1994; 4:15-20.
- Olszewska-Ziaber A, Ziaber J, Rysz J. [Atypical facial pains–sluder’s neuralgia–local treatment of the sphenopalatine ganglion with phenol–case report] Otolaryngol Pol. 2007; 61:319-21. [Article in Polish]
- Morelli N, Mancuso M, Felisati G, Lozza P, Maccari A, Cafforio G, Gori S, Murri L, Guidetti D. Does sphenopalatine endoscopic ganglion block have an effect in paroxysmal hemicrania? A case report. Cephalalgia. 2009 May 5.
- Saberski L, Ahmad M, Wiske P. Sphenopalatine ganglion block for treatment of sinus arrest in postherpetic neuralgia. Headache. 1999; 39:42-4.
- Prasanna A, Murthy P: Vasomotor rhinitis and sphenopalatine ganglion block. J Pain Symptom Manage. 13:332-337 1997
- Quevedo J, Purgavie K, Platt H, et al.: Complex regional pain syndrome involving the lower extremity. a report on 2 cases of sphenopalatine ganglion block as a treatment option Arch Phys Med Rehabil. 2005; 86:335-337.
- Quevedo JP, Purgavie K, Platt H, Strax TE. Complex regional pain syndrome involving the lower extremity: a report of 2 cases of sphenopalatine block as a treatment option. Arch Phys Med Rehabil. 2005; 86:335-7.
- Shah R, Racz G: Long-term relief of posttraumatic headache by sphenopalatine ganglion pulse radiofrequency lesioning. a case report Arch Phys Med Rehabil. 2004; 85:1013-1016.
- Berger J, Pyles S, Saga-Rumley S: Does topical anesthesia of the sphenopalatine ganglion with cocaine or lidocaine relieve low back pain. Anesth Analg. 1986; 65:700-702.
- Sluder G. The syndrome of sphenopalatine ganglion neuralgia. Am J Med Sci. 1910. 111:868-878.
- Sluder G. Nasal Neurology, Headaches and Eye Disorders. Mosby. St Louis. 1927.
- Puig CM, Driscoll CL, Kern EB (1998): Sluder’s sphenopalatine ganglion neuralgia—treatment with 88% phenol. Am J Rhinol; 12 (2): 113 – 8.
- Greenberg DA, Aminoff MJ, Simon RP. eds. (2012). "Chapter 6. Headache & Facial Pain in Clinical Neurology". amazon.com (8th ed.). McGraw-Hill. ISBN9780071759052. Archieved from the original on 2016-06-02.
- Edlow, J.A.; Panagos, P.D.; Godwin, S.A.; Thomas, T.L.; Decker, W.W. (October 2008). "Clinical policy: Critical issues in the evaluation and management of adult patients presenting to the emergency department with acute headache". Annals of Emergency Medicine. 52 (4): 407–36. doi:1016/j.annemergmed.2008.07.001. PMID18809105.
- Schuenke M, Schulte E, Schumacher U et-al. Head and Neuroanatomy - Latin Nomencl. (THIEME Atlas of Anatomy). Thieme. ISBN:1588904423. Read it at Google Books - Find it at Amazon
- Bruni JE, Montemurro D. Human neuroanatomy. Oxford University Press, USA. ISBN:0195371429. Read it at Google Books - Find it at Amazon.
- McMinn FRCS CSS. Last's Anatomy: Regional and Applied, 12e (MRCS Study Guides). Churchill Livingstone. ISBN:0702033952.
- Vilensky, Joel; Robertson, Wendy; Suarez-Quian, Carlos (2015). The Clinical Anatomy of the Cranial Nerves: The Nerves of "On Olympus Towering Top". Ames, Iowa: Wiley-Blackwell. ISBN978-1118492017
- Soliman, D. 2016. Pain Management by Prolotherapy and Perineural Injection therapy. Germany: Lambert Academic Publishing, 13-38.
Corresponding Author
Dr Dina Soliman
American Board in Regenerative Medicine from AARM
Interventional Regenerative Orthopedic Medicine Certified from AAOM
Member of AAOM and AABRM
DOI: https://dx.doi.org/10.18535/jmscr/v6i8.29
