Discovery Credit to SF-Bill.
Stellate Ganglion Block is one of several nerve block techniques sometimes used in an effort to manage chronic face pain. SF-Bill came up with a page full of graphic images of the Stellate Ganglion and of procedures used in an effort to block pain cascade through the sympathetic nervous system.
Select this link: [Stellate Ganglion Block]
Thank you Bill and Red.
does a neurosurgeon do his procedure or pain management?
Either or both. Some neurologists are certified to do it also, as are some anesthesiologists. Their offices should be willing to tell you if you call to schedule an appointment.
Regards, Red
i have a referral to a pain management specialist, who has already ordered another mri with and without contrast for the 17th of this month, so it will definately be on my question list. thank you
Does this type of block work the same way Botox does?
I am having Botox done now with good results, it’s just that it doesn’t last long.
What is the Worst thing that can happen doing nerve block and what percentage of that - and what other outcomes that are good can come from this?
Any form of nerve bloc acts by introducing anesthesia to some part of the nerve. Sphenopalatine Ganglion block is administered to a different nerve than the trigeminal nerve, through the nose. It is believed that the quieting action of this kind of bloc is exercised through the so-called "parasympathetic nervous system", which indirectly affects some of the nerve fibers of the trigeminal distribution.
For a (complex) description of the nerves affected, see http://arizonapain.com/pain-center/pain-treatments/sphenopalatine-ganglion-block/. This reference also identifies risks of the procedure as follows:
"The risk for this procedure is very low. The most common side effects of this procedure include developing a bitter taste in your mouth from the local anesthetic potentially dripping down from the nasopharynx down into your oropharynx or developing a slight numbness in the back of the throat from the local anesthetic dripping down into your throat.19 Occasionally some patients may develop epistaxis (nose bleed) from your physician accidently abrading your internal nare [sic] anatomy from placing of the block. Some patients may also experience slight lightheadedness that usually resolves after 20-30 minutes after the procedure. With any procedure that involves local anesthetic the theoretical risk of drug allergy and seizure (if the medication is injected into a blood vessel). Lastly with any penetration of skin and soft tissues, the risk of infection always exists."
Botox can be administered anywhere in the face. Botox is a (mildly) toxic agent that creates temporary pain relief by compromising the ability of the neurons to fire. This creates numbness, either partial or total. Over time, the nerve will gradually heal, regaining its ability to transmit pain signals.
For your own protection, be aware that I am not a medical professional. The information above is researched from both authoritative medical literature and patient reports in the Internet. You should validate this information against the experience of a licensed practitioner.
Regards
Red Lawhern, Ph.D.
Resident Research Analyst
I was having the spheno-pallantine ganglion block done about every 6 weeks for 4-5 times. I had immediate relief, it is a little uncomfortable but not bad. The relief would start to wear off at about 4 weeks and that was my cue to schdule another block. Unfortunately, I have had a relapse and have not been able to get it under control this time.
I am having the migraine protocol for the administration of botox. It lasts about 3 weeks, but those 3 weeks are wonderful! I am having this done every 12 weeks.
Hi Red,
Do you know if this helps with TN 2, bilaterally?
thx
Beth, Stellate Ganglion Block will be administered to one side at a time (possibly two injections in the same session). It does seem to have a record of effectiveness in both types of TN -- but not for all patients all the time, and generally for periods that vary between two to three days up to as long as a month.
I hope this is useful data...
Regards, Red
I can share with you that i have done SGB here in a pain clinic in Israel... it's not painful.. .but it didn't help.
it's a shoot in the neck.. but less horrifying than it sounds.
The doctor should get a Horner - meaning the eye on that side gets red - and that's how the surgeon now he succedded in hitting the right spot.
can you tell more about this ? and how does you describe your pain ? (constant pain ? shocks ? ) thanks
Nrthshrgrl said:
I am having the migraine protocol for the administration of botox. It lasts about 3 weeks, but those 3 weeks are wonderful! I am having this done every 12 weeks.
I get the occasional shock, but Neurontin really took care of them.
I have Cluster Headaches in addition to TN. My headaches come in clusters. The pain I get. The apple of my cheek feels like a Charlie horse… That is how painful the muscle spasms. I also get a lightening strike behind my eye.
The neuralgia part which is constant… The stabbing pain in my ear and temple.
The Botox worked immediately to quiet my face. My neurologist administered 33 shots along my forehead, head and neck. She will continue to increase the dose of the Botox and has said that over time I should get longer periods of relief. That is what I am hoping for.
can you tell more about this ? and how does you describe your pain ? (constant pain ? shocks ? ) thanks
Nrthshrgrl said:I am having the migraine protocol for the administration of botox. It lasts about 3 weeks, but those 3 weeks are wonderful! I am having this done every 12 weeks.
This is very interesting to me. My neuro has been doing botox for my cervical muscles, my neck has always been involved with the whole package of chronic pain and flared up the same time my facial pain did. I have a pain management doc too who has tried blocks in several branches of my cervical nerves, also rhizotomy, which did not have an effect. The botox helps sometimes, the last time my neuro did the botox he went into a muscle group in my scalp and I was almost pain free for 2 days with my face....so this seems like a good idea to ask my docs. Interestingly while in P. T., they kept telling me the facial pain is coming from the muscles from the front of my neck, still stretching them, stretching all the cervical muscles. Thank you for the all this great info on a different kind of block, I will be seeing my neuro soon again, pain management in Jan. so I will be asking.....do you do this?? I know they are studying botox for TN, all types, I am either type 2 TN and sometimes it behaves like atypical facial pain. It acts out like TMJ on the right side, ears hurt but the facial pain is all nerve, some muscle aching....when I had tmj surgery in '86 I had facial pain, the tmj did resolve, not the facial pain but then somehow I went into a remission for over 20 years. I have been suffering with this for over a year all over again. This is encouraging information, thank you Richard, you say I am not a doc but your research sounds so professional and your responses too, love all the very intelligent members of this group. Sharon
I just recalled in my memory, a long time ago, in the late 80's, a woman I knew was getting this type of block for tmj but it did not help her. The docs have been doing this type of block for a long time, how long for TN, both types or atypical facial pain?? Sharon
Granny (Sharon) -- I believe that TMJ is grossly over-diagnosed and TN is often mistaken for it by poorly trained dentists. "Atypical facial pain" is not a legitimate medical entity. It's a garbage diagnosis by elimination, often rendered by doctors who are uncertain of what is going on. The Medical Advisory Board of the TN Association defines this term as "facial pain of obscure origins". That group has also commented that facial pain is clearly NOT "psychogenic" in origin, or caused by depression. During the 2011 round of comments on the then-pending publication of the Diagnostic and Statistical Manual of the American Psychiatric Association, I was one of several commentators who urged abolishing the whole stinking mess which comprises so-called "conversion disorder" in the DSM -- a "disorder" for which there is no validated body of observational data beyond the opinions of the practitioners who get paid for treating it.
Thanks for the compliment. I happen to have been a professional researcher, but not in medicine. My doctorate and career experience were in engineering systems and advanced technology evaluation. I got into face pain as a research subject after my wife presented with two types of neuralgia on both sides of her face.
Go in Peace and Power
Red
You are quite welcome, and it is wonderful to have someone with the knowledge you can offer, bonus, you are healthy and you are doing this in behalf of someone you love dearly, I am sorry your wife is suffering, she has you and she is very fortunate, may you go in peace and power too and have a blessed holiday. Sharon
Richard A. "Red" Lawhern said:
Granny (Sharon) -- I believe that TMJ is grossly over-diagnosed and TN is often mistaken for it by poorly trained dentists. "Atypical facial pain" is not a legitimate medical entity. It's a garbage diagnosis by elimination, often rendered by doctors who are uncertain of what is going on. The Medical Advisory Board of the TN Association defines this term as "facial pain of obscure origins". That group has also commented that facial pain is clearly NOT "psychogenic" in origin, or caused by depression. During the 2011 round of comments on the then-pending publication of the Diagnostic and Statistical Manual of the American Psychiatric Association, I was one of several commentators who urged abolishing the whole stinking mess which comprises so-called "conversion disorder" in the DSM -- a "disorder" for which there is no validated body of observational data beyond the opinions of the practitioners who get paid for treating it.
Thanks for the compliment. I happen to have been a professional researcher, but not in medicine. My doctorate and career experience were in engineering systems and advanced technology evaluation. I got into face pain as a research subject after my wife presented with two types of neuralgia on both sides of her face.
Go in Peace and Power
Red
Sharon, my wife still deals with occasional twinges and stabs, particularly "behind" her right eye. But she says that it's like the tip of the iceberg has been melted off. She is on 2700 mg/day of Neurontin, with relatively minor side effects. She's been successful for over 12 years on this medication plan, including after she went through a bout of Shingles and post-herpetic neuralgia. She's a brave lady and a patient one, considering that she lives with an engineer... {:-)
Regards, Red
Granny said:
You are quite welcome, and it is wonderful to have someone with the knowledge you can offer, bonus, you are healthy and you are doing this in behalf of someone you love dearly, I am sorry your wife is suffering, she has you and she is very fortunate, may you go in peace and power too and have a blessed holiday. Sharon