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Sphenocath is latest weapon in battle against migraines


June 18. 2018 11:29PM

The Sphenocath is a moveable piece of plastic that, with the aid of an X-ray device, allows radiologists to get precisely to the point where a freezing agent can be effectively applied. (Image Source:

I have suffered with migraine headaches for much of my adult life. For the most part, they have been nowhere near the severity (from what I have read) of many other sufferers, women in particular.

But mine have been debilitating — enough to knock me off my feet with a stabbing pain shooting out from one eye or the other. They would come at least a couple of times a month and in recent years sometimes more frequently.

The worst came with a violent nausea, which would only make the pain worse, and make my family think I was hacking up a small car. The pain could last all day. They hit me at work, at home, on vacation, and even on assignment — in Saudi Arabia.

After the first few years, I was prescribed two migraine preventatives. They helped and I have taken them daily ever since.

Then Imitrex (generic name sumatriptin) came along in pill form. It was a godsend. If I caught the migraine at its onset, I could take 100 mg of Imitrex, seek a quiet, dark room and almost always be migraine-free in an hour or two.

This all changed in February when I received my first sphenopalantine ganglion block (SPG) at the radiology department at Catholic Medical Center in Manchester. The sphenopalatine ganglion is a group of nerve cells that is linked to the main nerve involved in headache.

The SPG is behind the nose. According to the American Migraine website, “It carries information about sensation, including pain, and also plays a role in autonomic functions, such as tearing and nasal congestion.”

The idea of freezing the back of your nose to mitigate migraines has been around for a century. But just shoving a cotton swab up the nose with a topical cooling agent was a hit-or-miss proposition and not always effective.

A few years ago, someone patented the Sphenocath. It is a moveable piece of plastic that, with the aid of an X-ray device, allows radiologists like Dr. Joseph Ullmann to get precisely to the point where the freezing agent can be effectively applied.

The procedure itself takes only a few minutes. An anesthetic is first swabbed into the nasal passages. It is mildly uncomfortable. Then the doctor inserts the Sphenocath device, guiding it to what I was sure was my brain but apparently is not quite that far up.

A squirt of freezing agent in each nostril and the procedure is over. You then stay lying flat on your back for 15 minutes and you are free to go. And usually pain free. I was able to drive both to and from the appointment.

Dr. Ullmann said the effects can be dramatic or less so. They can last just a day, or a year, or longer.

In my case, the result was a definite lessening in both the frequency and severity of the migraines. When I felt one begin, I was able to treat it with just 50 mg of Imitrex, half the usual dosage.

But a couple of the “old kind” of migraines returned in recent weeks, so a second procedure was in order. I had had this second one pre-authorized with my primary physician, so the appointment was quickly scheduled.

I don’t know how long this one will last. I am hoping it is even longer than the first one. But even if it’s another four months, that is a lot better than before.


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