Published on April 03, 2019

Another option for migraine sufferersAnother option for migraine sufferers

In the past, when patients suffered from an intractable migraine that didn’t respond to oral medication, their only course of action was to go to the emergency department for intravenous medicine. Now, those suffering from severe migraine pain on Cape Cod have another option.

Neurologists of Cape Cod in Hyannis offers relief with spenopalatine ganglion nerve blocks, commonly referred to as SPG blocks. Neurologist Sean Horrigan, MD, and nurse practitioner Tara Hart, NP, each offers the treatment. Falmouth pain specialist Adam Brown, MD, also offers the treatment.

“Migraines are an awful thing because it’s not an outward pain or injury,”said Hart. “It’s not something that people can see, so patients just suffer. The stories we hear by the time they get to us with chronic migraines are just so sad.”

The SPG blocks offer help via the ganglion, which is a bundle of nerves that lies deep behind the nose and is involved in a lot of headache pathways, according to Hart.

“It’s just topically treating that nerve cluster and hopefully breaking up that pain pathway,” she said. “It’s non-invasive with little to no side effects and patients tolerate it really well.”

The procedure itself utilizes two simple pain medications – Lidocaine and Marcaine. Patients lie down in a quiet dark room to make them as comfortable as possible and Hart gently inserts long cotton swabs that have been soaked in the anesthetic mixture; one in each nostril. The patient then rests for 20 to 30 minutes. Afterwards, she removes the swabs and lets the patient sit up and rest a bit more before sending them home.

“They can feel immediate relief,” she said. “The results are mixed and I would say it’s about 50/50 that people see a change right away. Unfortunately, other people do not get any relief from it.”

For those patients it does help, the treatment can last a few days up to a few weeks.

SPG blocks can also be used to help people with atypical face pain and trigeminal neuralgia. Hart has worked at Neurologists of Cape Cod as a registered nurse since 2014. She earned her Master’s degree and has been a practicing nurse practitioner for about a year. She is very heartened by all the new advances in treatment the office now offers.

A new anti-migraine drug class that the FDA approved this year promises even more hope for migraine patients, she said.

“It’s a really exciting time to be working in this practice.”