Sphenopalatine Ganglion Block in Refractory Familial Hemiplegic Migraine

The SPG block served as a minimally invasive, opioid-sparing technique for use in a debilitating episode of familial hemiplegic migraine presenting in status migrainosus that lasted for sixteen days and allowed for the patient to be safely discharged after a fourteen-day hospitalization. She received numerous treatments for migraine, many of which fell into the category of commonly used techniques for controlling migraine headache in the hospitalized patient. Despite these treatments, she was escalated in therapy to second and even third line treatments with little success. Ultimately, a three-stage regional anesthetic technique provided a tolerable level of pain control, in addition to providing partial relief of her left-sided deficits associated with familial hemiplegic migraine.