Sphenopalatine Ganglion Stimulation

Chapter

Abstract

The sphenopalatine ganglion (SPG) has a critical role in the modulation and regulation of cerebrovascular autonomic physiology in the head and face region. Consequently it has been implicated in the pathophysiology of different autonomic cerebrovascular phenomena in these regions of the body such as headache syndromes including cluster headaches, migraines, and trigeminal autonomic cephalgias (TACs) as well as cerebral vasospasm and stroke. This burgeoning interest and research of its role in these conditions has been accompanied by the development of strategies to target and modulate its activity. Electrical stimulation has emerged as a prime method for modulating the activity of the SPG because such modulation can be adjusted and is reversible. The relative ease of accessing the SPG in the pterygopalatine fossa has also made it easily amenable to approaches for electrical stimulation. In this chapter, we will discuss the indications, procedure, and potential complication of SPG stimulation.

Keywords

Migration Migraine Dura Prep 

References

  1. 1.
    Goadsby PJ. Pathophysiology of cluster headache: a trigeminal autonomic cephalgia. Lancet Neurol. 2002;1:251–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Akerman S, Holland PR, Lasalandra MP, Goadsby PJ. Oxygen inhibits neuronal activation in the trigeminocervical complex after stimulation trigeminal autonomic reflex, but not during direct dural activation of trigeminal afferents. Headache. 2009;49:1131–43.PubMedCrossRefGoogle Scholar
  3. 3.
    Bartsch T, Goadsby PJ. The trigeminocervical complex and migraine: current concepts and synthesis. Curr Pain Headache Rep. 2003;7:371–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Goadsby PJ. Sphenopalatine ganglion stimulation increases regional cerebral blood flow independent of glucose utilization in the cat. Brain Res. 1990;506:145–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Suzuki N, Hardebo JE, Kahrstrom J, Owman C. Selective electrical stimulation of postganglionic cerebrovascular parasympathetic nerve fibers originating from the sphenopalatine ganglion enhances cortical blood flow in the rat. J Cereb Blood Flow Metab. 1990;10:383–91.PubMedCrossRefGoogle Scholar
  6. 6.
    Toda N, Tanaka T, Ayajiki K, Okamura T. Cerebral vasodilatation induced by stimulation of the pterygopalatine ganglion and greater petrosal nerve in anesthetized monkeys. Neuroscience. 2000;96:393–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Yarnitsky D, Lorian A, Shalev A, Zhang ZD, Takahashi M, Agbaje-Williams M, Macdonald RL. Reversal of cerebral vasospasm by sphenopalatine ganglion stimulation in a dog model of subarachnoid hemorrhage. Surg Neurol. 2005;64:5–11.PubMedCrossRefGoogle Scholar
  8. 8.
    Ansarinia M, Rezai A, Tepper SJ, Steiner CP, Stump J, Stanton-Hicks M, Machado A, Narouze S. Electrical stimulation of sphenopalatine ganglion for acute treatment of cluster headaches. Headache. 2010;50(7):1164–74.PubMedCrossRefGoogle Scholar
  9. 9.
    Tepper SJ, Rezai A, Narouze S, Steiner C, Mohajer P, Ansarinia M. Acute treatment of intractable migraine with sphenopalatine ganglion electrical stimulation. Headache. 2009;49:983–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Narouze SN. Role of sphenopalatine ganglion neuroablation in the management of cluster headache. Curr Pain Headache Rep. 2010;14:160–3.PubMedCrossRefGoogle Scholar
  11. 11.
    Ibarra E. Neuromodulacion del Ganglio Esfenopalatino para Aliviar los Sintomas de la Cefalea en racimos. Reporte de un Caso. Bol El Dolor. 2007;64(16):12–8.Google Scholar
  12. 12.
    Schoenen J, Jensen RH, Lantéri-Minet M, Láinez MJ, Gaul C, Goodman AM, Caparso A, May A. Stimulation of the sphenopalatine ganglion (SPG) for cluster headache treatment. Pathway CH-1: a randomized, sham-controlled study. Cephalalgia. 2013;33(10):816–30.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of NeurosurgeryCenter for Neuromodulation, The Ohio State University Medical CenterColumbusUSA

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