When Jennifer Sorrell first heard about a new migraine treatment procedure, she was understandably a little squeamish. It would involve threading a catheter up her nose.
“I thought, ‘You’re going to put what up my nose?’ ” the 35-year-old Hampton, Virginia, resident recalls.
But by the time she tried the procedure—a type of nerve-block that uses a device called SphenoCath—Sorrell had been having migraines four to five days a week. A migraine sufferer since the age of 20, she had tried almost every migraine treatment to relieve the mind-numbing pain. Six different medications. Several anti-nausea medications. Daily preventative treatments. ER visits. Sometimes, she’d need an injection of a drug called Imotrex.
Her migraines greatly affected her daily life, forcing her to call out from her job as an X-ray technician, or to just work through the pain. Rainy damp weather made it worse.
“I wouldn’t go out,” Sorrell says. “I wouldn’t do anything. Because what if I got a migraine when I was out?”
The procedure worked, giving Sorrell almost instantaneous relief. All thanks to a special catheter called SphenoCath that’s used to deliver a local anesthetic that blocks nerve impulses.
Nerve blocks performed to the sphenopalatine ganglion—a collection of nerve cells located under the tissue lining the back of the nose—are nothing new, says Dr. Jason Romesburg, a neuroradiologist with Tidewater Diagnostic Imaging, practicing at Sentara Williamsburg Regional Medical Center. SPG blocks, as they’re called, have long been used—as far back as 100 years ago—to treat cluster headaches, migraines, TMJ pain and other issues.
SPG blocks historically have been done with a long needle that’s pushed under the front cheekbone and deep into the face to reach the back of the nasal cavity, according to Romesburg. Or, they’ve been done by sticking a long cotton swab into the nose and hoping it reaches the right place.
What’s different about SphenoCath is the delivery. The device is a flexible, spaghetti-sized catheter that’s inserted with the guidance of an X-ray machine, to make sure it’s in just the right place before an anesthetic such as Lidocaine is deployed.
“It allows a safe and targeted block, and therefore more effective,” says Romesburg. “You’re delivering it right to the site.”
Romesburg first started doing SPG blocks with SphenoCath several years ago, but it wasn’t until insurance companies began covering the procedure last year that interest grew, he says. The procedure is currently being done at Sentara hospitals in Hampton, Virginia Beach and Williamsburg, Virginia.
The procedure itself takes only about 10 minutes. It’s done with a patient lying on her back, with minimal radiation exposure and only a little discomfort when the catheter is stuck in the nose. Patients are asked to stay reclined for a little while afterward. The procedure can be repeated every few months as needed.
“To me, it tickles,” Sorrell says.
Worldwide, about 10 percent of the population suffers from migraines, which can happen when the sphenopalatine ganglion gets overstimulated. Once the anesthetic is released there, it’s absorbed through the lining of the nose and acts like a reset button, blocking the source of the pain. About half his patients have come back for a repeat procedure, Romesburg says. Sorrell said her first SPG block migraine treatment left her pain-free for 77 days, bringing her pain level from an 8 out of 10 to a 2 out of 10.
“The next day I woke up and thought, “Am I dreaming?” she says. “I was a completely different person the next day.”
Besides immediately relieving pain, the SphenoCath procedure has another positive effect— patients are generally able to decrease the amount of their migraine medication, Romesburg says. The hope is to decrease the intensity and frequency of migraines. Sorrell says she can’t recommend the SphenoCath migraine treatment enough. It’s changed her life that much.
“People notice a change in my attitude in general,” she says. “I’m exercising more, and taking longer walks. I’m able to live my life better.”
