Mon. Jul 15th, 2024

Ients with cluster headache develop into chronic [1], with extreme repercussion in hisher each day activities and poor high quality of life. Inhibiting sphenopalatine ganglion (SPG) could suppress the crisis [2], but its access is pretty challenging requiring 2-Hydroxybutyric acid Purity & Documentation aggressive methods [3]. Tx360 device is really a nasal applicator produced of plastic material easing the access to the SPG as well as the application of regional anaesthetic in its vicinity with minor inconveniencies [4]. Materials and techniques Twelve blocks (three every week through 4 weeks), in the SPG had been done with Bupivacaine 0,5 (0,three cc each and every nostril), employing the Tx360 device. We evaluate at the end of the 12th block (4 weeks), efficacy parameters (mean reduction of attack frequency and headache days), effect (Headache Effect Test [HIT-6]), and quality of life (MigraineSpecific Top quality of Life Questionary [MSQ]), tools. We also analysed 30 and 50 response prices. Benefits Five patients refractories to standard oral therapies have been treated (4 M, 1 F; imply age 41,six 11,8). At the 12th block there was a important reduction in mean attack frequency (6 vs. 15, p 0,00002), and imply pain intensity (7 vs. 9,6, p 0,005), not in mean headache days (18,6 vs 26, p 0,15). There was a important reduction in imply HIT-6 (63 vs. 71), and MSQ (57 vs. 68). Four individuals (80 ), had a 50 or higher reduction in attack frequency, and two (20 ), in headache days. There were no considerable adverse events but minor and transient nearby discomfort; only one particular patient suffer a syncope two hours following the second block, probably not related for the procedure. Conclusions Repetitive blocks from the SPG with all the Tx360 device appear to become an efficient therapy in chronic cluster headache, with minor adverse events. These added benefits were evident both in attack frequency and in good quality of life measures. Despite the fact that encouraging these benefits must be confirmed within a greater variety of individuals, and know how extended they will final. This therapy almost certainly must be tried prior to invasive remedies, with more really serious adverse events.References 1. Goadsby PJ. Pathophysiology of cluster headache: A trigeminal autonomic cephalalgia. Lancet Neurol. 2002;1:251-257. 2. Tepper SJ, Caparso A. Sphenopalatine Ganglion (SPG): Stimulation, Mechanism, Security, and Efficacy. Headache. 2017;57:14-28. 3. Narouze S, Kapural L, Casanova J, et al. Sphenopalatine ganglion radiofrequency ablation for the management of chronic cluster headache. Headache. 2009;49:57177. four. Candido KD, Massey ST, Sauer R, Darabad RR, Knezevic NN. A novel revisi to the classical transnasal topical sphenopalatine ganglion block for the treatment of headache and facial pain. Pain Doctor. 2013;16:E769-78.P12 Total detoxification is definitely the most powerful therapy of medication-overuse headache: A randomized controlled open-label trial Louise N Carlsen, Signe B Munksgaard, Rigmor H Jensen, Lars Bendtsen Danish Headache Center, Department of Neurology, RigshospitaletGlostrup, Lars Bendtsen; Ndr. Ringvej 69, 2600 Glostrup, Denmark Correspondence: Lars Bendtsen ([email protected]) The Journal of Headache and Discomfort 2017, 18(Suppl 1):P12 Background: There’s lack of evidence on the way to detoxify medication-overuse headache (MOH). The aim was to examine the effect of total stop of acute medication with restricted intake. Solutions: MOH-patients had been incorporated in a prospective, outpatient study and randomized to two-month detoxification with either A) no analgesics or acute migraine-medication, or B) acute me.