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Self administered Sphenopalatine Ganglion Block for patient use at home
Morris Maizels, MD, a headache physician who co-founded Southern Headache Society with me, has been a strong proponent of self administered Sphenopalatine Ganglion Block for patient use at home. He was the first to use it with his patients. With his permission, I have posted his instructions here.
Your pharmacist should dispense to you a bottle of 2% viscous lidocaine – please be sure it says “viscous” on the bottle.
The lidocaine works best used as early as possible in the headache attack. It seems to work best for headaches that are primarily behind the eyes or in the temples, rather than in the back of the head.
- Draw up about 1.0 ml of viscous lidocaine into a 1 ml syringe. It does not matter if there are air bubbles mixed in the syringe.
- The lidocaine goes into the nostril on the same side as the headache. If the headache is on both sides of your head, you will be injecting the lidocaine into both sides.
- If you have an aura before your headache. For most people, the aura is on the side opposite the headache. If that is true for you, inject the lidocaine on the side opposite to your aura (on the side the headache will develop) as soon as the aura starts.
- Lie down on your side curled up like a baby sleeping on its side, with your shoulder on the back of a firm pillow, and your head tilted back and rotated so you are looking up ~30 degrees.
- Put the syringe into the lower nostril, as far as it will comfortably go, with the tip pointing towards the outer (lateral) wall of the nostril. Inject the contents of the syringe, and then sniff the medicine so that you feel it goes to the back of the nostril, but not into the throat. If you feel burning or numbness into the eye, or if the eye tears, you know you have gotten the medicine where it needs to be. Stay lying down with your head turned for 2 – 3 minutes.
- If your headache is on both sides, roll over and repeat the procedure on the other side. Stay lying down for 2-3 minutes on this side.
- When you sit up, whatever medicine has not been absorbed will roll back into your throat. It will taste bitter and may make your throat numb. Don’t eat or drink until the numbness has gone away – otherwise you might swallow food or liquid into your windpipe.
You may repeat the lidocaine as often as 4 times/day.
If the lidocaine relieves the headache but the headache returns, you can repeat the lidocaine within 1 hour.
If you are somewhere that you cannot lie down – you can try injecting the lidocaine and sniffing it, but it might not get to the right location.
Please keep track on a headache calendar each time you have a headache, and each time you use the lidocaine and do a SPG Block at home. Share this information with your prescribing doctor.
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Gabrielle A.(Patient Since 2018)
Dr. Loftus and his team have literally changed my way of life. I was suffering from debilitating migraines and often ended up in the emergency room to obtain pain relief when medications were not working. I have been under the care of a neurologist since I was 5 years old for migraines. I have been on virtually every medication and prophylactic available to migraine sufferers. Nothing kept my headaches at bay. Two years ago, after 2 visits to the ER in a week, I began researching neurologists and migraine specialists. I was drawn to Dr. Loftus’ mission and after reading many reviews, I scheduled a visit. It took a few visits and medications until we found the right combination, through it all, Dr. Loftus was not giving up. I am thrilled to report that for the last year and a half, I have not been near an emergency room. My migraines are under control and very mild when they occur. I have had one debilitating attack in the last year. My entire quality of life has been changed for the better thanks to Bellaire Neurology and Dr. Loftus. If you are seeking relief and life change; look no more. Call and make your appointment!
Jennifer W.(Patient Since 2018)
I am very happy with the treatment I was provided. I made an appointment because I had more than one medical concern. Instead of bouncing back and forth between two doctors, Dr. Loftus was able to help me in one visit. We sat down and he talked me through every treatment option that was available, and the pros and cons of each. I was able to ask questions and express my concerns about certain medications.
Providing headache and hyperhidrosis care & wellness for over 25 years.
Dr. Brian Loftus, M.D.
Dr. Loftus is Board Certified in Headache Medicine as well as Neurology. In private practice since 1994, Dr. Loftus’ practice has gotten busier and he has decided to concentrate his practice in areas that he can make a particular difference compared to other neurologist. Therefore, Dr. Loftus has chosen to focus his neurology practice on headaches & head pain, headaches during pregnancy, and hyperhidrosis. In the spring of 2006, Dr. Loftus relocated his practice from the Texas Medical Center to Bellaire, just 5 miles west. He has been named a Texas Monthly “Super Doctor” and an H Texas magazine “Top Doctor” multiple times.