Sphenopalatine Ganglion (SPG) Block
Targeted nerve block for migraine, cluster headache, and facial pain — MiRx™ intranasal protocol available, as well as fluoroscopy- and ultrasound-guided approaches, performed by Tzvi Grossman, MD.
Targeting the Gateway to Facial Pain
The sphenopalatine ganglion (SPG) is a parasympathetic nerve cluster located in the pterygopalatine fossa behind the nose. It plays a central role in the transmission of pain signals associated with migraines, cluster headaches, trigeminal autonomic cephalalgias, and atypical facial pain. Blocking this ganglion interrupts the pain pathway, providing rapid and often sustained relief.
Dr. Grossman offers multiple delivery approaches depending on patient anatomy, pain presentation, and clinical context — including the minimally invasive MiRx™ intranasal catheter protocol, as well as traditional fluoroscopy-guided and ultrasound-guided approaches for precise anatomical targeting.
Conditions Treated
- Episodic and chronic migraine
- Cluster headache
- Trigeminal neuralgia and facial pain
- Atypical facial pain syndromes
- Sphenopalatine neuralgia (Sluder's syndrome)
- Post-dural puncture headache
Delivery Approaches
- MiRx™ Intranasal: Catheter delivers anesthetic via nasal mucosa — no needles, tolerated by most patients
- Transnasal (cotton-tipped applicator): Classic technique
- Fluoroscopy-guided: Infrazygomatic approach, contrast confirmed
- Ultrasound-guided: Real-time visualization of pterygopalatine fossa
What to Expect
- Office-based procedure: 15–30 minutes total
- Minimal discomfort with topical anesthesia
- Immediate relief often experienced during procedure
- Series of blocks often recommended for chronic conditions
- Radiofrequency ablation of SPG available for long-term relief
Ideal Candidates
- Inadequate response to oral migraine prophylactics
- Frequent headache days (≥8–15/month)
- Cluster headache in active cycle
- Facial pain with autonomic features