Pulsed Radiofrequency on Sphenopalatine Ganglion as the Interventional Pain Management in Cluster Headache Secondary to Sphenoid Meningioma
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Introduction: Cluster headache is one of the neurovascular headaches characterized by severe recurrent unilateral pain distributed around the orbit and accompanied by autonomic symptoms such as lacrimation, conjunctival injection nasal congestion or rhinorrhea, edema of the eyelid, sweating, and miosis. The attack usually lasts for 15 to 180 minutes. The possible mechanism of cluster headache is through the trigeminal-autonomic reflex. Management of the cluster headache is divided into pharmacological therapy including abortive and prophylaxis, as well as interventional pain management like deep brain stimulation, occipital nerve stimulation, and radiofrequency of the sphenopalatine ganglion. Objective: This report aims to demonstrate the effectivity of pulsed radiofrequency sphenopalatine ganglion on cluster headaches secondary to meningioma. Case Report: A 47-year-old female consulted the pain clinic with a chief complaint of profound facial pain for a year. The patient also reported autonomic symptoms such as rhinorrhea and lacrimation. The patient was diagnosed with meningioma and already treated with conventional therapy such as gabapentine, carbamazepine, omeprazole, and mecobalamin. Due to the location of meningioma which causes the tumor inoperable. The patient complained of constant and worsening pain, therefore pulsed radiofrequency on sphenopalatine ganglion was chosen to treat the patient. The patient reported relief of pain ever since. Discussion: Among the consequences and benefits, pulsed radiofrequency is the choice of interventional pain management. Possibly the pain from the compression of the greater palatine nerve, intervention on the sphenopalatine will cause relief of the pain. Pulsed radiofrequency on sphenopalatine ganglion was reported successful in alleviating the pain of the patient. Conclusion: Pulsed radiofrequency of the sphenopalatine ganglion successfully alleviates the pain of the cluster headache due to meningioma. However, further study with a bigger population is recommended to see the efficacy of interventional pain management objectively.
Panconesi A. Alcohol-induced headaches: Evidence for a central mechanism? J Neurosci Rural Pract. 2016 Apr 25;07(02):269–75.
Fontaine D, Santucci S, Lanteri-Minet M. Managing cluster headache with sphenopalatine ganglion stimulation: A review. Vol. 11, Journal of Pain Research. Dove Medical Press Ltd.; 2018. p. 375–81.
Wei DYT, Yuan Ong JJ, Goadsby PJ. Cluster headache: Epidemiology, pathophysiology, clinical features, and diagnosis. Vol. 21, Annals of Indian Academy of Neurology. Medknow Publications; 2018. p. S3–8.
Branco M, Rodrigues R, Lopes M, Ruano L. Cluster-Like Headache Secondary to Sphenoid Sinus Mucocele. Case Rep Neurol Med. 2018 Dec 5;2018:1–3.
Greenberg MS. Handbook of Neurosurgery. 9th ed. Greenberg MS, editor. Vol. 1. New York: Thieme Medical Publishers, Inc. ; 2020.
Hadidchi S, Surento W, Lerner A, Liu CSJ, Gibbs WN, Kim PE, et al. Headache and Brain Tumor. Neuroimaging Clin N Am. 2019 May;29(2):291–300.
International Classification of Headache Disorder. ICHD. 2018. Cluster Headache.
Tronvik E, Jensen R, Cortelli P, Cevoli S, Garcia J, Lainez MJA. Cluster Headache and other Trigeminal Autonomic Cephalgias. Leone M, May A, editors. Cham: Springer International Publishing; 2020.
Long RJ, Zhu YS, Wang AP. Cluster headache due to structural lesions: A systematic review of published cases. World J Clin Cases. 2021 May 16;9(14):3294–307.
Polyzoidis S, Koletsa T, Panagiotidou S, Ashkan K, Theoharides TC. Mast cells in meningiomas and brain inflammation. Vol. 12, Journal of Neuroinflammation. BioMed Central Ltd.; 2015.
Krystel-Whittemore M, Dileepan KN, Wood JG. Mast cell: A multi-functional master cell. Vol. 6, Frontiers in Immunology. Frontiers Media S.A.; 2016.
Long RJ, Zhu YS, Wang AP. Cluster headache due to structural lesions: A systematic review of published cases. World J Clin Cases. 2021 May 16;9(14):3294–307.
Kou L, Huang J, Xu Y, Han C, Ma K, Guo X, et al. Cluster-Like Headache Secondary to Anamnesis of Sphenoid Ridge Meningioma: A Case Report and Literature Review. Front Neurol. 2019 Jan 25;10.
Li J, Ren H, Wang B, Wu D, Luo F. Multicentre, prospective, randomised, controlled, blinded-endpoint study to evaluate the efficacy and safety of pterygopalatine ganglion pulsed radiofrequency treatment for cluster headache: study protocol. BMJ Open. 2019 Mar 23;9(3):e026608.
Fang L, Jingjing L, Ying S, Lan M, Tao W, Nan J. Computerized tomography-guided sphenopalatine ganglion pulsed radiofrequency treatment in 16 patients with refractory cluster headaches: Twelve- to 30-month follow-up evaluations. Cephalalgia. 2016 Feb 20;36(2):106–12.
Láinez MJA, Puche M, Garcia A, Gascón F. Sphenopalatine ganglion stimulation for the treatment of cluster headache. Vol. 7, Therapeutic Advances in Neurological Disorders. 2014. p. 162–8.
Goadsby PJ, Sahai-Srivastava S, Kezirian EJ, Calhoun AH, Matthews DC, McAllister PJ, et al. Safety and efficacy of sphenopalatine ganglion stimulation for chronic cluster headache: a double-blind, randomised controlled trial. Lancet Neurol. 2019 Dec;18(12):1081–90.
Ho KWD, Przkora R, Kumar S. Sphenopalatine ganglion: block, radiofrequency ablation and neurostimulation - a systematic review. J Headache Pain. 2017 Dec 28;18(1):118.
Park D, Chang MC. The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review. Journal of Yeungnam Medical Science. 2022 Jul 31;39(3):200–5.
Sam J, Catapano M, Sahni S, Ma F, Abd-Elsayed A, Visnjevac O. Pulsed Radiofrequency in Interventional Pain Management: Cellular and Molecular Mechanisms of Action - An Update and Review. Pain Physician. 2021 Dec;24(8):525–32.
Fei Y, Huang B, Deng J, Xu L, Yao M. Efficacy of Dorsal Root Ganglion Pulsed Radiofrequency Combined with Paravertebral Injection of Recombinant Human Interferon-α2b in Herpetic Neuralgia. J Pain Res. 2021 Mar;Volume 14:711–9.
Li J, Yin Y, Ye L, Zuo Y. Pulsed radiofrequency of C2 dorsal root ganglion under ultrasound guidance for chronic migraine: a case report. J Pain Res. 2018 Sep;Volume 11:1915–9.
Elahi F, Ho KWD. Successful Management of Refractory Headache and Facial Pain due to Cavernous Sinus Meningioma with Sphenopalatine Ganglion Radiofrequency. Case Rep Neurol Med. 2014;2014:1–4.
Ornello R, Palmisani S, Murphy M, Sacco S, Al‐Kaisy A, Lambru G. Sphenopalatine Ganglion Pulsed Radiofrequency for the Treatment of Refractory Chronic SUNCT and SUNA: A Prospective Case Series. Headache: The Journal of Head and Face Pain. 2020 May 23;60(5):938–45.
Elahi F, Ho KWD. Successful Management of Refractory Headache and Facial Pain due to Cavernous Sinus Meningioma with Sphenopalatine Ganglion Radiofrequency. Case Rep Neurol Med. 2014;2014:1–4.
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