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        New Message Board Archives >> Medications, Treatments, Therapies 2005 >> Sympathetic nerve injection--remission!
        
(Message started by: zrmulcahy on Mar 7^th, 2005, 9:15am)

Title: Sympathetic nerve injection--remission!
Post by zrmulcahy on Mar 7^th, 2005, 9:15am

Here's what seems to be a promising treatment I hadn't heard about before. It put 8 of 11 patients into remission (for a median of 8 mo.), and 2 of the other 3 had complicating factors that may have made it less effective. One kept drinking alcohol during the treatment period and the other was addicted to opiates. The injection is also relatively noninvasive and uncomplicated, compared to some of the other surgeries they try for clusters. I believe the C7 transverse process refers to the C7 vertebra, so the injection would be to the spine, not the head. Read on.

Headache: The Journal of Head and Face Pain
Volume 44 Issue 2 Page 183 - February 2004
doi:10.1111/j.1526-4610.2004.04038.x

Brief Communication
Cluster Headache and the Sympathetic Nerve
J. Albertyn, MB, ChB, MMed; R. Barry, MB, ChB, MMed; C. L. Odendaal, MB, ChB, MMed, GFN (SA)

Objective.To determine the effect of a sympathetic block at C7 on cluster headache.

Backround.Eleven patients presenting to a pain control unit with cluster headache were included in the study after giving informed consent.

Methods.In all patients, a mixture of 5 mL of 0.5% bupivacaine hydrochloride and 1 cc of methylprednisolone acetate was injected onto the base of the C7 transverse process.

Results.The injection was applied during the acute phase of headache in 6 patients and all experienced immediate and complete relief. The other 5 patients received the injection between attacks. Of the 11 patients treated, 8 went into remission by aborting the cluster. In some patients, repeated injections were given before the cluster was aborted. Three patients did not respond to treatment. One patient with chronic paroxysmal hemicrania experienced pain relief of the acute attack after treatment, but the procedure did not abort the subsequent attacks. A surgical sympathectomy removing the stellate ganglion rendered him pain-free for 15 months after which he was lost to follow-up.

Conclusion.Blocking the sympathetic nerve aborts an acute attack of cluster headache and may play a major role in aborting the cluster. Although only one patient with chronic paroxysmal hemicrania responded to surgical sympathectomy, this procedure may be considered as an alternative if there is poor response to oral medication or a sympathetic block.
In conclusion, a new and simple method for treating cluster headache is presented. Sympathetic nerve block can be recommended in the treatment of cluster headache because of its simplicity and lack of complications.

Title: Re: Sympathetic nerve injection--remission!
Post by Bob_Johnson on Mar 8^th, 2005, 9:10am

Thanks for an interesting report. Now--we wait and see if others report this approach and outcomes. The frustrations around Clusters is seeing new treatments come and go....

Title: Re: Sympathetic nerve injection--remission!
Post by floridian on Mar 8^th, 2005, 9:24am

Nerve blocks sometimes work - and this procedure sounds like it works better than other types of nerve blocks. People on the board have had a variety of nerve blocks, and they frequently wear off after a week or so. But a better nerve block is a good thing.

Some acupuncture procedures are similar to nerve blocks. But the current track record for acupuncture and cluster headaches is not good - maybe someday.

http://www.med-owl.com/clusterheadaches/tiki-index.php?page=Acupuncture

Title: Re: Sympathetic nerve injection--remission!
Post by wideglide on Mar 9^th, 2005, 2:15pm

Thanks for the report, but I gotta ask why you left the other thread on this board hangin'? What happened after the wedding? "Enquiring minds" wanna know...

............wg [smiley=huh.gif]

Title: Re: Sympathetic nerve injection--remission!
Post by zrmulcahy on Mar 9^th, 2005, 11:39pm

Ran into a setback gathering supplies. I'll definitely update as soon as I try it.