SPG Pulsed Radiofrequency for Chronic Cluster Headache

The Efficacy and Safety of Sphenopalatine Ganglion Pulsed Radiofrequency Treatment for Chronic Cluster Headache

Cluster headache (CH) is a devastating disorder characterized by ipsilateral headache and associated trigeminal autonomic symptoms, with a yearly prevalence of 0.1%. There is a huge clinically unmet demand for an effective therapeutic method for CH. Previous evidences indicate that pulse radiofrequency (PRF) targeting the sphenopalatine ganglion (SPG) is a safe, minimally invasive, effective treatment for CH. This randomized, controlled trial aimed to establish the safety and efficacy of SPG PRF for patients with chronic CH.

Inclusion Criteria:

• Chronic cluster headache;
• At least four attacks per week;
• Minimum age of 18 years;
• Non-response to verapamil and lithium treatment in the past, intolerance, or contraindication to verapamil and lithium, along with non-response, intolerance, or contraindica-tion to topiramate, or gabapentin.

Exclusion Criteria:

• Pregnancy or breastfeeding;
• Presence of cardiac pacemaker or other neuromodulatory devices;
• Pyschiatric and cognitive disorders;
• Serious drug habituation or overuse of acute-headache medication;
• History of stroke or intracranial aneurysm, or at risk for serious or acute cardiovascular events;
• Infection at the puncture site;
• Previous history of invasive treatments such as sphenopalatine ganglion radiofrequency thermocoagulation and chemical destruction.