Ients with cluster headache turn out to be chronic [1], with Solvent Yellow 16 manufacturer severe repercussion in hisher everyday activities and poor excellent of life. Inhibiting sphenopalatine ganglion (SPG) could suppress the crisis [2], but its access is quite tough requiring aggressive techniques [3]. Tx360 D-Galacturonic acid (hydrate) medchemexpress device is actually a nasal applicator created of plastic material easing the access for the SPG and also the application of nearby anaesthetic in its vicinity with minor inconveniencies [4]. Materials and methods Twelve blocks (three each and every week in the course of four weeks), of your SPG have been performed with Bupivacaine 0,5 (0,three cc every single nostril), using the Tx360 device. We evaluate at the finish of your 12th block (four weeks), efficacy parameters (imply reduction of attack frequency and headache days), impact (Headache Effect Test [HIT-6]), and high quality of life (MigraineSpecific High-quality of Life Questionary [MSQ]), tools. We also analysed 30 and 50 response rates. Outcomes Five sufferers refractories to regular oral therapies were treated (four M, 1 F; mean age 41,6 11,8). At the 12th block there was a important reduction in imply attack frequency (6 vs. 15, p 0,00002), and mean discomfort intensity (7 vs. 9,6, p 0,005), not in imply headache days (18,6 vs 26, p 0,15). There was a considerable reduction in mean HIT-6 (63 vs. 71), and MSQ (57 vs. 68). Four patients (80 ), had a 50 or higher reduction in attack frequency, and two (20 ), in headache days. There have been no significant adverse events but minor and transient local discomfort; only a single patient suffer a syncope two hours soon after the second block, possibly not associated for the procedure. Conclusions Repetitive blocks of the SPG with all the Tx360 device appear to become an effective remedy in chronic cluster headache, with minor adverse events. These advantages have been evident both in attack frequency and in top quality of life measures. While encouraging these benefits have to be confirmed inside a greater number of patients, and know how long they may last. This therapy possibly ought to be attempted before invasive remedies, with much more serious adverse events.References 1. Goadsby PJ. Pathophysiology of cluster headache: A trigeminal autonomic cephalalgia. Lancet Neurol. 2002;1:251-257. two. Tepper SJ, Caparso A. Sphenopalatine Ganglion (SPG): Stimulation, Mechanism, Safety, and Efficacy. Headache. 2017;57:14-28. three. Narouze S, Kapural L, Casanova J, et al. Sphenopalatine ganglion radiofrequency ablation for the management of chronic cluster headache. Headache. 2009;49:57177. 4. Candido KD, Massey ST, Sauer R, Darabad RR, Knezevic NN. A novel revisi towards the classical transnasal topical sphenopalatine ganglion block for the treatment of headache and facial discomfort. Pain Physician. 2013;16:E769-78.P12 Total detoxification could be the most successful therapy of medication-overuse headache: A randomized controlled open-label trial Louise N Carlsen, Signe B Munksgaard, Rigmor H Jensen, Lars Bendtsen Danish Headache Center, Department of Neurology, RigshospitaletGlostrup, Lars Bendtsen; Ndr. Ringvej 69, 2600 Glostrup, Denmark Correspondence: Lars Bendtsen ([email protected]) The Journal of Headache and Discomfort 2017, 18(Suppl 1):P12 Background: There’s lack of proof on how to detoxify medication-overuse headache (MOH). The aim was to compare the impact of total stop of acute medication with restricted intake. Methods: MOH-patients had been integrated in a prospective, outpatient study and randomized to two-month detoxification with either A) no analgesics or acute migraine-medication, or B) acute me.
