The Journal of Headache and Pain

Official Journal of the "European Headache Federation" and of "Lifting The Burden - The Global Campaign against Headache"

The Journal of Headache and Pain Cover Image

Volume 15 Supplement 1

Abstracts from the 4th European Headache and Migraine Trust International Congress: EHMTIC 2014

Open Access

EHMTI-0191. A novel approach for the treatment of cluster headache – onabotulinumtoxina block of the sphenopalatine ganglion

  • D Bratbak1,
  • S Nordgård1,
  • L Stovner1,
  • M Linde1 and
  • E Tronvik1
The Journal of Headache and Pain201415(Suppl 1):E4

Published: 18 September 2014


Primary EndpointTherapeutic PotentialCluster HeadachePatient NumberComplete Study


Blockade of the sphenopalatine ganglion with OnabotulinumtoxinA injections (SphenoBlock) represents a novel approach for treating intractable chronic cluster headache (iCCH).


The aim of this pilot study was to explore the safety aspects and therapeutic potential of SphenoBlock.


After signing written confirmed consent ten patients with iCCH were injected with 25 U (n=5) or 50 U (n=5) onabotulinumtoxinA towards the sphenopalatine ganglion in an observational study, approved by the Institutional Review Board, with 6 months follow-up. The procedure was performed with a novel image-guided technique. The primary endpoint was to evaluate safety of the procedure, but change in attack frequency from baseline to week 4, 12 and 24 was also registered.


Data for the first 5 patients are presented. One patient experienced intermittent ipsilateral visual deficits lasting 4 weeks. Patient number 5 was a failed injection. Four patients were defined as frequency responders (>50% reduction from baseline) in week 4, 3 patients responded in week 12, and 2 patients in week 24 (Figure 1). Complete study data will be presented at the meeting.

Figure 1


SphenoBlock in iCCH shows promising preliminary results and give reasons for cautious optimism for further studies on this low-cost alternative treatment of iCCH.

Authors’ Affiliations

Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway


© Bratbak et al; licensee Springer. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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