2026 Volume 53 Issue 1 Pages 148-151
There is limited evidence supporting nerve block therapy for trigeminal autonomic cephalalgias, and its recommendation level remains low. The patient was a 61-year-old man who had experienced recurrent left orbital pain with varying characteristics for seven years and had previously been treated for paroxysmal hemicrania and trigeminal neuralgia. On this occasion, short-lasting unilateral neuralgiform headache attacks were suspected. Pharmacological treatment, including adjustment of oral medications and intravenous lidocaine administration, as well as a supraorbital nerve block, was ineffective. Pharmacotherapy was subsequently discontinued because a drug eruption developed after switching to lamotrigine. As an alternative treatment, a stellate ganglion block was performed, resulting in complete pain relief for half a day. The procedure was continued once weekly, and remission was achieved after the fifth treatment. Stellate ganglion block may represent a potential alternative or adjunctive therapeutic option for patients in whom pharmacological treatment is difficult.
