Sphenopalatine Ganglion Block for Postacute Sequelae SARS-CoV-2 Infection Headaches: A Case Report and Review of the Literature.

BACKGROUND

In a subset of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), neurological symptoms including "brain fog" and headache persist beyond the acute phase of the infection, often referred to as postacute sequelae SARS-CoV-2 infection (PASC), or Long COVID. Current practice supports a multi-modal approach to address PASC symptoms. One technique for chronic headaches not utilized for PASC is sphenopalatine ganglion blocks (SPGB). We evaluate the pathophysiology of PASC headaches, review the utilization of sphenopalatine ganglion blocks in primary headaches, and discuss the potential for SPGB in PASC headaches.

CASE REPORT: We present a patient with PASC headaches who failed various conservative and interventional therapies. Worsening symptoms resulted in pursuing bilateral SPGB, resulting in an 80% improvement in symptoms. To our knowledge, we report the first PASC headache treated with an SPGB via infrazygomatic injection.

CONCLUSION

SPGB can treat PASC headaches and improve a patient's quality of life.