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Sluder's Syndrome - Sphenopalatine Neuralgia

This as a cause of headache has not been validated by The International Headache Society and may not be a unique entity, but instead a form of cluster headache.

This facial pain disorder is characterized by unilateral headache behind the eyes with pain in the upper jaw or roof of the mouth, with occasional aching in the back of the nose, the teeth, the temple, the occiput, ear, shoulders, or the neck. The pain is associated with nasal and/or sinus congestion, swelling or redness of nasal mucous membranes, tearing and redness of the face. This disorder is more common in women and appears to be caused by an irritation of the sphenopalatine ganglion from intranasal infection, toxicity, deformity or scarring.

The diagnosis can be made by decongesting and anesthetizing an area in the back of the nasal passage (the posterior end of the middle turbinate) usually with a cocaine agent or a mixture of afrin or neo-synephrine with lidocaine. A more permanent block can be achieved with an injection of phenol or alcohol into the greater palatine foramen which is an opening in the hard part of the roof of the mouth through which the greater palatine nerve passes. Some physicians recommend a surgical procedure known as a vidian neurectomy which is an operation in which the offending part of the nerve is removed which requires entering the maxillary sinus and removing a part of the back wall of the sinus.

References
1. The International Headache Society. The International Classification of Headache Disorders, 2nd edition. Written 2004. http://216.25.100.131/ihscommon/guidelines/pdfs/ihc_II_main_no_print.pdf
2. University of Manitoba. Accessed August 2008. http://www.umanitoba.ca/cranial_nerves/other/index.html
3. Douglas Hoffman. A Case of Contact Point Headache? http://www.doctorhoffman.com/sluder.htm
4. Steven Dankle, M.D. Organization for Community Networks. Accessed August, 2008. http://ofcn.org/cyber.serv/hwp/hwc/ent/news/ent476.html
5. The Journal of Laryngology and Otology. March 1995, Vol. 109, pp. 193-195. Experience with the xylocaine test as a prognostic aid for surgery in Sluder's neuralgia. http://journals.cambridge.org

If the above link for (1) does not work go here http://www.teethremoval.com/ihc_II_main_no_print.pdf

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