Epione..the pain clinic

21/04/2021

02/10/2019

SPHENOPALATINE GANGLION BLOCK (SPG)

This is a ganglion,a bunch of nerves, present behind our cheek bone adjacent to the nasal bone and controls the pain of almost the whole of the head and neck region.

In cases of chronic non remitting headaches this becomes the site of target for further management when the patient and doctor both are frustrated with the poor relief provided by the medicine. Especially in the following ailments which generally are described non scientifically as headache.
Cluster headache
Migraine
Trigeminal neuralgia
Post herpetic neuralgia (PHN)
Paroxysmal hemicrania
Cancer of the head or neck
Facial pain that is atypical
Complex regional pain syndrome (CRPS)
Temporomandibular disorder
Nasal contact point headache
Vasomotor rhinitis

This procedure is a boon for the chronic migraine patients who are on pregnant and the medicines they are taking may jeopardize the health of their unborn baby,
This procedure is done in an awake patient, lying head up, with x ray support. Patient only feels the pain of a single needle prick that is used to give local anesthesia ( numbing the area where procedure is to be done). A specialized needle is then guided to the exact location of the nerve bunch behind the nose under observation.
After the pain Physician is sure about the RIGHT placement of the needle, a larger amount of energy is passed through the needle and Pain Carrying capacity of the nerve is reduced.
Side effects of the procedure are not many but does include partial relief, local hematoma and bruise, paraesthesia,
Patient needs to be fasting for at least 4 hours prior to the procedure and avoid the last pain killer so that pain relief could be judged at the best.
Live pain free.

23/09/2019

WHEN HEADACHES BECOME HEADACHE

Headaches are the most common health condition. Almost every living human gets headache at least once in a lifetime. The reasons may be as simple as loss of regular sleep, and missing a timely cup of tea, traffic snarls or as complicated as a brain tumor, bleeding inside the head (intracranial hemorrhage ) or brain contusion.
International headache society classifies headaches in two major groups :

Primary i.e. Where no other pathology could be identified and the only symptom is headache e.g. migraine or cluster headaches or

Secondary headaches: when a clear separate pathological entity can be identified e.g. brain tumor etc.
Whereas secondary headaches are treated by getting rid of or treating the underlying pathology, primary headaches are difficult to treat.
Sometimes these can be kept in control with medicine. But in most instances the headaches get a difficult to manage with medicine only and it becomes frustrating for the physicians as well as the patients. It also becomes problematic for the family members to keep changing from one physician to another in hunt of a better remedy.

In such patients interventions, minimal invasive procedures, are a boon. SPHENOPALATINE GANGLION block and TRIGEMINAL GANGLION block by using RFA (radio-frequency ablation) is a promising procedure. This involves delivering electric energy to the nerves that cause headache and control it's intensity. By delivering electric energy we produce heat around the nerve and reduces it's capacity to carry pain. This technique reduces the pain to a large extent.

People suffering from chronic long term headache that is not getting relieved by medicine can get a benefit to of this procedure.

For any queries and logistics plz feel free to call Dr Rohit Gulati @9891421992

04/09/2019

One of the many appriciation letters, recieved recently

30/08/2019

Recently treated an Assamese patient for peripheral vascular disease ( low blood supply in right leg n foot) with ischaemic changes already set in, with severe claudication ( pain on walking). She turned up for a "THANK YOU" today with her family.

25/08/2019

Meeting an old patient, from Uganda, after 3 long years. Had treated her for low back pain then. In perfect condition now.

11/08/2019

Getting recognized by our parallel facility. Took a lecture and getting facilitated at ORTHOPEDIC UPDATE at ITC, MAURYA , NEW DELHI.

21/07/2019

An Oman national, suffering from Vascular insufficiency in left upper limb, on the verge of hand getting amputated. Hand having severe pain with one finger already amputated.

Treated with cervical sympathectomy.

The blood flow returned, PAIN VANISHED, amputation deferred,

He blessed me so many times. A great feeling getting hugged and missed and blessed by a patient and the thankful family.

26/04/2019

Promoting Pain Management at BLK.