The stimulation of the Sphenopalatine Ganglion (SPG) is, besides various invasive and minimally invasive operative procedures, a new treatment method for therapy-resistant cluster headache patients. The aim of our systematic review is to compare the efficacy and safety of SPG stimulation with no treatment.

The available evidence indicates that the stimulation of the SPG concerning the efficacy is superior to no treatment, but mainly due to procedure- and device related complications, and should be considered only for therapy-resistant chronic cluster headache patients. Our results are based on only one RCT which does not contain long-term follow-up data and shows some limitations. There is not sufficient evidence to demonstrate the superiority of SPG stimulation for patients with therapy-resistant cluster headache compared to no treatment.

At present, we recommend against the inclusion of SPG stimulation in the Austrian BMG catalogue of procedures and suggest a re-evaluation in 2019.