Bilateral Sphenopalatine Ganglion Blocks for Refractory Burning Mouth Syndrome

BACKGROUND: Burning mouth syndrome (BMS) is a debilitating condition that produces a burning pain of the oral cavity and does not have identifiable inciting factors. There are no established treatments, but neuropathic medications have been trialed with variable efficacy. Utilizing targeted nerve blocks could provide therapeutic benefit when treating patients with refractory BMS symptoms. CASE REPORT: This case describes the treatment of a 61-year-old woman with BMS who presents with refractory symptoms despite maximum dose trials of neuropathic medications. She was successfully treated using bilateral sphenopalatine ganglion blocks. The patient reported a decrease in pain from 7/10 to 1/10 one day after the procedure and described a 90% benefit. CONCLUSIONS: Bilateral sphenopalatine ganglion blocks should be considered to treat refractory BMS. KEY WORDS: Refractory burning mouth syndrome, burning tongue, stomatodynia, nerve block, local anesthesia, pain management