Intranasal Lidocaine for Migraine Relief
Migraine is a painful condition characterised by recurrent attacks of headache, with or without associated visual and gastrointestinal disturbances. It affects 17% of adult women and 6% of adult men. The cause is unknown but evidence suggests its a disturbance in intra- and extracranial circulation. Migraine may occur at any age but usually begins between the ages of 10 and 30 years of age, more often in women than men. Attacks may occur daily or once every several months with each episode lasting a few hours to days if left untreated. Nausea, vomiting and photophobia may also be associated symptoms. Due to the shortcoming of oral treatment a new alternative has been developed.
Nasal drops containing the anaesthetic lidocaine can provide quick relief for migraine headaches, though relapses are likely, according to an article in the July 24, 1996 issue of The Journal of the American Medical Association (JAMA). Morris Maizels, M.D., from the Department of Family Practice, Southern California Permanente Medical Group, Woodland Hills, CA, and colleagues evaluated the effectiveness of intranasal lidocaine for treatment of acute migraine headache.
The researchers found: “Intranasal lidocaine provided rapid and effective relief of pain in approximately 55 percent of patients with migraine headache in our urgent care population. Most of the effect occurred within five minutes, and nausea and photophobia (an abnormal sensitivity or intolerance to light) were similarly relieved. For patients for whom follow- up data were available, 42 percent of lidocaine responders had relapse of headache to a moderate or severe intensity.” They continue: “The onset of relapse with lidocaine, however, was usually within one hour. For the rest of the group, intranasal lidocaine effectively terminated a headache episode without relapse. The rapid relief is consistent with the pharmacological properties of lidocaine. “The study included 81 patients (67 women and 14 men) with a chief complaint of headache who fulfilled criteria of the International Headache Society for migraine. Patients were randomised in a 2:1 ratio to receive a four percent solution of intranasal lidocaine or saline placebo, respectively. The primary outcome measure was at least 50 percent reduction of headache within 15 minutes after treatment. Reduction in pain intensity of 50 percent was significant within 5 minutes. Complete or near complete relief of headache was seen in 21 percent of lidocaine patients and seven percent of control patients. The researchers found that of those participants who received relief within five minutes of using intranasal lidocaine, 58 percent had persistent symptom relief for the 24-hour period follow-up. Adverse effects were limited to local symptoms of burning and numbness in the nose or in and around the eye. Numbness in the throat was often associated with a sense of gagging. These local symptoms were noted almost exclusively in the lidocaine group. The theoretical site of action of intranasal lidocaine is the sphenopalatine ganglion (SPG) that are located at the back of the nasal passages. By the anaesthetic action of lidocaine on the SPG the impulses sent out are nullified and in most cases the pain is erased.
Migraine Relief is a lidocaine intranasal solution available in a convenient 15ml nasal spray bottle. One to two sprays are applied into the nostril/s of the affected side (headache) only as soon as possible. After blowing your nose to clear your nostrils tilt the head back and insert nasal applicator into affected side nostril while blocking the other nostril with your finger. Press down on the pump while breathing deeply through the nostril. If the headache is bilateral (both sides of the head) apply spray into both nostrils. If it is unilateral (one side of the head) it is sprayed into the nostril of the affected side. Lidocaine nasal spray is available from our laboratory – contact us for details.
Precautions
Allergy to lidocaine or local anesthetics, a history of cardiac arrhythmias.
