Topical Lidocaine for Migraine Treatment

Topical Lidocaine Appears Promising as Treatment for Migraine

This is an interesting article because of its implications. A few things to consider. Migraines are believed to be related to some sort of electrical disturbance within the brain itself. If this is the case, then why would a topical anesthetic have an effect on these migraines? The author suggests that the lidocaine may affect the trigeminal ganglion, the housing for the cell bodies of the neurons going to many areas of the face. Could it be that many migraines are misdiagnosed, and the vast majority of them are truly tension-type headaches? There is still so much we do not understand about the human nervous system.

(Annual meeting, American Society for Clinical Pharmacology and Therapeutics) Dr. Frederick Freitag and Dr. E. Lockhart of the Diamond Headache Clinic in Chicago ran a placebo-controlled trial of 40 patients with migraine without aura. Among those using lidocaine, pain rated on a 10-point scale declined from a mean of 6.93 at baseline to 5.51 at 2 hours, and to 1.70 at 8 hours, a significant reduction compared with placebo. Seven patients who used lidocaine were pain-free at 2 hours and eight were pain-free at 8 hours. Some subjects reported a tingling or burning sensation, but there were no significant adverse effects. According to Dr. Freitag, previous studies have shown that IV and nasally administered lidocaine relieve migraine pain, most likely by desensitizing the trigeminal nerve. The lidocaine patch could be used on its own or as an adjunct to other medications, Dr. Freitag noted. “When patients get a migraine attack, it takes a while for the normal oral medication to work, while this provides relief very quickly.” He added, “We foresee people using it primarily as a mainstay of therapy.”

 

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