Intravenous lignocaine infusions for severe chronic daily headache

Area of Science:

• Neurology
• Pain Management
• Pharmacology

Background:

• Chronic daily headache (CDH) and status migrainosus represent severe, intractable headache conditions.
• Limited effective treatment options exist for severe, refractory CDH, including analgesic rebound headache.
• Intravenous lignocaine is an anesthetic agent with potential neuromodulatory effects.

Purpose of the Study:

• To evaluate the safety and efficacy of intravenous lignocaine infusion for severe chronic daily headache (CDH).
• To assess lignocaine's effectiveness in managing analgesic rebound headache and status migrainosus.

Main Methods:

• A retrospective survey of 19 consecutive patients treated between 1994 and 1998.
• Patients received intravenous lignocaine infusions for severe CDH, including rebound headache and status migrainosus.
• Outcomes assessed included adverse events, short-term headache resolution, and long-term efficacy.

Main Results:

• Twenty-seven lignocaine infusions were administered to 19 patients (16 women).
• Eighty-two percent of infusions for analgesic rebound headache (22 infusions in 18 patients) resulted in headache resolution.
• Four infusions for status migrainosus (in 3 patients) successfully relieved headache; lasting relief was achieved in some patients, while others experienced recurrence or no long-term benefit.

Conclusions:

• Intravenous lignocaine infusion demonstrates utility in managing severe, intractable chronic daily headache (CDH).
• Lignocaine infusion is a potentially effective treatment for status migrainosus.
• Further research may clarify long-term efficacy and patient selection for lignocaine therapy.