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Related Experiment Videos

Cluster headache. Local anesthetic abortive agents.

J P Kittrelle, D S Grouse, M E Seybold

    Archives of Neurology
    |May 1, 1985
    PubMed
    Summary

    Topical lidocaine rapidly relieves acute cluster headaches by numbing the sphenopalatine fossa, indicating an anesthetic mechanism, not sympathomimetic. This offers a safe, nonaddicting treatment option for cluster headache pain.

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    Area of Science:

    • Neurology
    • Pain Management
    • Pharmacology

    Background:

    • Cluster headaches are intensely painful neurological events.
    • Cocainization of the sphenopalatine fossa rapidly aborts acute cluster headaches.
    • The mechanism of cocaine's action (sympathomimetic vs. local anesthetic) was previously unknown.

    Purpose of the Study:

    • To determine if local anesthetic effects are responsible for cocaine's cluster headache relief.
    • To investigate lidocaine as a safe, nonaddicting alternative for cluster headache treatment.
    • To elucidate the mechanism of action for cocaine in aborting cluster headaches.

    Main Methods:

    • A 4% lidocaine solution was applied to the sphenopalatine fossa in patients with cluster headache.
    • Patients received lidocaine for both nitrate-induced and spontaneous cluster headache attacks.
    • The study compared lidocaine's efficacy to cocaine's known effects.

    Main Results:

    • Four out of five patients experienced rapid relief from cluster headaches and associated symptoms after lidocaine application.
    • Lidocaine proved effective in aborting both induced and spontaneous cluster headache attacks.
    • The findings suggest an anesthetic, rather than sympathomimetic, action is responsible for pain relief.

    Conclusions:

    • Local anesthetic effects, not sympathomimetic actions, mediate cocaine's cluster headache abortive properties.
    • Pain transmission in cluster headaches likely involves the sphenopalatine fossa.
    • Topical lidocaine is a safe and effective agent for the rapid abortion of acute cluster headaches.

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