A new, minimally invasive treatment that sprays lidocaine directly onto nerves in the back of the nose offers chronic migraine sufferers sustained relief from pain, according to a new study. The research, presented March 1 at the Society of Interventional Radiology’s Annual Scientific Meeting in Atlanta, revealed a 36 percent decrease in pain levels for up to 30 days following the procedure.
“Migraine headaches are one of the most common, debilitating diseases in the United States, and costs and side effects of medicine to address migraines can be overwhelming,” lead researcher Kenneth Mandato, MD, a vascular and interventional radiologist at Albany Medical Center in New York, said in a Society news release.
“Intranasal sphenopalatine ganglion (SPG) blocks are image-guided, targeted, breakthrough treatments. They offer a patient-centered therapy that has the potential to break the migraine cycle and quickly improve patients’ quality of life,” he added.
For the study, Mandato and his colleagues followed 112 patients who had been diagnosed with migraines or cluster headaches, another type of extremely painful and cyclical headache. The average age of study participants was 45.
Before treatment, patients were asked to rate their level of pain on a visual analog scale (VAS) ranging from 1 to 10. Pre-treatment levels averaged 8.25, with scores greater than 4 occurring at least 15 days of the month.
During treatment – which did not involve injections or sedation – researchers inserted a “spaghetti-sized” catheter into the nasal passages of each patient and administered 4 percent lidocaine to the SPG, a nerve bundle just behind the nose associated with migraines. The spray was applied to both nostrils.
On the day following the SPG block, study participants reported average pain levels were halved, dropping to an average VAS score of 4.10. Thirty days after the procedure, patients reported an average pain level of 5.25, a 36 percent decrease from pre-treatment scores. Although 6 percent of the participants saw no improvement in their condition, 88 percent said they used less pain relief medication after the treatment.
As to how the treatment works, Mandato explained in the news release: “Administration of lidocaine to the sphenopalatine ganglion acts as a ‘reset button’ for the brain’s migraine circuitry. When the initial numbing of the lidocaine wears off, the migraine trigger seems to no longer have the maximum effect that it once did.”
Mandato acknowledged that SPG blocks are not a cure for migraines, but rather a temporary option for treatment of chronic headaches. The research team will continue to follow study participants for six months to determine how long the nasal spray provides pain relief. Because the procedure is minimally invasive, Mandato believed patients could repeat the procedure if necessary.
Credit : Dr. Ashutosh Marwah (Pediatric Cardiologist 20 Years Experience)
