Intravenous lignocaine infusions for severe chronic daily headache.
OBJECTIVE
To determine the safety and efficacy of intravenous lignocaine infusion in patients with severe chronic daily headache (CDH).


METHODS
Retrospective survey of consecutive patients.


METHODS
19 patients, 18 with rebound headache and three with status migrainosus. Two patients had both conditions at different times.


METHODS
Neurology unit in a major metropolitan teaching hospital, 1994-1998.


METHODS
Adverse events; headache resolution; long term efficacy.


RESULTS
The 19 patients (16 women) received 27 lignocaine infusions. Seven minor adverse events were noted during four infusions. Twenty-two infusions were given for analgesic rebound headache in 18 patients, with headache resolution in 82% of infusions (17 of the 18 patients responded at least once). Four patients obtained lasting relief, six returned to their regular manageable pattern of migraine (in two of these patients CDH recurred after six months), four were lost to follow-up, and in four there was no long term benefit. Five infusions were given for status migrainosus in three patients, with four of these infusions successfully relieving the headache.


CONCLUSIONS
Intravenous lignocaine appears to be useful in the management of severe intractable CDH and status migrainosus.
Hand
P J
PJ
Department of Neurology, Alfred Hospital, Melbourne, VIC.
Stark
R J
RJ
D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002908:Chronic Disease; D002985:Clinical Protocols; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D012189:Retrospective Studies; D018781:Tension-Type Headache / Q000188:drug therapy*; D016896:Treatment Outcome
D000779:Anesthetics, Local; D008012:Lidocaine