title: Cluster headache with ptosis responsive to intranasal lidocaine application: a case report.
abstract: BACKGROUND
  The application of lidocaine to the nasal mucosal area corresponding to the sphenopalatine fossa has been shown to be effective at extinguishing pain attacks in patients with a cluster headache. In this report, the effectiveness of local administration of lidocaine on cluster headache attacks as a symptomatic treatment of this disorder is discussed.
  
  
  METHODS
  A 22-year-old Turkish man presented with a five-year history of severe, repeated, unilateral periorbital pain and headache, diagnosed as a typical cluster headache. He suffered from rhinorrhea, lacrimation and ptosis during headaches. He had tried several unsuccessful daily medications. We applied a cotton tip with lidocaine hydrochloride into his left nostril for 10 minutes. The ptosis responded to the treatment and the intensity of his headache decreased.
  
  
  CONCLUSIONS
  Intranasal lidocaine is a useful treatment for the acute management of a cluster headache. Intranasal lidocaine blocks the neural transmission of the sphenopalatine ganglion, which contributes to the trigeminal nerve as well as containing both parasympathetic and sympathetic fibers.
authors.affiliation: Department of Ophthalmology, Selcuk University Selcuklu Medical Faculty, Konya, Turkey. drberkerbakbak@yahoo.com.
authors.forename: Berker
authors.initials: B
authors.lastname: Bakbak
authors.forename: Sansal
authors.initials: S
authors.lastname: Gedik
authors.forename: Bengu Ekinci
authors.initials: BE
authors.lastname: Koktekir
authors.forename: Mehmet
authors.initials: M
authors.lastname: Okka