Maizels M
Department of Family Practice, Kaiser-Permanente, 5601 DeSoto Avenue, Woodland Hills, CA 91365-4084, USA.
Headache. 1999 Jun;39(6):439-42. doi: 10.1046/j.1526-4610.1999.3906439.x.
To report the consistent effect of intranasal lidocaine 4% on preventing headache following aura in one individual.
A treatment that could prevent the headache which follows an aura would be an important advance in the treatment of migraine. No migraine abortive treatment has been shown to have such an effect.
A 15-year-old adolescent boy with a history of recurrent headache since aged 2, fulfilling the criteria for migraine with aura, was seen in consultation. Intranasal lidocaine 4% was used during the aura phase to prevent the headaches.
Before using intranasal lidocaine, the patient invariably experienced a migraine following a typical visual aura. The episodes occurred approximately weekly, with a stable pattern for several years. When given during the aura, intranasal lidocaine prevented the headache following the aura, and remained successful on all but two occasions over 1 1/2 years of use (approximately 75 episodes). There was no effect on the duration of the aura itself.
Intranasal lidocaine consistently prevented the development of headache symptoms following aura in this individual. Such an effect suggests a role for the sphenopalatine ganglion in the development of migraine pain.
报告4%鼻内利多卡因对一名个体预防先兆后头痛的持续效果。
一种能够预防先兆后头痛的治疗方法将是偏头痛治疗的一项重要进展。尚无偏头痛中止治疗被证明有此效果。
一名15岁青少年男性，自2岁起有复发性头痛病史，符合伴先兆偏头痛的标准，前来咨询。在先兆期使用4%鼻内利多卡因预防头痛。
在使用鼻内利多卡因之前，患者在典型视觉先兆后总会出现偏头痛。发作大约每周一次，数年保持稳定模式。在先兆期给予鼻内利多卡因时，可预防先兆后的头痛，在超过1年半的使用时间里（约75次发作），除两次外均成功预防。对先兆本身的持续时间无影响。
鼻内利多卡因持续预防了该个体先兆后头痛症状的出现。这种效果提示蝶腭神经节在偏头痛疼痛发生中起作用。
