Individuals with refractory migraines have persistent debilitating headaches that are unresponsive to standard treatments.
A recent study published in the journal Regional Anesthesia & Pain Medicine reports that patients hospitalized with refractory migraines showed a significant reduction in pain at discharge following intravenous infusions of lidocaine along with other medications. Although the effects of the treatment started to wane by the end of the month, around 43% of patients showed sustained improvements in pain intensity at 1 month. The patients studied had the most severe form of refractory migraine, and even such temporary relief from headaches can lead to significant improvements in their quality of life.
A migraine is a neurological condition involving debilitating pulsing or throbbing headaches, often accompanied by increased sensitivity to sounds and light, nausea, and vomiting. Migraines can occur either intermittently or on a chronic daily basis. Individuals with chronic migraines experience headaches more than 15 times a month, with at least 8 days of migraines. Chronic migraines affect about 1.4-2.2% of the global population and are highly disabling, with a negative impact on occupational and social life. A significant minority of individuals with chronic migraines do not respond to standard treatments. Such headaches are referred to as refractory chronic migraines. Individuals with chronic migraines who do not respond to outpatient interventions and exhibit severe symptoms require hospitalization. Treatments for such chronic migraine patients include intravenous infusions of various drugs such as nonsteroidal anti-inflammatory drugs, corticosteroids, and neuroleptics. Intravenous infusions of lidocaine, a local anesthetic commonly used to relieve pain, have shown promise for the inpatient treatment of chronic headaches. Although its mechanism of action remains unknown, lidocaine could relieve headaches by modulating brain pathways involved in pain or reducing inflammation associated with migraines.
