Intranasal Lidocaine Spray for Trigeminal Autonomic Cephalgia, Simple and Effective Treatment Modality: A Case Series of Five Patients.

BACKGROUND

Sphenopalatine ganglion block (SPGB) is a potential treatment option for trigeminal autonomic cephalgia (TAC) performed fluoroscopically or endoscopically. We explored the role of noninvasive SPGB via intranasal application of lidocaine (INL) in hemicrania continua (HC) and probable TAC.

CASE REPORT: In 4 patients of HC, INL spray decreased baseline acute attacks from Numeric Rating Scale (NRS-11) 8-10/10 to nil acute attacks and baseline continuous NRS-11 from 2-6/10 to 0-2/10 in 3 months. In patient of probable TAC, multiple acute attacks a day of NRS-11 10/10 decreased to NRS-11 1-2/10 in 3 months follow-up, with acute attacks of 1-2 in a day.

CONCLUSIONS

Ten percent INL spray may be used as noninvasive treatment modality for HC and probable TAC, both for acute attacks and decreasing basal continuous pain.