Nasal spray treatment promises lasting cure for Migraine sufferers
Those suffering from perpetual and acute migraines can now hope to get well from a preliminary study that suggests delivering the anesthetic lidocaine (Xylocaine) directly to a mass of nerves behind the nasal cavity provides considerable relief to sufferers, but it remains to be seen if the procedure would provide a significant cure that lasts for several months and applicable to a larger group of patients.
According to Dr. Kenneth Mandato, a vascular and interventional radiologist at Albany Medical Center in Albany, NY, and the study’s lead author, the technique is “a minimally invasive treatment option,” and he considers the procedure “a clear simple alternative” to standard migraine treatments.
“This nasal spray option is safe, convenient and innovative,” Mandato said.
For the study, the researchers recruited 112 patients aged around 45 years – but all diagnosed with migraines or some other intensely painful and cyclically occurring headache, known as cluster headaches.
The participants were asked to indicate their pain levels on a standardized scale of 1-10, and then they underwent an “image-guided therapy” session where a spaghetti-sized catheter was inserted into the nostril and through the nasal passage to deliver a dose of lidocaine to the nerve center called the – sphenopalatine ganglion. This was done for both nostrils.
According to Mandato, the participants did not need to undergo any sedation before the procedure is carried out, and that the target nerve bundle “resembles a complex highway crossing with many [nerve] signals and exits going in all directions.” The hope of the researchers was to directly deliver lidocaine into a nerve center that short-circuits the headache’s causing pathway.
Some patients reported a drop in their migraine levels the day after the procedure, and for some others, the pain actually rose marginally nearly a week after the procedure. This shows the treatment is not suitable for everyone. Seven of the participants or 6% of them reported they did not derive any relief or benefit from the procedure, but 88% stated they would actually be requiring less pain relievers to deal with their migraines following the procedure.
Mandato and his team admit the procedure delivers a temporary relief and would have to be repeated often for longer results. Dr. Richard Lipton, director of the Montefiore Headache Center in New York City, said he found the study “very dramatic.”
“Unmet treatment needs in chronic migraine are huge, as is the overuse of medications,” Lipton said. “When a body gets used to having a chronic headache suppressor, the patient can experience a rebound in the absence of that suppressor. So developing an effective treatment that can reduce the need for acute medicine would be very valuable,” he noted.
“These results sound very promising,” Lipton added. “Of course, it remains to be seen if the demonstrated benefit already seen holds up over a longer period of time, and with a bigger group of patients.”
Although they have received no funding for the study, Mandato and his associates will be presenting the finding on Sunday at the Society of Interventional Radiology annual meeting in Atlanta and then perhaps publishing it in a peer-reviewed journal.
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