Potential treatment for post-traumatic headache after concussion: Intranasal lidocaine
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An initial-stage study found that intranasal lidocaine holds promise as a potential treatment for post-traumatic headache (PTH) after a concussion. Researchers Victoria Griffiths et al. found that 88% of participants (aged 13-30) experienced a clinically significant reduction in pain within 10-20 minutes after treatment. Additionally, 74% of patients who were offered the treatment accepted, and 93% expressed satisfaction. While 96% reported mild side effects, 98% reported thatthe procedure was tolerable and 81% said they would receive the treatment again. Intranasal lidocaine for migraines has been studied, but this is the first study of intranasal lidocaine for concussion-related PTH, which is a “common and debilitating symptom following concussion,” for which there are limited treatments. Lidocaine provides analgesia (blocking or limiting pain), and when delivered through the nose, it blocks the “sphenopalatine ganglion (SPG), a key structure in headache pathophysiology.”
Published in Neurotrauma Reports, this study included 57 patients who received intranasal lidocaine delivered into the nose by a healthcare provider in a concussion clinic. The group had a median pain score of 5 out of 10 before the procedure, and 2 out of 10 within 10-20 minutes after treatment; this is a median reduction of 3 points, “where a ≥ 2-point change is clinically significant.” Although 96% of the patients experienced at least one side effect, the most common being “unpleasant taste” and “irritation or numbness of the throat,” 81% said they’d be willing to receive intranasal lidocaine treatment in the future.
The study authors chose the 10-20 minute post-treatment timeframe to gauge pain levels and side effects because the study was primarily a feasibility study and was not designed to determine the long-term efficacy of intranasal lidocaine for PTH after a concussion. The authors say that controlled trials are needed to determine the efficacy of intranasal lidocaine for this population.
