Objectives: To determine the safety and efficacy of intravenous lignocaine
infusion in patients with severe chronic daily headache (CDH).
Design: Retrospective survey of consecutive patients.
Participants: 19 patients, 18 with rebound headache and three with status m
igrainosus. Two patients had both conditions at different times.
Setting: Neurology unit in a major metropolitan teaching hospital, 1994-199
8.
Main outcome measures: Adverse events; headache resolution; long term effic
acy.
Results: The 19 patients (16 women) received 27 lignocaine infusions. Seven
minor adverse events were noted during four infusions. Twenty-two infusion
s were given for analgesic rebound headache in 18 patients, with headache r
esolution in 82% of Infusions (17 of the 18 patients responded at least onc
e). Four patients obtained:lasting relief, six returned to their regular ma
nageable pattern of migraine (in two of these patients CDH recurred after s
ix months), four were lost to follow-up, and in four there was no long term
benefit. Five infusions were given for status migrainosus in three patient
s, with four of these infusions successfully relieving the headache.
Conclusions: Intravenous lignocaine appears to be useful in the management
of severe intractable CDH and status migrainosus.