New research suggests long-term improvement for chronic migraines is possible with the use of repetitive sphenopalatine ganglion blockades with 0.5% bupivacaine delivered via nasal applicator device.
Study subjects reported sustained reduction of headache days and improved quality of life scores for up to 6 months, Dr. Roger K. Cady of the Headache Care Center in Springfield, Mo., and his associates wrote in Headache.
In the double-blind, parallel-arm, placebo-controlled, randomized pilot study, 41 subjects with chronic migraines were randomized 2:1 to receive a series of 12 sphenopalatine ganglion blocks with either 0.3 cc of 0.5% bupivacaine or saline delivered by a health care professional via nasal applicator twice a week for 6 weeks, The bupivacaine group reported a decrease in the number of headache days 1 month post-treatment, whereas the saline group saw only a slight improvement. Headache intensity (as measured by Headache Impact Test) scores were decreased in the bupivacaine group at 1 month and 6 months post-treatment, but only a modest reduction was seen in those receiving saline.
Subjects receiving bupivacaine reported a reduction in acute medication usage and improved quality of life measures (as defined by average pain in the previous 24 hours, mood, normal work, and general activity) up to 6 months post-treatment, whereas quality of life measures were only minimally affected in the saline group.
Read the full article here: Headache: The Journal of Head and Face Pain. (doi: 10.1111/head.12546).