Minimally invasive migraine treatment 'reduced painkiller use in 88% of patients'

A new intranasal treatment for migraine has been found to lower use of pain-relief medication among 88% of patients in a retrospective analysis.

Migraine headaches are one of the most common, debilitating diseases in the US.

At the Society of Interventional Radiology's Annual Scientific Meeting, clinicians from Albany Medical Center and the State University New York Empire State College in Saratoga Springs, NY, explained how the new treatment - image-guided, intranasal sphenopalatine ganglion (SPG) blocks - provided ongoing relief tomigraine patients.

"Migraine headaches are one of the most common, debilitating diseases in the United States, and the cost and side effects of medicine to address migraines can be overwhelming," says Dr. Kenneth Mandato, the study's lead researcher and an interventional radiologist at Albany Medical Center.

"Intranasal sphenopalatine ganglion blocks are image-guided, targeted, breakthrough treatments," he elaborates. "They offer a patient-centered therapy that has the potential to break the migraine cycle and quickly improve patients' quality of life."

The retrospective analysis involved 112 participants with migraine or cluster headaches, who scored the severity of their symptoms on a visual analog scale (VAS) between 1 and 10. Prior to receiving the new treatment, participants reported an average VAS score of 8.25. Scores greater than 4 occurred at least 15 days per month on average.

Treatment is administered nasally to a nerve bundle associated with migraines

The treatment is minimally invasive and involves 4% lidocaine being administered to the patient via a "spaghetti-sized catheter" inserted through the patient's nasal passage. Through this route, the lidocaine is delivered to the patient's sphenopalatine ganglion - a bundle of nerves just behind the nose that are associated with migraines.

According to the researchers, the day after the SPG block, the VAS scores of the patients were halved to an average of 4.10. Thirty days after the procedure, the average VAS score was 5.25 - a 36% decrease from the baseline levels. Overall, 88% of patients said they were using less or no migraine medication for relief following the procedure.

Dr. Mandato explains how the SPG block works:

"Administration of lidocaine to the sphenopalatine ganglion acts as a 'reset button' for the brain's migraine circuitry. When the initial numbing of the lidocaine wears off, the migraine trigger seems to no longer have the maximum effect that it once did. Some patients have reported immediate relief and are making fewer trips to the hospital for emergency headache medicine."

However, Dr. Mandato emphasizes that SPG blocks are not a cure for migraines. Rather, the treatment is a temporary solution, much like other existing treatment options for chronic headaches. Despite this, Dr. Mandato believes that the treatment is safe enough for patients to have the SPG block on multiple occasions if necessary.

The researchers will continue to track the 112 participants to gauge their responses 6 months after treatment. A double-blind, prospective study is also being planned that will "more rigorously evaluate" the effectiveness of SPG blocks.

Previously  a study published in the journal Neurology that found people who are neglected or abused in childhood are more likely to experience migraines in adulthood.

"Childhood maltreatment can have long-lasting effects like associated medical and psychological conditions, including migraine, in adulthood," the authors of that study concluded. "When managing patients with migraine, neurologists should take childhood maltreatment into consideration."

Source:journal Neurology/Society of Interventional Radiology's Annual Scientific Meeting,