Refractory chronic migraine cases are often difficult to treat. The sustained, debilitating headaches degrade the patient’s quality of life. Inpatient treatment with intravenous infusions is recommended to rapidly break the cycle of pain; the efficacy of lidocaine infusions has been suggested. However, the evidence-based studies are limited. In a recent retrospective study, 609 inpatients with refractory chronic migraine received multiday continuous lidocaine infusion of 1 mg/min, titrated to a maximum of 4 mg/min.
Patients showed immediate significant improvement after the infusion. 43.2% of the acute responders showed sustained response even at one month . Pain ratings decreased from 7.0 on admission to 1.0 at discharge for all patients and to 4.0 at post-discharge visits . The number of headache days decreased from approximately 26 at baseline to about 22 at the post-discharge visits…
