Intravenous Lidocaine Infusion for the Treatment of Post‐Acoustic Neuroma Resection Headache: A Case Report

Abstract

Presentation of a case report of a 47-year-old male with a post-acoustic neuroma resection intractable headache responding to intravenous lidocaine infusion. The patient was then switched to mexiletine, with good response.

Intravenous Lidocaine in the Treatment of Refractory Headache: A Retrospective Case Series

“…Matharu et al have recently presented evidence that SUNCT syndrome appeared to be controlled by IV lidocaine during the period of infusion 10 . Schere and Silberstein report that IV lidocaine can treat postacoustic neuroma resection headache 23 …”

“…10 Schere and Silberstein report that IV lidocaine can treat postacoustic neuroma resection headache. 23 The mechanism by which lidocaine affects headache pain is unknown. Animal models suggest that lidocaine may interrupt a portion of the nociceptive pathway.…”

Intravenous Lidocaine and Mexiletine in the Management of Trigeminal Autonomic Cephalalgias

“…Most patients (82%) improved, including the two with CH. Postacoustic neuroma headache [53] and trigeminal neuralgia may also respond to IV lidocaine treatment.…”

The Use and Method of Action of Intravenous Lidocaine and Its Metabolite in Headache Disorders

“…The IV infusion of lidocaine has been studied in a number of refractory headache disorders, including short‐lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT), short‐lasting neuralgiform headache attacks with cranial autonomic symptoms (SUNA), chronic migraine, chronic tension type headache, hemicrania continua (HC), and new daily persistent headache . Lidocaine was also reported to be effective in postneurosurgical pain . These open‐label studies reported significant benefit in pain control, with 25% of patients achieving a complete response .…”

“…18 Lidocaine was also reported to be effective in postneurosurgical pain. 19 These open-label studies reported significant benefit in pain control, with 25% of patients achieving a complete response. 18 The use of nerve blocks with lidocaine (or other anesthetic agents) is beyond the scope of this discussion.…”