Local anesthetic administration for frequent episodic tension-type headache in the elderly

Abstract

Aims:Although various symptomatic and prophylactic treatments exist for frequent episodic tension-type headaches (FETTH) in the elderly population, the constrained efficacy and associated complications and side effects of standard treatments necessitate a search for novel therapeutic options. This study aimed to assess the therapeutic efficacy of locally administered lidocaine to the pericranial muscles in elderly patients with FETTH.Methods:This retrospective pilot study included elderly patients suffering from FETTH who received weekly bilateral injections of 2 mL 0.5% local lidocaine into the trapezius, masseter, frontal, temporal, splenius capitis, sternocleidomastoideus, and semispinalis capitis muscles over 5 weeks. Patients with infrequent episodic and chronic tension-type headaches were excluded. The monthly number of painful days, visual analog scale (VAS) score, and monthly number of analgesics used were recorded before (pre-treatment) and eight weeks after (post-treatment) the treatment.Results:The study included 31 elderly individuals, with a mean age of 68.42 years (minimum-maximum: 65-81 years). In comparison to pre-treatment levels, the post-treatment observations demonstrated statistically significant reductions in the number of painful days [(5.8±1.7) vs. (4.6±1.9), p=0.003], VAS scores [(74.3±14.2) vs. (59.5±25.4), p=0.001)], and the number of analgesics used [(6.6±3.2) vs. (4.8±3.7), p=0.001].Conclusions:This study suggests that local lidocaine administration to the pericranial muscles could serve as an efficient alternative therapeutic approach for FETTH in the elderly.

Keywords

• tension-type headache
• frequent episodic tension-type headache
• lidocaine
• myofascial trigger points