A Pilot Study of Intranasal Lidocaine in Acute Management of Pediatric Migraine

Inclusion Criteria

• •1. Children aged 7-16 years
• •2. Migraine headache fulfilling Irma's criteria:
• •* Headache lasting 1-72 hours with at least 4 out of 6 of the following features:
• •* Moderate to severe episode of impaired daily activities
• •* Focal localization of headache
• •* Pulsatile description
• •* Nausea or vomiting or abdominal pain
• •* Photophobia, phonophobia, or avoidance of light and noise, or
• •* Symptoms increasing with activity or resolving by rest.
• •OR:
• •3. Post-traumatic headache as per ICHD-3 (beta edition) definition with migraine-like features (see above):
• •A) Any headache fulfilling criteria C and D
• •B) Traumatic injury to the head has occurred
• •C) Headache is reported to have developed within 7 days after one of the following:
• •i. The injury to the head, ii. Regaining of consciousness following the injury to the head, iii. Discontinuation of medication(s) that impair ability to sense or report headache following the injury to the head
• •D) Headache persists for \> 3 months after the injury to the head
• •E) Not better accounted for by another ICHD-3 diagnosis
• •4. Verbal report of a pain score of 4 or greater on a 10 point numeric pain score (range 0-10 with increasing severity, i.e. 0 = no pain and 10 = most severe pain) after receiving first line therapy (non-narcotic analgesia) in either the out-patient or PED setting
• •5. Normal vital signs for age
• •6. Normal neurological exam (no focal deficits or abnormalities)