Hi and welcome
Marcaine (bupivacaine) is one of the drugs that can be used to perform a nerve block as a method of blocking the pain of a CH. The effectiveness of these can vary between it lasting a few months for some people to lasting a few days for others. There are other methods which can kill or cut nerves which are obviously permanent however even this is not always totally effective plus it can result in the loss of sensation to parts of the face. In some cases the CH pain just switches to the other side of the face.
For botox, whilst there are positive results for it being used to treat migraine the results are less clear for it being used to treat CH as the results for botox are comparable to that for a placebo (dummy treatment):
Treatment of headache with botulinum toxin A—a review according to evidence-based medicine criteria -"S Evers, A Rahmann, J Vollmer-Haase and I-W Husstedt", Cephalalgia Volume 22, Issue 9, pages 699–710, November 2002:
Quote:The aim of this review is to evaluate the studies available from reference systems and published congress contributions on the prophylactic treatment of idiopathic and cervicogenic headache with botulinum toxin A, and to classify these studies according to evidence-based medicine (EBM) criteria. The studies were analysed with respect to the study design, the number of patients enrolled, the efficacy parameters, and the significance of results. We used the following classification of EBM. I: randomized, controlled study with sufficient number of patients; II: well-designed, controlled study (or randomized, controlled study with insufficient number of patients, no exact diagnosis, missing data of botulinum toxin A dose); III: well-designed, descriptive study; IV: case reports, opinions of experts. For tension-type headache, two studies were found with negative evidence of I with respect to the primary endpoint. There are about as many positive as negative studies with evidence of II or III. For the therapy of migraine, one study with both negative and positive evidence of I, one in part positive study of II, and three positive studies classified as III are available. Two studies on cervicogenic headache with evidence of II and III are contradictory. In addition, we found several positive case reports. For patients with cluster headache, there are positive and negative case reports. We found one positive case report for the treatment of chronic paroxysmal hemicrania. As a result of this analysis, we consider no sufficient positive evidence for a general treatment of idiopathic and cervicogenic headaches with botulinum toxin A to date. Further studies are needed for a definite evaluation of subgroups with benefit from such treatment.
The standard approach to treating CH is the combination of a preventive which should cut down how many CHs you get plus abortives which are used to kill off any CHs that you get.
Common preventives include verapamil, lithium and topomax. These are drugs that are taken daily and they should result in you getting a lot less CHs than you would otherwise get. Their effectiveness does vary between people with CH but a CH prevented is a whole load of pain avoided. Since these take a few days or so to take effect it is common for people to start on a prednisione taper over a week or so which is a very effective preventive for short term use.
For abortives, oxygen (Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to
or
) is highly effective when used at a high flow rate (15lpm+) and using a non-rebreather mask. Using 25lpm I can kill off my CHs in about 5 minutes or less. Injectable imitrex (also known as sumatriptan or imigran) can also kill off a CH in a similar time.
Also read up about how many of us are using vitamin D3 to great effect as a preventive with over 80% having a successful result using it. I've gone about 2.5 years pain free with vitamin D3.
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NewbieLass' ?s about marcaine, botox, nerve blocks (Read 3034 times)
