We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......

Intranasal Lidocaine for Treatment of Migraine

Richard J. Lane, MD
JAMA. 1996;276(19):1553. doi:10.1001/jama.1996.03540190025021.
Text Size: A A A
Published online


To the Editor.  —In my otolaryngology clinical practice, I have identified and treated patients with middle turbinate headache syndrome (MTHS),1 which may simulate symptoms of acute migraine. These patients have enlarged middle turbinates often due to pneumatization (concha bullosa). It is theorized that contact between an enlarged middle turbinate and either the septum or lateral nasal wall may cause headache referred to the ophthalmic division of the trigeminal nerve. These patients also typically respond to lidocaine or cocaine introduced intranasally with temporary relief of pain and headache. The diagnosis of MTHS is suspected with nasal endoscopy and is confirmed with a coronal computed tomographic (CT) scan of the sinus that demonstrates concha bullosa. Since the clinical presentation can be similar to migraine headache, I would recommend a coronal CT scan of the sinus and turbinates be performed in patients with headaches of questionable etiology.Treatment of MTHS is directed at relieving the


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.