Local Anesthetic Therapy in a Patient with Primary Headache and Lipid Keratopathy

Case Report and Pathophysiological Discussion

Authors

DOI:

https://doi.org/10.37467/gkarevmedica.v10.3227

Keywords:

Primary bilateral lipid keratopathy, Headache, Therapy with local anesthetics, Neural therapy

Abstract

A headache is characterized as a craniofacial pain that may derive from any involvement of the structure of the head, neck or cranial cavity. It may be associated with any pathology, negatively affecting the quality of life of the individuals afflicted by it. We present the case of a woman with bilateral lipid keratopathy associated with a headache of a moderate to severe intensity, refractory to treatment with non-steroidal anti-inflammatory drugs, treated with lidocaine 1% injections in supraorbital and infraorbital nerves. A clear improvement was observed in visual symptoms and headache with a decrease in symptom frequency, duration and intensity. The improvement lasted over 6 months, which positively impacted the patient’s quality of life. The treatment was well tolerated and no adverse effects were observed. In this case, local injections of lidocaine showed a favorable outcome. Well-designed studies should be conducted to elucidate the role of LA for this condition.

References

Baraff, L.J., Byyny, R.L., Probst, M.A., Salamon, N., Linetsky, M., & Mower, W.R. (2010). Prevalence of herniation and intracranial shift on cranial tomography in patients with subarachnoid hemorrhage and a normal neurologic examination. Academic Emergency Medicine, 17(4), 423–428. https://doi.org/10.1111/j.1553-2712.2010.00704.x DOI: https://doi.org/10.1111/j.1553-2712.2010.00704.x

Blumenfeld, A., Ashkenazi, A., Napchan, U., Bender, S.D., Klein, B.C., Berliner, R., Ailani, J., Schim, J., Friedman, D. I., Charleston IV, L., Young, W.B., Robertson, C.E., Dodick, D.W., Silberstein, S.D., & Robbins, M.S. (2013). Expert consensus recommendations for the performance of peripheral nerve blocks for headaches - A narrative review. Headache, 53(3), 437–446. https://doi.org/10.1111/head.12053 DOI: https://doi.org/10.1111/head.12053

Burch, R., Rizzoli, P., & Loder, E. (2018). The Prevalence and Impact of Migraine and Severe Headache in the United States: Figures and Trends From Government Health Studies. Headache, 58(4), 496–505. https://doi.org/10.1111/head.13281 DOI: https://doi.org/10.1111/head.13281

Buse, D.C., Loder, E.W., Gorman, J.A., Stewart, W.F., Reed, M.L., Fanning, K.M., Serrano, D., & Lipton, R.B. (2013). Sex differences in the prevalence, symptoms, and associated features of migraine, probable migraine and other severe headache: Results of the American Migraine prevalence and prevention (AMPP) study. Headache, 53(8), 1278–1299. https://doi.org/10.1111/head.12150 DOI: https://doi.org/10.1111/head.12150

Cassuto, J., Sinclair, R., & Bonderovic, M. (2006). Anti-inflammatory properties of local anesthetics and their present and potential clinical implications. Acta Anaesthesiol Scand., 50(3), 265–282. https://doi.org/10.1111/j.1399-6576.2006.00936.x DOI: https://doi.org/10.1111/j.1399-6576.2006.00936.x

Castro-Rebollo, M., Montes-Moloón, M., & Pérez-Rico, C. (2009). Queratopatía lipoidea primaria bilateral. Archivos de La Sociedad Espanola de Oftalmologia, 84(5), 263–266. https://doi.org/10.4321/s0365-66912009000500008 DOI: https://doi.org/10.4321/S0365-66912009000500008

Chavan, S.S., Pavlov, V.A., & Tracey, K.J. (2017). Mechanisms and Therapeutic Relevance of Neuro-immune Communication. Immunity, 46(6), 927-942. https://bit.ly/3yiN66n DOI: https://doi.org/10.1016/j.immuni.2017.06.008

Clinch, C.R. (2001). Evaluation of acute headaches in adults. American Family Physician, 63(4), 685–692. https://doi.org/10.1016/s1443-8461(01)80045-9 DOI: https://doi.org/10.1016/S1443-8461(01)80045-9

Do, T.P., Remmers, A., Schytz, H.W., Schankin, C., Nelson, S.E., Obermann, M., Møller Hansen, K., SInclair, A.J., Gantenbein, A.R., & Schoonman, G.G. (2019). Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list. Neurology, 92(3), 134–144. https://doi.org/10.1212/WNL.0000000000006697 DOI: https://doi.org/10.1212/WNL.0000000000006697

Dodick, D.W., Turkel, C.C., Degryse, R.E., Aurora, S.K., Silberstein, S.D., Lipton, R.B., Diener, H.C., & Brin, M.F. (2010). OnabotulinumtoxinA for treatment of chronic migraine: Pooled results from the double-blind, randomized, placebo-controlled phases of the PREEMPT clinical program. Headache, 50(6), 921–936. https://doi.org/10.1111/j.1526-4610.2010.01678.x DOI: https://doi.org/10.1111/j.1526-4610.2010.01678.x

Edlow, J.A., Panagos, P.D., Godwin, S.A., Thomas, T.L., & Decker, W.W. (2008). Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache. Annals of Emergency Medicine, 52(4), 407–436. https://doi.org/10.1016/j.annemergmed.2008.07.001 DOI: https://doi.org/10.1016/j.annemergmed.2008.07.001

Egli, S., Pfister, M., Ludin, S., Puente de la Vega, K., Busato, A., & Fischer, L. (2015). Long-Term Results of Therapeutic Local Anesthesia (Neural Therapy) in 280 Referred Refractory Chronic Pain Patients. BMC complementary and alternative medicine, 15, 200. https://bit.ly/3AsjMwP DOI: https://doi.org/10.1186/s12906-015-0735-z

Eipe, N., Gupta, S., & Penning, J. (2016). Intravenous lidocaine for acute pain: an evidence-based clinical update. BJA Education, 16(9), 292–298. https://doi.org/10.1093/bjaed/mkw008 DOI: https://doi.org/10.1093/bjaed/mkw008

Engel, R., Barop, H., Giebel, J., Ludin, S.M., & Fischer, L. (2022) The Influence of Modern Neurophysiology on the Previous Definitions of "Segment" and "Interference Field" in Neural Therapy. Complement Medicine Research, 29(3), 257-267. https://doi: 10.1159/000522391 DOI: https://doi.org/10.1159/000522391

Fischer, L., Barop, H., Ludin, S.M., & Schaible, H.G. (2022). Regulation of acute reflectory hyperinflammation in viral and other diseases by means of stellate ganglion block. A conceptual view with a focus on Covid-19. Autonomic Neuroscience, 237, 102903, 1-13. https://doi: 10.1016/j.autneu.2021.102903 DOI: https://doi.org/10.1016/j.autneu.2021.102903

Goadsby, P.J., & Evers, S. (2020). International Classification of Headache Disorders - ICHD-4 alpha. Cephalalgia, 40(9), 887–888. https://doi.org/10.1177/0333102420919098 DOI: https://doi.org/10.1177/0333102420919098

Hahnenkamp, K., Durieux, M., Hahnenkamp, A., Schauerte, S., Hoenemann, C., Vegh, V., Theilmeier, G., & Hollmann, M. (2006). Local Anaesthetics Inhibit Signalling of Human NMDA Receptors Recombinantly Expressed in Xenopus Laevis Oocytes: Role of Protein Kinase C. British Journal of Anaesthesia, 96(1), 77-87. https://doi:10.1093/bja/aei271 DOI: https://doi.org/10.1093/bja/aei271

Hickman, F.R. (1983). Guideline for primary care management of headache in adults. International Journal of Mathematical Education in Science and Technology, 14(4), 445–448. https://doi.org/10.1080/0020739830140409 DOI: https://doi.org/10.1080/0020739830140409

Hollmann, M., Herroeder, S., Kurz, K., Hoenemann, C., Struemper, D., Hahnenkamp, K., & Durieux, M. (2004). Time-dependent Inhibition of G Protein-coupled Receptor Signaling by Local Anesthetics. Anesthesiology, 100(4), 852-860. https://bit.ly/3ykBMqw DOI: https://doi.org/10.1097/00000542-200404000-00015

Levy, J., Benharroch, D., & Lifshitz, T. (2005). Bilateral severe progressive idiopathic lipid keratopathy. International Ophthalmology, 26(4–5), 181–184. https://doi.org/10.1007/s10792-007-9032-2 DOI: https://doi.org/10.1007/s10792-007-9032-2

Locker, T.E., Thompson, C., Rylance, J., & Mason, S.M. (2006). The utility of clinical features in patients presenting with nontraumatic headache: An investigation of adult patients attending an emergency department. Headache, 46(6), 954–961. https://bit.ly/3P7P0h9 DOI: https://doi.org/10.1111/j.1526-4610.2006.00448.x

Loreto, M. (2014). Headaches, Assessment and Initial Management. Rev.Med.Clin.Condes, 25(4), 651–657. DOI: https://doi.org/10.1016/S0716-8640(14)70086-0

Miranda, S., Tandón, U., Medina, F., Hernández, D., & Viera, D. (2016). Degeneración nodular de Salzmann: a propósito de un caso. Archivos de La Sociedad Canaria de Oftalmología, 27, 11–15. https://mdc.ulpgc.es/utils/getfile/collection/scoft/id/531/filename/561.pdf

Nazlıkul, H., Ural, F.G., Öztürk, G.T., & Öztürk, A. (2018). Evaluation of neural therapy effect in patients with piriformis syndrome. Journal of back and musculoskeletal rehabilitation, 31(6), 1105–1110. https://doi.org/10.3233/BMR-170980 DOI: https://doi.org/10.3233/BMR-170980

Nassar, A.C., Geney, M.C., Martínez, F.H., Muñoz-Sellart , M., & Vinyes, D. (2021). Improving the Quality of Life of Patients with Headache Treated with Neural Therapy. MEDICA REVIEW. International Medical Humanities Review / Revista Internacional De Humanidades Médicas, 9(1), 13–28. https://doi.org/10.37467/gkarevmedica.v9.3015 DOI: https://doi.org/10.37467/gkarevmedica.v9.3015

Olesen, J., Gustavsson, A., Svensson, M., Wittchen, H. U., & Jönsson, B. (2012). The economic cost of brain disorders in Europe. European Journal of Neurology, 19(1), 155–162. https://doi.org/10.1111/j.1468-1331.2011.03590.x DOI: https://doi.org/10.1111/j.1468-1331.2011.03590.x

Olesen, J., Bes, A., Kunkel, R., Lance, J. W., Nappi, G., Pfaffenrath, V., Clifford Rose, F., Schoenberg, B. S., Dieter, S., Tfelt-Hansen, P., Welch, K. M. A., Wilkinson, M., Germaine Bousser, M., Diener, H. C., Dodick, D., First, M., Goadsby, P. J., Göbel, H., Lainez, M. J. A., ... Wöber-Bingöl, C. (2013). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia, 33(9), 629–808. https://doi.org/10.1177/0333102413485658 DOI: https://doi.org/10.1177/0333102413485658

Pang, Y., Zhang, Q., & Bao, Y. (2019). A CARE-compliant article: ipsilateral progressive idiopathic lipid keratopathy: A case report. Medicine, 98(35), e16589. https://bit.ly/3AxX6vv DOI: https://doi.org/10.1097/MD.0000000000016589

Rasmussen, B.K., & Olesen, J. (1992). Symptomatic and nonsymptomatic headaches in a general population. Neurology, 42(6), 1225 LP – 1225. https://doi.org/10.1212/WNL.42.6.1225 DOI: https://doi.org/10.1212/WNL.42.6.1225

Rey, M., Muñoz, M., Catalán, M., & Vinyes, D. (2021). Treatment of Localized Vulvar Pain with Neural Therapy: A Case Series and Literature Review. Complement Med Res, 28(6), 571-577. https://doi.org/10.1159/000514945 DOI: https://doi.org/10.1159/000514945

Rothman, R.E., Keyl, P.M., McArthur, J.C., Beauchamp, N.J., Danyluk, T. & Kelen, G D. (1999). A decision guideline for emergency department utilization of noncontrast head computed tomography in HIV-infected patients. Academic Emergency Medicine, 6(10), 1010–1019. https://doi.org/10.1111/j.1553-2712.1999.tb01184.x DOI: https://doi.org/10.1111/j.1553-2712.1999.tb01184.x

Ruiz, M., León, C., Castillo, J., Martínez, M., Sánchez, S., & Quintela, E. (2010). Distribución por diagnósticos de las cefaleas que acuden a los servicios de urgencias de atención primaria. Semergen, 36(1), 10–15. https://doi.org/10.1016/j.semerg.2009.10.002 DOI: https://doi.org/10.1016/j.semerg.2009.10.002

Santos, S., Cuadrado, M.L., Guerrero, A.L., Huerta, M., Porta, J., Pozo, P., & Pareja, J.A. (2017). Guía consenso sobre técnicas de infiltración anestésica de nervios pericraneales. (Consensus recommendations for anaesthetic peripheral nerve block). Neurología, 32(5), 316–330. https://doi.org/10.1016/j.nrl.2016.04.017 DOI: https://doi.org/10.1016/j.nrl.2016.04.017

Scholz, A. (2002). Mechanisms of (Local) Anaesthetics on Voltage-gated Sodium and Other Ion Channels. British Journal of Anaesthesia, 89(1), 52-61. https://doi:10.1093/bja/aef163 DOI: https://doi.org/10.1093/bja/aef163

Scottish Intercollegiate Guidelines Network. (2018). Pharmacological management of migraine : a national clinical guideline. Healthcare Improvedment Scotland, 45. https://bit.ly/3uqotn6

Silva-Arautjo, A., Tavares, M.A., Lemos, M.M., Soares, M.I., Castro, J., & Salgado, J. (1993). Primary lipid keratopathy: a morphological and biochemical assessment. British Journal of Ophthalmology, 77, 248–250. DOI: https://doi.org/10.1136/bjo.77.4.248

Volcy, M. (2008). Cefalea en el servicio de urgencias: nuevos conceptos en el diagnóstico, la epidemiología y el tratamiento. Acta Neurol Colomb, 24(4) 118–133. https://bit.ly/2K3Dzs7

Vos, T., Flaxman, A. D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., Shibuya, K., Salomon, J. A., Abdalla, S., Aboyans, V., Ackerman, I., Aggarwal, R., Ahn, S. Y., Ali, M. K., AlMazroa. M. A., Alvarado, M., Anderson, H. R., Anderson, L. M., Andrews, K. G., Atkinson, C., ... Murray, C. J. L. (2012). Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 380(9859), 2163–2196. https://doi.org/10.1016/S0140-6736(12)61729-2 DOI: https://doi.org/10.1016/S0140-6736(12)61729-2

Watkins, L., Milligan, E., & Maier, S. (2001). Glial activation: A driving force for pathological pain. Trends in neurosciences, 24, 450-5. DOI: https://doi.org/10.1016/S0166-2236(00)01854-3

Weinschenk, S. (2012) Neural therapy - a review of the therapeutic use of local anaesthetics. Acupunct Rel Ther, 1(1), 5–9. https://doi.org/10.1016/j.arthe.2012.12.004 DOI: https://doi.org/10.1016/j.arthe.2012.12.004

Downloads

Published

2022-07-05

How to Cite

Nassar Tobón, A. C., Pérez Benjumea, P. A., & Vinyes, D. . (2022). Local Anesthetic Therapy in a Patient with Primary Headache and Lipid Keratopathy: Case Report and Pathophysiological Discussion. MEDICA REVIEW. International Medical Humanities Review / Revista Internacional De Humanidades Médicas, 10(2), 139–149. https://doi.org/10.37467/gkarevmedica.v10.3227