Sphenopalatine Ganglion Nerve Block vs. Elavil for Treatment of Transformed Migraines
Sphenopalatine Ganglion Nerve Block vs. Elavil for Treatment of Transformed Migraines
This study will compare a local anesthetic technique that has been used to treat subjects
 suffering from transformed migraines (chronic migraines) versus medical management with
 traditional antidepressant Amitriptyline / Elavil.

 Subjects will be randomized into one of two treatment groups to compare the safety and
 efficacy of the therapies. Subjects will recieve either sphenopalatine ganglion nerve block
 with 5% lidocaine gel into the nasopharynx or medical management with traditional
 antidepressants, Elavil, to produce a reduction in the frequency and severity of the
 headache.

 We propose that there will be a difference in the outcomes when comparing the two methods of
 treating transformed migraines and that one research arm will result in more patient
 satisfaction and greater efficacy in the treatment of subjects
Arm one will receive Sphenopalatine Ganglion Nerve Block weekly for 4 weeks

 Arm two will receive Amitriptyline / Elavil daily for 30 Days
Inclusion Criteria:

 1. Male and female age 18-90

 2. Subject have formal medical diagnosis of migraine headache

 3. Subjects currently require treatment for headache

 4. Subjects who have received optimal medical management from migraines including
 triptans (Imitrex, Amerge and Relpax)

 5. Subjects who have recieved optimal medical management for migraines including
 anticonvulsants (Depakote, Lamictal, klonopin

 Exclusion Criteria:

 1. Less than 18 years of age

 2. Subjects will be excluded if they are already being treated with lidocaine (patch or
 other vehicle) for chronic pain

 3. Untreated Heart Failure

 4. Pregnancy

 5. Individuals unwilling to comply with study procedures and follow-up