Acupuncture treatment of chronic migraine headaches: a case report

Medical Acupuncture Journal, Abstract 6 - Acupuncture Treatm.
http://www.medicalacupuncture.com/aama_marf/journal/vol10_.
A Journal For Physicians By Physicians
Spring / Summer 1998 - Volume 10 / Number 1
"Aurum Nostrum Non Est Aurum Vulgi" ABSTRACT 6
ACUPUNCTURE TREATMENT OF CHRONIC
MIGRAINE HEADACHES: A CASE REPORT
By Bryan L. Frank, M.D., RC.,
INTRODUCTION
A 40-year-old white male presented with a 5-year history of daily,
incapacitating headaches. Neurologists diagnosed him with cluster
migraines. He had been poorly responsive to numerous medications,
cervical manipulation, oxygen, and rest. The patient received 8
acupuncture treatments over 8 weeks. He cancel ed his 1-month
fol ow-up visit, and reported doing wel , with only rare and mild
PRESENTING COMPLAINT
Headaches initial y presented as cervico-occipital; unresponsive to
chiropractic manipulation. Pain had progressed in frequency, severity;
alternating in laterality, temporal, and supraciliary in presentation.
Associated symptoms included generalized muscle pain, irritability,
fatigue, photosensitivity, bitemporal swel ing, GI distress, vomiting,
diarrhea, visual disacuity, confusion, nightmares, and impaired cognition.
Headaches were described as "vicious, skul -splitting, like a red-hot dril
bit in my temples." Past history was significant for similar onset and
symptoms. Numerous neurology consultations had failed to achieve
reasonable control of headaches.
PRIOR MEDICATIONS
Elavil, Inderal, Vicodin, Darvocet, Sansert, Imitrex IM, Cafergot,
Verapamil, Doxepin, Midrin, Motrin, Roxicet, Neurontin, Lidocaine Nasal
Medical Acupuncture Journal, Abstract 6 - Acupuncture Treatm.
http://www.medicalacupuncture.com/aama_marf/journal/vol10_.
CURRENT MEDICATIONS
Neurontin (12/day), Vicodin, Percocet, ibuprofen, Sudafed, Centrum,
ginger.
PRIOR DIAGNOSTICS TESTS
MRI, CT Scan, skul and sinus series, LFTs, blood profiles, al ergy
tests (al negative).
PMHX
Bilateral carpal tunnel release, 1987; left inguinal hermorrhaphy,
1967; tobacco 1 -2 ppd x 24 years, NKDA.
ROS
Vertigo, tinnitus, dental caries, photosensitivity, "sinus stuffiness,"
nausea, diarrhea, vomiting, hemorrhoids, Type 11 DM, urinary
frequency, neck pain, low back pain, joint pain, and depression.
Specifical y, the patient had withheld numerous foods in the past, but
was unable to identify triggering agents for headaches.
TREATMENT
Patient was treated with an integrated approach of acupuncture
models. Energetic approach included Jue Yin/Shao Yang circuit, with Yin
tonification. Supplemental points from a neuroanatomic model, or for
classical indications, were included at each treatment. Auriculotherapy
points were included at the end of the first 4 treatments.
PATIENT RESPONSE
This individual had a prompt decrease in frequency and severity of
headaches. The first several treatments reduced frequency to 1-2
headaches per week. Patient reported 2 weeks without a headache after
the fourth treatment. He received 8 acupuncture treatments over 8
weeks. His 1 -month fol ow-up visit was cancel ed; he reports doing wel ,
with only rare and mild cephalalgia.
DISCUSSION
Migraine cephalalgia is a common and often debilitating il ness.
Treatments, as with this patient, may include numerous diagnostic
procedures, different classes of medications, lifestyle alterations, and
stil , continued suffering. Acupuncture may often lead to significant
clinical improvement.
In this case, the energetic axis of Jue Yin/Shao Yang was chosen.
The Shao Yang region includes the lateral head, neck, trunk, and legs,
and is traditional y responsible for the territory and functioning of
musculature and movement. Jue Yin serves as a hinge between Yin and
Yang. The Liver assures smooth flow of Qi; the Gal Bladder, for
Medical Acupuncture Journal, Abstract 6 - Acupuncture Treatm.
http://www.medicalacupuncture.com/aama_marf/journal/vol10_.
nourishing the muscles with Qi, and al owing them to move. Pericardium(Master of the Heart), and Triple Heater, are associated withsympathetic and parasympathetic function, respectively.
Shao Yang
Yin Shao Yang
Yang Jue Yin
Yang Shao Yang
Yin Jue Yin
Migraines are considered flash symptoms associated with Yin ShaoYang and Yin Jue Yin. Other flash symptoms consistent with this patientfollow.
Numerous authors have discussed myofascial problems, which mayserve to trigger or aggravate migraines. Points chosen for their classicalindications, local and regional sphere of influence, or their function as"sympathetic switches," are often useful from a neuroanatomic model.
Auriculotherapy and auricular medicine may be valuable in either theoveral acupuncture treatment plan, or used as a separate system.
Points useful to consider for migraine treatment are presented.
FOR ADDITIONAL READING
1. Helms JM. Acupuncture energetics: a clinical approach for
physicians. Berkeley: Medical Acupuncture Publishers, 1995:391-427.
2. Helms, JM. Medical acupuncture for physicians: course syllabus.
RA-5.
3. Baldry, PE. Acupuncture, trigger points, and musculoskeletal pain.
Second Edition. London, Churchil Livingstone; 1994: 229-237.
4. Wong J and Cheng, R. The science of acupuncture therapy. Second
Edition. Hong Kong, Kola Mayland Co.; 1987: 42-43.
5. Stux, G. and Pomeranz, B. Basics of acupuncture. Second Edition.
Berlin, Springer-Vertag; 1991:231- 233.
Medical Acupuncture Journal, Abstract 6 - Acupuncture Treatm.
http://www.medicalacupuncture.com/aama_marf/journal/vol10_.
AUTHOR INFORMATION
Dr. Bryan L. Frank is the Director of Rocky Mountain Medical
Acupuncture in Colorado Springs, Colorado; is a clinical instructor for
the UCLA School of Medicine's Medical Acupuncture for Physician's
course; and is Vice-President of the AAMA.
Bryan L. Frank, M.D., P.C.
Rocky Mountain Medical Acupuncture3245 International Circle, Suite 102Colorado Springs, CO 80910Phone: 719-635-5960 - Fax: 719-635-5964 - Email: [email protected] NEXT ABSTRACT >
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