Effects of C2 Peripheral Nerve Field Stimulation Using Electroacupuncture for Migraine / 全日本鍼灸学会雑誌

ABSTRACT

[Objective] To report reduction in frequency of headaches and use of medication and improvements in quality of daily life via C2 peripheral nerve field stimulation using electroacupuncture (EA-C2-PNfS) in a patient with migraines triggered by weather changes. [Case] A woman in her 60s complaining of headache.[Clinical History] Her headaches began to worsen in X-41 years. The OTC drug became ineffective from around X-15 years, and subject was diagnosed with migraine and overuse of headache medication by a neurosurgeon. Her headache was alleviated by the appropriate medications. She began a new job from August, X-1 year and headaches and over-medication increased in frequency. The acupuncture treatment was started in May, X year. The frequency of headaches was 8 times mo (month).[Subjective Symptoms] Throbbing pain occurred mainly in the frontal and occipital regions, often accompanied by nausea, vomiting, and optic/auditory hyperesthesia. The main trigger was weather changes.[Family History] Father, maternal grandmother and brothers have a history of headaches.[Diagnosis] Migraine.[Evaluation] Headache Diary (frequency of headache and medication), Headache Impact Test (HIT-6) (Quality of daily life).[Treatment] EA-C2-PNfS was performed once a week. Interval of the treatment was adjusted depending on the patient's condition. [Results] Though weather- related transient aggravations were occasionally observed, the frequencies of the headache and use of medication gradually decreased; The frequency of the headache was 8 times/mo at the start of the treatment, 6 times/mo after 12 weeks, 8 times/mo after 24 weeks, 3 times/mo after 36 weeks, once a mo after 48 weeks, 4 times mo after 54 weeks. The frequency of medication was 8 times/mo at the start of the treatment, 2 times/mo after 12 weeks, 6 times/mo after 24 weeks, 3 times mo after 36 weeks, once a mo after 48 weeks, 4 times/mo after 54 weeks. The score of HIT-6 also improved from 68 to 57. The treatment was concluded with patient satisfaction.[Discussion] In this case, migraine triggered by weather changes was remarkably alleviated. Recently an activation of the spinal trigeminal nucleus was implicated in the pathology of weather-associated headaches. EA-C2-PNfS may inhibit the abnormal activity of spinal trigeminal nucleus.