Introduction
Angioneurotic headache is usually believed to be caused by disturbance of cerebral vessels and nerves and to be related to various active agents in blood. Clinically angioneurotic headache is unilateral and recurrent, often accompanied by nausea, vomiting and premonitory signs. It is usually of family history and frequently seen among women. It is similar to headache and migraine in TCM. The causes are either attack by exogenous pathogenic wind or dysfunction of the liver, spleen and kidney that lead to retention of pathogenic factors in the meridians, or hyperactivity of liver yang, or obstruction by phlegm and stagnation, or failure of qi and blood to nourish the head.
Syndrome differentiaton
Wind attacking meridians
Frequent severe headache, onset with the attack of cold and wind, pain involving the neck and back, thin and white tongue fur, taut and tense pulse.
Hyperactivity of liver yang
Headache, dizziness, occurrence with mental upsets or nervousness, dysphoria and susceptibility to rage, insomnia, flushed cheeks and bitter taste in the mouth, red tongue with yellow fur and taut pulse.
Asthenia of both qi and blood
Continuous headache, dizziness, relapse with overstrain, spiritual lassitude and fatigue, pale complexion, light-colored tongue, thin and weak pulse.
Interior obstruction of phlegm and turbid substance
Headache, chest oppression, nausea, vomiting of phlegm and drool, white and greasy tongue fur, slippery pulse.
5. Qi stagnation and blood stasis
Prolonged duration, fixed location of pain, prickly pain, or history of traumatic injury of the head, purplish tongue or with ecchymoses, thin and unsmooth pulse.
Treatment
1. Body Acupuncture
Prescription:
Baihui (GV 20) and Taiyang (EX-HN 5).
Modification:
For wind attacking meridians, acupoints should be selected according to the location of headache. Yintang (EX-HN 3), Shangxing (GV 23) and Hegu (LI 4) are added for pain in the forehead; Touwei (ST 8), Fengchi (GB 20), Waiguan (TE 15) and Xiaxi (GB 43) are added for pain in the side of the head; Fengchi (6B 20) and Kunlun (BL 60) are added for pain in the back of the head; Fengchi (GB 20) and Taichong (LR 3) are added for pain in the vertex of the head; for hyperactivity of liver yang, Fengchi (GB 20) and Xingjian (LR 2) are added; for asthenia of both qi and blood, Qihai (CV 6), Zusanli (ST 36), Pishu (BL 20) and Shenshu (BL 23) are added; for interior obstruction of phlegm and turbid substance, Fenglong (ST 40) and Neiguan (PC 6) are added; for qi stagnation and blood stasis, Fengchi (GB 20), Hegu (LI 4), Taichong (LR 3), Sanyinjiao (SP 6) and Geshu (BL 17) are added.
Performance:
Each time 4 - 6 acupoints are selected according to the pathological conditions. For the treatment of asthenia of both qi and blood, reinforcing needling technique and moxibustion are used. The rest syndromes are needled with reducing or mild reinforcing and reducing needling techniques. For the treatment of blood stasis, Taiyang (EX- HN 5) is pricked for bloodletting.
2. Ear Acupuncture
Prescription:
Subcortical (AT4), Occipital (AT3), Forehead (AT1), Temple (AT2), Liver (CO12) and Gallbladder (CO11).
Performance:
Each time 3 - 4 acupoints are selected and the needles are retained for 30 minutes. Or Wangbuliuxingzi (Semen Vaccariae) is used for ear pressure.