Overview
Nerve headache usually has family history and is frequently seen. Clinically angioneurotic headache is unilateral and recurrent, often accompanied by nausea, vomiting and dizziness. Headache could be released in a quiet or dark environment or after having a rest. Before or during the episode, it is usually accompanied by neurological or mental dysfunctions. It is similar to headache and severe intermittent headache in TCM. Beside the exogenous pathogenesis, it is more related with factors such as constitution, emotions, diet and so on, which lead to the retention of wind, or hyperactivity of liver yang, or obstruction of the collaterals in the brain by phlegm and stagnation, or malnutrition of the brain due to asthenia of Yin, Yang, qi and blood. It is treated by herbs for dispersing pathogenic wind, dredging collaterals, promoting blood circulation to relieve pain.
Treatment
1. Baihui (DU20)
DU20 should be needled horizontally forward or backward with a 30°angle, according to the headache location with the moderate stimulation, twirling-rotating and patient having strong needling sensation, manipulated at intervals, and retained for the longer time than usual. It is treated once a day or once every other day, and 10-15 times make up one course of treatment.
2. Taiyang (EX-HN5)
This is an extra point locating in the depression about 1 finger-breadth posterior to the middle point between the lateral end of the eyebrow and the outer cantus. It is needled 0.3-0.5 cun obliquely backwards, with the method of twirling-rotating and lifting-thrusting at moderate stimulation to make the local area or faces feeling sour and distension, finally kept for half an hour. It is done once every day or once every other day, 10 times make up one course of treatment. It can also be pricked for bloodletting if there is blood stasis in the local collaterals with three-edged needle at the depth of 0.5-1 cun, which can be used together with cupping in the same point for 10-20 minutes after pricking.
3. Fengchi (GB20)
GB20 is needled horizontally 1 cun with twirling method, manipulated at intervals and kept for 20-30 min, till needling sensation being transmitted to the whole temple or forehead, which is applied once every day or once every other day for 10-15 sessions. It also can be given point injection usually with Vitamin B1, Vitamin B12, procaine, 10% glucose injection or saline water at amount of 0.5 ml in each point.
4. Fengfu (DU16)
Patients should sit in promotion to keep the neck muscle relaxing. The needle tip must be slowly inserted toward the mandible about 1-1.2 cun with mild manipulation till shock sensation appeared locally or in the limbs before withdrawing the needle. It is done every day or every other day for ten sessions as a course.
5. Neiguan (PC6)
At first the pressing hand pushes firmly against the area between PC7 and PC6 in order to induce the needling sensation toward to the elbow instead of the hands. Then needle is obliquely upwards inserted at depth of 1 cun for 30 minutes. Treatment is required one time a day for 10 times as one course. It is effective to those who have headache with temple strongly blowing.
6. Lieque (LU7)
Patients should sit or lay and is strictly and ordinarily sterilized. The point in the affected side is selected and is punctured 0.5-1 cun to the elbow with mild reducing and reinforcing needling method after the arrival of qi. To keep the effect, the subcutaneous needle can be embedded in the same point after withdrawing the needle for 1-7 days.
Note
Acupuncture therapy has better effective rate at the beginning when the aching is not severe. They can obviously release the headache attack, but it is difficulty to immediately check the pain. For recurrent headache, the therapeutic course should be given regularly. If the headache attack is related with menstruation circle, the patients should be treated before menstruation period.
The patients are required to have strong needling sensation by the way of being manipulated at intervals, retained longer than usual or is applied together with electric needle, and ear needling method in order to promote immediate effect.