秋葉原・南浦和院の群発頭痛、片頭痛、緊張型頭痛、腰痛、肩こりなら悠鍼灸院・整骨院・整体院　院長ブログページ

群発頭痛症例　NO３４　しっかりと通院してくださいましたが、納得のいく効果が出せませんでした。

• 2018.09.12

３０代　男性　東京都

１５年前に群発頭痛を発症。１年半おきに群発期がやって来て、２カ月続く。１日の発作回数は初期が１～２回、ピーク時は３～６回。ピーク時（２週目くらいから）の症状がひどく、回数が多いうえに痛みのレベルも強く、頻繁にMAXレベル１０の発作に襲われる。イミグラン点鼻薬と錠剤を痛みのレベルによって使いわける。強い発作の時はイミグランが効かないこともある。

［経過］

・初診時は群発期開始から１週間。まだピークに入っていない状況。発作は１日１～２回。

・５日後に２回目の施術。前回の施術当日は発作がなかった。その後は１日に１回。痛みのレベルは２～３で薬の効きも良い。この時点での経過はそれほど悪くない。

・４日後に３回目の施術。当日はまた発作が出なかったが、昨日は発作が４回来てしまい、１回だけ強いレベル９の発作が出てしまった。ピークに入ってしまった。

・４日後に４回目の施術。翌日までは発作がなかったが、２日後に３回、３日後は５回、当日もすでに３回の発作。しかしMAXがあまり来ていないことが唯一の救い。

・２日後に５回目の施術。不調続く。施術翌日の発作も防げず、その日はほぼMAXが来てしまい、発作が終わった後も１日中頭の重みに苦しんでしまった。

・３日後に６回目の施術。翌日３回、２日後には４回、当日４回。しかしMAXは来ない。薬が効くので、いつもよりかは楽？？もっと明確な効果が欲しいところ。

・４日後に７回目の施術。平均１日３回の発作。しかし強い発作は１回だけ。薬は効きがそこそこよい。回数は多い物のピーク時の割にMAXが少ない。

・４日後に８回目の施術。施術当日にMAXが２回。翌日からは３回、４回、６回。回数は多いが弱い。施術当日にMAXが来てしまったことにひっかかりを覚える。

・３日後に９回目の施術。施術当日ほぼMAXが１時間半。薬が効かず。翌日３回、２日後に５回。しかし薬が効き２０分で治まる。

・１週間後に１０回目の施術。当日レベル９、翌朝MAXの発作。その後は４～６回、レベルは４～６。明らかに反動ど思われる発作が施術後に起きている。ピークは続き、発作の回数は多いが痛みレベルは下がって、薬の効きは良いため、またこれ以上の改善を目指すよりも施術後の反動でMAXが来てしまうことの辛さの方が大きいと判断し様子見としました。

１０回目の施術から２か月後に定期調整にいらして頂きました。その後のご報告では前回施術後から１０日程は平均４回、そこから１０日程１～３回の発作が来ていて、群発期が終了したそうです。結果的に痛みのレベルは抑える事が出来ましたが、発作回数や期間も短縮することは出来ませんでした。また７回目から反動もあり、満足のいく結果とは言えませんでした。

このような経過でしたが患者様ご自身が諦めず定期調整し、次の群発期に備えるという判断をして下さいました。もし次の群発期で良い結果が得られれば、更に多くの群発頭痛の方を救えることになると思います。患者様の思いも含め、改善があること切に願っています。

埼玉県さいたま市南浦和　悠鍼灸院・整骨院・整体院　　山田　将太

Male in his 30’s Akiruno, Tokyo

Cluster headache developed 15 years ago. The cluster period has come every half year and it lasts two months. The number of attacks per day is 1 to 2 times at the beginning and 3 to 6 times at the peak. The symptoms at the peak (around 2 weeks) are severe, the number of times is high, the level of pain is strong, and attacks of MAX level 10 are frequently attacked. Use imigran nasal drops and tablets according to the level of pain. In cases of strong seizures imigran may not work.

Treatment course

· At the first visit, one week from the start of the cluster period. It is not in the peak yet. Seizures 1 to 2 times per day.

· Second treatment after 5 days. There was no seizure on the day of the previous treatment. Then once a day. The level of pain is 2 to 3 and the effect of the medicine is good. The progress at this point is not too bad.

· Third treatment after 4 days. I did not have a seizure again on that day, but I had four seizures in yesterday, and only one strong seizure at level 9 came out. I got into the peak.

· Fourth treatment after 4 days. There were no seizures until the next day, 3 times after 2 days, 5 times after 3 days, 3 times already already on the day. But the only salvation that MAX is not coming so much.

· 5th treatment after 2 days. Sudden continuation. I could not prevent seizures the next day after treatment, almost MAX came on that day and suffered from the weight of my head all day after the attacks ended.

· Third treatment after 3 days. 3 times the next day, 4 times after 2 days, 4 times the day. But MAX does not come. Because medicine works, is it easier than usual? What? Where I want more clear effects.

· Seventh treatment after 4 days. Average seizures three times a day. However, there is only one strong seizure. The medicine has good effectiveness. MAX is small compared to the peak time of many times.

· Eighth treatment after 4 days. MAX twice on the day of treatment. From the next day three times, four times, six times. The number of times is high but weak. I caught on the fact that MAX came on the day of treatment.

· Ninth treatment after 3 days. Approximately MAX is about one and a half hours on the day of treatment. The medicine does not work. Three times the next day, five times in two days. But the medicine works and it gets subsided in 20 minutes.

· Tenth treatment after one week. Level 9 of the day, seizure of MAX the next morning. After that it was 4-6 times, the level was 4-6. An apparent seizure seems to occur after treatment. Peak continues, the number of seizures is high, but the pain level is lowered, the medicine’s effectiveness is good, so the spicy of having MAX coming at the reaction after treatment rather than aiming for further improvement is greater I judged it and watched over it.

I went to the regular adjustment two months after the 10th treatment. In the subsequent report, it seems that the 10th day after the last treatment was an average of 4 times, seizures from 1 to 3 times have been coming from there for 10 days, and the cluster period has ended. As a result, I was able to suppress the level of pain, but I could not shorten the number of attacks and the period. There was also a reaction from the seventh time, which was not a satisfactory result.

Although it was such a course, the patient himself regularly adjusted without giving up and made a judgment to prepare for the next cluster period. If good results are obtained in the next cluster period, I think that we will be able to rescue even more cluster headache patients. I sincerely wish for improvement, including patient’s thoughts.