What medication treats neurogenic headaches?
The primary cause of these headaches stems from prolonged nervous system dysfunction triggered by chronic tension, irritability, dizziness, restlessness, anxiety, palpitations, tinnitus, fatigue, or severe psychological trauma.
The direct triggers are mental tension and muscle stiffness. As a stubborn condition among psychiatric disorders, it requires identifying the root cause. Once diagnosed, the cure rate is high.
Neurogenic headaches primarily encompass tension headaches, functional headaches, and vascular-neurogenic headaches. They are often triggered by mental stress or anger, presenting with persistent dull pain, pressure, or heaviness in the head. Some patients describe a "tight band" sensation around the head. Most experience bilateral pain, commonly affecting the temples, occipital region, vertex, or entire head.The headache is characterized by dull ache, throbbing pain, pressure, numbness, or a band-like constriction. Intensity ranges from mild to moderate, rarely causing bed rest or disrupting daily activities. Some patients experience chronic, year-long headaches, with symptoms sometimes dating back 10-20 years.
Patients may experience headaches throughout the day, with painful periods outnumbering pain-free intervals. Factors such as emotional agitation, anger, insomnia, anxiety, or depression often exacerbate the headaches.
A subset of patients exhibit not only features of muscle tension headaches but also clinical manifestations of vascular headaches, primarily reporting bilateral temporal throbbing headaches.This combination of tension-type and vascular headache symptoms is termed mixed headache. Patients often experience accompanying symptoms such as dizziness, irritability, anxiety, palpitations, shortness of breath, fear, tinnitus, insomnia with vivid dreams, lower back pain, and neck stiffness. Some patients exhibit distinct tender points on both sides of the occipital region or temporal areas.
Medications for Neurogenic Headaches -- Examination and Diagnosis
Laboratory tests for neurogenic headaches typically show no abnormalities, as they are functional disorders. Brain examinations such as cranial CT, MRI, EEG, cerebral Doppler ultrasound, and cerebrospinal fluid analysis are generally normal.Most patients may show transient or reversible cerebral hypoperfusion on cerebral Doppler ultrasound, which results from temporary compression of blood vessels by spasms in the head and neck muscles.
While brain imaging isn't contraindicated for patients with long-standing neuralgic headaches, repeated CT scans are unnecessary. They serve only to rule out brain tumors or other organic lesions. Multiple scans not only incur significant costs, placing an economic burden on patients, but also expose the body to radiation hazards.
Medications for Neuralgic Headaches -- Therapeutic Agents
1. Vasoconstrictors: Used for preventing migraine aura.Examples include ergotamine tartrate with caffeine, administered before headache onset. These are commonly used medications for neurogenic headaches.
2. Magnesium preparations: Block sympathetic ganglia, relax vascular smooth muscle, and dilate blood vessels. Administer 15 ml of 33% magnesium sulfate solution orally three times daily.
3. Calcium antagonists: Inhibit platelet release of serotonin and thromboxane A2, persistently suppress vasoconstrictive substances, and dilate blood vessels, thereby improving vascular tone. Examples include nifedipine, diltiazem, and verapamil.
3. Calcium channel blockers inhibit platelet release of serotonin and thromboxane A2, persistently suppressing vasoconstrictive substances to dilate blood vessels and improve vascular tone. Examples include nifedipine, indolol, nimodipine, amiodarone, and flunarizine hydrochloride.
4. Analgesics. These drugs bind to opioid receptors in the brain, activating the central pain-relief system and raising the pain threshold to achieve analgesic effects. Commonly used medications include aspirin, sumatriptan (Zolmitriptan), celecoxib (Vioxx), tramadol, and carbamazepine.
5. Anxiolytics and Sedatives. These suppress central nervous system excitability. Examples include Xidifu, Fenalu, Duluping, and Clonazepam.
6. Other Medications. Tofu Er (Kunming Shen Shuai Guo Su Tablets), Compound Danshen Tablets, and Indomethacin may also yield therapeutic effects.
7.Tianma Toufengling Tablets are specifically indicated for treating various refractory neurogenic headaches (including chronic vascular-neurogenic headaches, tension headaches, muscle contraction headaches, functional headaches, etc.) and their associated symptoms such as dizziness, irritability, anxiety, palpitations, shortness of breath, fear, tinnitus, head pressure, insomnia with vivid dreams, lower back pain, and neck stiffness.Tianma Toufengling Tablets regulate neural function, enhance cerebral blood and oxygen supply, alleviate mental tension, and relieve cranial muscle spasms. They demonstrate exceptional efficacy for diverse neurogenic headaches, dizziness, palpitations, irritability, anxiety, insomnia, and related symptoms.
What Medication for Neuralgic Headaches? -- Traditional Chinese Medicine Formula for Migraine:
9g Polygala tenuifolia, 7 jujubes. Decoct in water. Suitable for neuralgic headaches.
12g Angelica sinensis root tip, 10g each of peach kernel, frankincense, myrrh, rhubarb, natural copper, 15g each of Drynaria fortunei rhizome and catechu, 6g each of earthworm and safflower,3g Dragon's Blood, 0.5g Cinnabar, 0.5g Musk. Decoct in water. Suitable for traumatic headaches.
60-90g Sunflower Disc. Add 400-500ml water, simmer over low heat until reduced to 150ml. Strain and take orally, once daily. Suitable for migraines.
6g Angelica Dahurica, 6g Acorus Tatarinowii, 6g Glycyrrhiza Uralensis, 10g Pinellia Ternatea, 10g Citrus Reticulata, 10g Poria Cocos, 10g Cinnamomum Cassia, 10g Cinnamomum Cassia, 10g Cinnamomum Cassia, 10g Cinnamomum Cassia, 10g Cinnamomum Cassia, 10g Cinnamomum Cassia, 10g Cinnamomum Cassia, 10g Cinnamomum Cassia, 10g Cinnamomum Cassia, 10g
Angelica dahurica, Acorus tatarinowii, Glycyrrhiza uralensis each 6g; Pinellia ternata, Citrus reticulata peel, Poria cocos each 10g. Decoct in water. Suitable for neurogenic headaches.
Salvia miltiorrhiza 40g; Ligusticum chuanxiong, Paeonia lactiflora, Cyperus rotundus each 25g; Corydalis yanhusuo 10g;Poria cocos, Saposhnikovia root 30g each, White mustard seed, Notopterygium root 15g each, Bupleurum root 5g, Angelica dahurica 3g. Decoct in water. Suitable for vascular headaches.
Silkworm pupae 60g. Grind into fine powder. Take 6g per dose, twice daily. Suitable for migraines and wind-heat headaches.
30g each of Salvia miltiorrhiza and Pueraria root, 15g each of earthworm, Ligusticum wallichii, red peony root, and Achyranthes root, 10g whole scorpion, 6g fried licorice root. One dose daily, concentrated decoction divided into two servings. For external application: equal parts raw Pinellia tuber, Angelica dahurica, Corydalis tuber, and Notopterygium root ground into powder. Pack into pouches the size of a face mask.Apply the pouch to the painful area during headache episodes, optionally supplemented with infrared radiation to enhance penetration. Suitable for vascular headaches.
Angelica sinensis, Achyranthes root, Ligusticum root each 20g; Rehmannia root, peach kernel, safflower, platycodon root each 15g; licorice, citrus peel, bupleurum root each 10g. Decoct and take orally. Suitable for traumatic brain injury headaches.