Use of Kampo Medicine for Trigeminal Autonomic Cephalalgias (TACs)

Abstract

The trigeminal-autonomic cephalalgias (TACs) are characterized by unilateral headache and, usually, by prominent cranial parasympathetic autonomic symptoms that are lateralized and ipsilateral to the headache. TACs are classified into cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks, and hemicrania continua. Based on various findings, TACs are thought to originate in the hypothalamus. Shimotsuto is a basic prescription for treating blood deficiency. In Kampo medicine, blood deficiency is explained as a lack of blood. The symptoms are so varied that it is difficult to understand the pathological condition. Based on the similarity between the symptoms of blood deficiency and those of hypothalamic syndrome, we hypothesized that the pathology of blood deficiency is a condition of hypothalamic dysfunction. Therefore, we used shimotsuto-containing prescriptions for cluster headache and hemicrania continua, and observed efficacy in four cases. Shimotsuto may be an option for treating TACs.