“Clinical Hypnosis and Electro-Acupuncture in the Treatment of Headaches: Integrating International Headache Society (IHS) Classification and Traditional Chinese Medicine into a Multimodal Approach”.

Integrating International Headache Society (IHS) Classification and Traditional Chinese Medicine into a Multimodal Approach (1.0 CE/CME) Paola Brugnoli, MD In medicine a headache is a symptom of a number of different conditions of the head and neck. There are a number of different classification systems for headaches. The most well-recognized is that of the International Headache Society: The International Classification of Headache Disorders (ICHD). It contains explicit diagnostic criteria for headache disorders and is accepted by the World Health Organization (WHO). Acupuncture in Traditional Chinese Medicine have been used to relieve headaches and migraines, as well as their underlying causes, for thousands of years. In 2003, the WHO published a landmark study, titled “Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials” which concluded that headache can be treated with acupuncture. Treatment of a headache depends on the underlying etiology or cause. Treatment of headaches can be difficult with only a pharmacological approach. Reductions in stress with clinical hypnosis and changes in daily living activities designed to reduce the frequency and intensity of tension headache episodes are recommended. Oral medications are not particularly effective due to the nature of cluster headaches, which presents with sudden severe pain and typically has rapid resolution. Pharmacologic treatment of migraine headaches falls into 2 basic categories: preventive and abortive. Various rescue medications can be used in the event of failure of triptan treatment for migraine headache, but they can have potential toxicity, and other limitations. A multimodal approach with clinical hypnosis and electro-acupuncture can be quite effective for managing the acute and chronic pain of mild to moderate headaches. Methods: 10 patients who were suffering for chronic headaches were recruited for ten weeks Pre-procedural pain (VAS) and post- procedural pain (VAS) were assessed (0-10 scale). We evaluated the patient’s s anxiety and muscular tension using the The Hamilton Anxiety Scale (HAMA); a rating scale developed to quantify the severity of anxiety symptomatology and muscular tension. Patients had a single-session of hypnosis and electroacupuncture in a week for 10 weeks. After ten weeks the patient’s headaches pain and anxiety are measured. Results: At baseline, the headaches chronic pain was high and the anxiety and the muscular tension level of the chronic headaches was medium-high. This presentation will illustrate basic research design logic, measurement techniques and scales as well as sampling methods. Real clinical cases data will be examined, analyzed and summarized during the Symposium. Upon completion of this workshop, participants will be able to • Develop knowledge of the headaches clinical scenarios, in international headache society classification, and traditional chinese medicine; • Assess, analyze and experiment a multimodal approach in headaches, and their management with hypnosis techniques; • Develop a knowledge of the hypnotic and electro-acupuncture methods for the management of chronic pain, anxiety and muscular tension in headaches; discuss recent advances in a headache’s multimodal approach; and • Describe up-to-date hypnosis modalities in managing headaches.