Case Studies

Acupuncture for Migraine: A difficult case and HRV

Kristen Sparrow • June 27, 2014

Migraine is such a miserable condition, I don’t understand how migraine patients manage as well as they do.  The case here is a woman who is 47 and developed migraines after the birth of her child at age 45.  The migraines have become almost intractable and she not only is on propranolol and other preventatives but also has relpac and other emergency remedies.  From the time I started seeing her, she has tried botox at Stanford (total of 30 injections) which left her with severe neck pain and no help for migraines.
In sum, this is a really difficult case, and not one where Acupuncture is the only thing being tried, which adds a tremendous number of variables.
But this is the real world and these are the people we need to try to help, as well as people who are willing to just try alternatives.  Given the severity and brutality of this patient’s migraines, I completely understand her readiness to try any and all treatments.  In the last two weeks, she has not been headache free, but has not had to use any emergency remedies, which is progress.  She IS planning to try botox again… The addition of so many variables, botox, infusions etc, make the data extremely jagged, but submitted for interest sake anyway.
So how has her stress level responded to acupuncture and over time?  We can look at a few different parameters.  Charts here, discussion follows each chart.

This chart shows the difference in LF/HF (stress levels) from the 5minute pre-treatment reading to the first 5 minutes after needling.  Think about this for a minute.  Look at the dramatic drop in her LF/HF AFTER needling a logically stressful intervention.  In some cases it drops 700%.  What does this show?  Who knows, but my job is to postulate 😉 .
1. Her system is very reactive and it appears to react towards stress reduction which is place of health.  This has been the crux of my research, and would indicate that she will respond in time.
2. Part of this is to compare treatment strategies and how they influence the HRV.  From my data, it looks like she responds well to robust needling (more than 15 needles), does fine with facial needling but not auricular acupuncture.  These are “quick and dirty” take aways.
For comparison purposes, here is a similar chart on another recent headache patient discussed here.

She also shows remarkable reduction in stress profile from pre-treatment to 1st 5 minute segment, but not on the same scale as the previous patient.
How about her stress levels over time?  Or her parasympathetic (rest and digest) level over time?
Though there is tremendous “noise” in this kind of evaluation and research, patterns do tend to develop over time even in extremely variable data.  Her LF/HF over time is charted.  Normalized HF follows.  Normalized HF takes into account the underlying “noise” so you get a better comparison.

I will report back on progress with this fascinating case.