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MECHANISM AND TREATMENT OF MUSCLE CONTRACTION HEADACHE WITH SPECIAL REFERENCE TO THE BLOCK OF MOST ELECTROSENSITIVE POINT OF CRANIOCERVICAL MUSCLES Shinya Manaka 1 , Koichi Kitamura 1,3 , Takanori Fukushima 2 , Kimiyoshi Hirakawa 2 1Dept. of Neurosurgery, The University of Tokyo, Faculty of Medicine 2Dept. of Neurosurgery, Tokyo Police Hospital pp.233-239
Published Date 1971/3/1
DOI https://doi.org/10.11477/mf.1406202865
  • Abstract
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Local anesthetic block is available for diagnosis and treatment of the muscle contraction headache. Authors proposed a new method of local anes-thetic block for the treatment of the muscle contraction headache, called "MEP-Block". The procedures consist of detecting the Most Electro-sensitive Point (MEP) of the muscle and infilt-rating the local anesthetic agent there, which produce a prompt relief of headache

The procedures are as follows.

1) The skin over the aching muscle is electric-cally stimulated through the monopolar cathode saline-soaked-swab electrode, the indifferent elect-rode being a lead plate attached to the leg.

2) Electrical stimulus is a square pulse of 0. 5 msec in duration, and about 20 V in intensity, which is delivered repeatedly with the frequency of 2-3 cps.

3) The point of the lowest threshold for themuscle twitching is sought.

4) When the electrosensitive point is deter-mined, the injection needle insulated exept for the tip is introduced into the muscle perpendi-cularly at this point.

5) The same electrical stimuli are applied to the muscle through the needle, which is inserted untill the point showing the lowest threathold for the muscle twitching is encountered. Thus MEP has been hit.

6) A small amount of local anesthetic solution (for example, O. 2-2 ml of 1% Xylocaine) is in-jected at this point which eliminates the twitch responses and pain promptly.

MEPs for the craniocervical muscles are usually located as shown in Fig. 2. In Fig. 3 are the areas depicted to which each component of the craniocervical muscles is responsible in producing pain. Those figures might give some reference in determining where should be injected in an individual cases of the muscle contraction head-ache.

The mechanism of MEP-Block, which has an excellent effect on the muscle contraction head-ache, was discussed from the anatomical and physiological point of view. It is tenable that MEP is just the point where the peripheral nerves enter the muscles. This may be the reason why the MEP-Block promptly eliminates the pain as well as the persistent contraction of involved muscle. In other words, the fundamen-tal mechanism of the MEP-Block is not only the interruption of the pain conduction of pain fibers from the muscle, but also the block of moter fibers which results in a reluxation of the muscle, and breaks down the vicious circle consisted of correation between muscle contraction and noxi-ous pain stimuli.


Copyright © 1971, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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