Successful treatment of chronic migraine unresponsive to triptans with herbal medicines containing Cinnamomi Cortex: A case report

Background: Migraine is a neurological disorder characterized by severe, unilateral, pulsating headaches with visual, olfactory, and auditory hypersensitivity, as well as autonomic symptoms. Currently, triptans are the standard treatment, but they often fail to relieve symptoms. Herbal medicines are alternative treatments to overcome these limitations. Case presentation: A 73-year-old Asian man visited our hospital with a 5-year history of headache and pulsation of blood vessels in the left temple. He had been using sumatriptan for three years, but it was ineffective. Based on the International Classification of Headache Disorders, 3rd edition (ICHD-3), he was diagnosed with migraine without aura. The herbal medicines Gyejigayonggolmoryeo-tang (GYT) and Shihogayonggolmoryeo-tang (SYT), both of which contain Cinnamomi Cortex, were prescribed. Forty-two days after starting herbal medicine treatment, the numeric rating scale (NRS) score decreased from 10 to 5, and the frequency of migraine attacks decreased from four times to once weekly. On day 97, the NRS score further improved to 3; therefore, SYT was discontinued. Oreongsan (ORS), an herbal medicine containing Cinnamomi Cortex, was administered only during pain attacks. On day 146, the pain almost disappeared, with an NRS score of 2, and only ORS was prescribed. On day 188, the patient was pain-free without ORS. At the last follow-up (day 456), the patient reported no recurrence of symptoms. Conclusions: Here, we describe a male patient with migraine symptoms unresponsive to triptans who experienced improvement shortly after using herbal medicines containing Cinnamomi Cortex. Therefore, these may be an appropriate alternative to triptans for treating migraine.