Potential Role of Goreisan in Managing Postdural Puncture Headache After Intrathecal Nusinersen in Spinal Muscular Atrophy: A Case Series

ABSTRACT Aim Postdural puncture headache (PDPH), a common complication of lumbar puncture, can impair daily functioning, especially in patients requiring repeated intrathecal procedures. This study describes headache outcomes following repeated intrathecal procedures in patients with spinal muscular atrophy (SMA) and explores the potential effects of the Kampo medicine goreisan (TJ‐17) on PDPH‐related headache. Methods This case series included five adult SMA patients (four males, one female; age range 37–52 years) who developed PDPH after intrathecal procedures. Headache severity was assessed using the Numeric Rating Scale (NRS). Changes in NRS score before and after goreisan monotherapy were evaluated. Safety was monitored through clinical follow‐up. Results Headache severity decreased in all patients, with mean NRS scores declining from 3.12 at baseline to 0.66 after goreisan self‐administration; no serious adverse events were observed. Conclusion In SMA patients undergoing repeated intrathecal procedures, goreisan was associated with improved PDPH‐related headache symptoms. While further study is needed, for patients who require repeated intrathecal interventions, goreisan may be a feasible complementary PDPH management therapy.