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A 27 yr old female patient presented with symptoms of severe headache along with heaviness and slight numbness of the head. The pain aggravates while fasting, travelling, improper sleep or disturbed sleep, stress, exposure to heavy sound or intense light, strong smell of perfumes. She had severe throbbing type of pain especially on one side of the head. It may be either left side or right side and it varies with the attacks. The symptoms are sometimes associated with nausea or vomiting. Usually the pain occurs on early morning and will persists for more than 3 days when no medications was taken. She was suffering from migraine without aura (common migraine) since almost 10 years. At the beginning the pain will only occurs at the time of stress like exams,etc and the intensity of the pain was not this much severe. But after 2-3 yrs the duration of attack began to reduce and the intensity of headache began to increase. Now she have headache almost in every week or once in 15 days. She feels really tired and at the time of attack and always preferred to take rest in a dark room. The pain will relieve only after taking pain killer injection and giving compressions to the head or by vomiting.
This case can be diagnosed as Common Migraine i.e Migraine without aura.
What is a migraine and how is it different from other types of headaches?
The migraine is one of the worse headaches a person can experience. It is described as a throbbing or pulsating pain that can be on one side of the head. It can begin in a specific area and then spread while it builds in intensity. A migraine is associated with nausea and vomiting. The person will also be sensitive to light, sounds and even certain smells. Sleeping can be difficult and many people become depressed. They can last for a couple of hours or for several days. A person that suffers with migraine headaches will most likely have recurring episodes but they usually become less painful with age.
There are two main types of migraines:
The most common type is the “migraine without aura” and it can be felt on one side of the head or both . this type normally causes photophobia, nausea, vomiting, fatigue and mood swings.
The second type is the “migraine with aura”. Aura is a neurological phenomenon that is usually visual and they happen between ten and thirty minutes before the pain begins. The person will normally experience hallucinations or wavy images and bright shimmering lights at the edge of their vision. Some people experience a temporary loss of vision which is accompanied by dizziness, vertigo, numbness of the face, tongue and other extremities along with speech abnormalities and weakness. Some of the other types of migraine headaches that are uncommon are called basilar artery, adomind, headache-free, carotidynia, ophthalmoplegic and status migrainosus. Some women suffer from menstrual migraines right before their cycle begin and some will develop this condition when pregnant or after they begin menopause.
It is not known at this time what causes a person to have this type of headache but studies show that many times patients with this condition have a family history of migraines.they usually inherit sensitivity to the “triggers” that can cause inflammation in the nerves and blood vessels surrounding the scalp and brain. These triggers are what makes a person have the migraine for the first time and some of them include certain types of alcohol such as red wine, caffeine, over-exertion, fatigue, environment, perfume, stress and certain medications.
This condition which is called as Common Migraine in Modern medicine can be correlated to Arthevabhedaka in Ayurveda Classics.
Arddhavabhedaka - a comparable clinical condition of migraine is a commonly occurring vascular headache presenting with pain on one half of the head as cardinal features. It is described as a separate clinical entity in the classics of charaka and susruta while vagbhata included this condition in the classification of vataja- siroroga.
The general aetiological factors or causes of Ardhavabhedaka are:
Suppression of natural urges
Over exposure to smoke,sunlight and snow
Overindulgence in sports,sex,sleep and keeping awake
Exposure to heavy breeze
Drinking too much wine
Looking down continuously for long periods
Exposure to unaccustomed, anxious and raw smell
Too much speaking
Excessive intake of dry, rough food
Due to all these causes the doshas will vitiates and gets localised at the head to produce diseases like headache.
The patient was advised with strict dietary and lifestyle modification to avoid the triggers. There are many triggers for migraines and trying to avoid them all would be an exercise in hermitry.
She was advised to:
Stay hydrated and drink at least 8-10 glass of water daily.
Keep a chart to know the complete diet and occurrence of attack and compare whether any food allergies are involved.
Go for bed before 10
Exercise or go for a walk regularly.
Always try to stay happy and avoid stress
Do meditation or breathing exercise regularly
Use body wash to smell good instead of perfume or cologne.
Avoid the usage of cold foods and always prefer warm and light food.
Avoid indigestion by taking food at regular intervals.
Avoid caffeinated drinks, carbonated beverages, cheese, chocolate, wine,etc.
Don't eat heavy food for dinner.
Reduce the usage of phone or laptop continuously.
Other than this lifestyle modification, ayurvedic treatments like nasya, dhoomapana, shiro abhyanga and shirodhara was done for 14 days.
Nasya was done with ksheerabala
Prescribed Ayurveda Medication for Migraine:
Varanadi kashayam was given twice daily before food
Sirashoolavajra ras 1 tab twice daily was given after food
Migrakot tablet 2 tab twice daily was given after food and symptomatic treatments were also done according to the condition of the patient.
The patient was undergoing treatment for 45 days and got 70% relief from the symptoms after the first 14 days of treatment itself and was completely cured after that. During the follow up she had some attacks of headache while having stress but the intensity was very mild and patient was completely stable. Patient was advised to keep up with the proper diet and routine for her well being.
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