Type of headache which may occur with symptoms such as nausea/vomiting/ sensitivity to light. In many of the people, throbbing pain is felt only on one side of the head.
Due to urbanization, lifestyle of the people of modern era has changed. Due to changed work expectations for better lifestyle, stress is causing incidence of acute and chronic disorders.
MIGRAINE, one of the chronic illness,and has spread in many parts of population. It is chronic neurological disorder. Some people who get migraine have warning symptom, called an aura,before the actual headache begins. An aura is a group of symptoms, of vision changes.
In Ayurveda, Ardhavabhedaka is very much similar to migraine. It is described as vataja/vatakaphaj/tridoshaj shiroroga.
SYMPTOMS-
- Migraine progresses through four stages-
- Prodrome
- Aura
- Attack
- Post-drome
PRODROME
- One/ Two days before a migraine, some changes will warn you for an upcoming migraine.
- Constipation, Food cravings, Neck stiffness, Mood changes, Thirst and urination, Yawning frequent.
AURA
It is considered reversible symptoms of the nervous system. It can occur before/ during migraines, although it is usually visual but can also include other disturbances. Aura symptoms begins gradually,, builds up over several minutes and lasta for 20 to 60 minutes.
- visual phenomena can occur such as seeing various shapes, bright spots/ flashes of light.
- hearing noises/music.
- pins and needles sensations in an arm/leg.
- difficulty speaking.
ATTACK
Migraine usually lasts from 4 - 72 hours if untreated. Attack of migraine includes -
- pain that usually occur on one side of your head, but often on both sides.
- pain that throb/pulses.
- sensitivity to light/sound/ smell/ touch.
- nausea and vomiting.
POST-DROME-
- After migraine attack, you might feel drained, confused and washed out for upto a day. Sudden head movement might occur.
WHEN TO SEE YOUR DOCTOR FOR MIGRAINE DISEASE ?
Migraine is often undiagnosed and untreated. Regular signs and symptoms record and attack records should be kept and to report doctor to know about its severity. Headaches history also might help.
In case of any severe signs and symptoms mentioned below occur, then without delay consult doctor/ go to the hospital immediately --
- headache with fever/stiff neck/mental confusion/ seizures/ double vision/ weakness/ numbness/ trouble speaking.
- chronic headache worse after coughing/exertion/straining/ sudden movement.
- an abrupt severe headache.
CAUSES AND RISK FACTORS-
- A migraine headache is caused by abnormal brain activity that triggered many things.
- It tends to appear between the ages of 10 and 45, sometimes later in life. It run in families. Mostly, it occurs in women as compared to men.
- Migraine headaches can also triggered by certain foods like-
- Baked goods/ chocolate/ dairy foods/MSG ( monosodium glutamate) foods.
- Tyramine rich foods like smoked fish/ chicken livers/ figs/ certain beans/ aged cheese/ red wine
- Avocado/banana/citrus fruit
- Onions
- Peanuts/ processed, fermented, pickled/ marinated foods
- Hormonal changes in women like fluctuations in estrogen before/during menstrual periods, pregnancy, menopause.
- Oral contraceptives and hormone replacement therapy in women can worsen migraines.
- Stress
- Bright lights/ sun glare/ loud sounds.
- Strong smell= include perfumes/ paint thinner
- Sleep changes
- intense physical exertion
- weather changes
PREVENTION-
- avoid loud noises, bright lights.
- pay attention to food choices such as avoid chocolate, red wine, processed meats, sweeteners, cheese.
- record headache of times and severity of headaches.
- beware of hormonal changes.
- pay attention to the weather.
- take nutritive foods and supplements.
- eat + sleep on a regular schedule.
- avoid stress.
- don’t miss your meal especially lunch and breakfast.
- choose relaxing exercises.
- have a managing schedule with lifestyle management.
DIAGNOSIS-
Diagnosis of migraine is usually based on the history. Acc. To diagnostic criteria established by the International Headache Society, patients must have had at least 5 headache attacks that lasted 4-72 hrs & the headache must have at least 2-3 of the following characteristics in it :-
1) Pulsating quality
2) Moderate/ severe pain intensity
3) Aggravation by / causing avoidance of routine physical activities.
Now, in addition to the above mentioned criteria, patient must have had atleast one of the following :-
1) Nausea/ vomiting
2) Photophobia & phonophobia
GENERAL TIPS/ HOME REMEDIES -
- Keep a food diary along with your headache diary --- to help identify what you ate before migraine attacks.
- If you think a specific food is triggering migraine attacks/ you may try to avoid that food for a month affects.
- Be careful about trying extremely strict diets, it can lead to missing various nutrients.
- Try to change things like white bread, white rice and pasta in your diet to whole grains.
- Aim to increase fruit and vegetables intake.
- Aim to eat healthy fats not low fats.
- Limiit sodium to < than 2300 mg/ day. Most salt in our diets comes from processed foods like heat-and-eat frozen meals, canned soups, ready-to-eat snacks like chips and crackers.
- Consider eating 5 small meals per day. To stay longer, eat a carbohydrate with a protein/good fat.
- Don’t eat/drink anything that triggers your migraine. Some common food triggers are alcohol//aged cheeses,/caffeine. And chocolate.
- Drink water through the day instead of sugary drinks like soda/juice.
- Eat magnesium rich foods. Magnesium mineral is important for a no. Of body functions, also it binds to specific receptors in brain.
WHAT TO AVOID?
- Spicy, heavy, cold, oily foods
- Foods that contain a lot of sodium/ additive foods containing monosodium glutamate(MSG)/ artificial sweeteners such as aspartame.
- alcohol/smoking
- stress
- changes in the weather/ changes in sleeping habit patterns.
- certain medications without prescription
- eggs/ tomatoes/ onions/ dairy products/ citrus fruits
- pasta and bread products
- chocolate/ aged cheese/ nuts/ aspartame/excessive caffeine
- Avoid exposure to wind and sunlight.
- Avoid smoked meat and fish.
WHAT TO EAT?
- orange/green and yellow vegetables ( summer squash/sweet potatoes/carrots/ spinach)
- meals and water intake on time.
- brown rice
- dried/ cooked fruits
- well cooked and boiled food
- cherries/ cranberries
- boiled and cooked fresh meats/fish/poultry
- Vitamin B-2 / Riboflavin containing food like salmon, red meat, grains and mushrooms.
- light diet/ rest/ relaxation
QUESTIONS AND ANSWERS -
Q.1.) How hormones affect migraine in women?
Ans.- Migraine is more common in women, menstruation in migraine trigger 10% of women with migraine. Hormonal medications such as oral contraceptives / hormone replacement therapy can also worsen the condition.
Q.2) What are some features of migraine aura?
Ans.- Some features are -
- usually develops over 5-20 mins and lasts less than 60 mins.
- most commonly visual but can be sensory/motor/ any combination of these.
- visual symptoms may be positive/ negative.
Q.3) What is migraine headache?
Ans.- It is a complex disorder characterized by recurrent episodes of headache, mostly unilateral and sometimes associated with visual/ sensory symptoms -collectively known as an aura- arises before the head pain but that may occur during/afterward. Most common occurs in women and also has genetic component.
Q.4) What are the signs and symptoms of migraine?
Ans.- Typical symptoms of migraine include :-
- throbbing/ pulsatile headache, moderate to severe pain that intensifies with movement/ physical activity.
- unilateral / localized pain in the fronto-temporal and ocular area.
- pain builds up over a period of 1-2 hrs.
- headache lasts 4-72hrs.
- nausea and vomiting, anorexia, food intolerance, light - headedness
- light and sound sensitivity.
Q.5) What are some migraine variants?
Ans.- It includes childhood periodic syndromes, migraine with brainstem aura, hemiplegic migraine, status migrainosus, retinal migraine.
Q.6) What is the diagnosis of migraine?
Ans.- It is based on patient history. International Headache Society diagnostic criteria are that patients must have had atleast 5 headache attacks that lasted 4-72 hrs and that the headache must have had atleast 2 of the following characteristics:-
- unilateral location
- pulsating quality
- moderate/severe pain intensity
- aggravation / causing avoidance of routine physical activity characters in it.
In addition, patient must have had atleast 1 of the following :-
- nausea/ vomiting
- photophobia, phonophobia
Q.7) How common is migraine in children and adolescents?
Ans.- In early childhood and before puberty, migraines are more frequent among boys. In adolescence ; migraine affects young women > than young men. Migraine occurs in about 3% of children of preschool children. 4% to 11% of elementary school children, and 8% to 15% of high school aged children. As adults, women are 3 times more likely to have a migraine than men.
Q.8) What is an aura?
Ans.- An Aura is a sign of warning indicate that migraine is about to begin. It usually occurs about 30 mins before a migraine starts. Most common are visual include blurred/distorted vision/blind spots/brightly colored/ flashing/ moving lights/lines. Other kind includes change in ability to speak/move/hear/smell/taste/touch. It lasts about 20 minutes.
Q.9) Why nausea occur in migraine?
Ans.- Strong headaches like migraine happen when nerves in brain signal blood vessels on its surface to get bigger. Low levels of serotonin, also linked to motion sickness and nausea. It may also because of certain nerve pathways(vagus and glossopharyngeal) , brain pathways, excite an area in the brainstem that triggers the vomiting center.
Q.10) What actually happens in the brain during a migraine?
Ans.- Migraine pain happens due to waves of activity by group of excitable brain cells, trigger chemicals, such as serotonin, to narrow blood vessels. Serotonin, it is a chemical necessary for communication between nerve cells..
Q.11) How Migraine is treated in Ayurveda?
Ans.- In Ayurveda system of Medicine, natural methods are used like - Panchakarma Therapy procedures include nasya karma, swedan, abhyanga, snehana. Yoga techniques also helps to calm mind and body, ease stress and anxiety, reduce pain. Pathyadi decoction also used.