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.
Beijing - Acupuncture can reduce migraine headaches, say researchers, adding that doctors should provide information about acupuncture as an option when discussing preventive treatment strategies with patients.
"Acupuncture can be recommended as a prophylactic treatment and clinicians should provide patients with information about acupuncture as an option when discussing prophylactic treatment strategies," said researchers from China.
For people with frequent migraines, preventive treatments to reduce headache frequency are available, but not all patients respond well to drug therapy and many prefer to avoid it.
Evidence for the benefit of acupuncture on migraine prevention has been mixed, according to the study.
For the findings, published in the journal The BMJ, researchers set out to compare the effectiveness of manual (real) acupuncture with sham (placebo) acupuncture or usual care.
Their findings are based on 147 patients (average age 37) with a history of migraine without aura who were recruited from seven hospitals in China from June 2016 to November 2018.
None of the patients had received acupuncture before, and all were instructed not to take any painkillers or start any other treatments during the trial.
After four weeks of baseline assessment, patients were randomly allocated to receive either 20 sessions of manual acupuncture at true acupuncture points, 20 sessions of non-penetrating sham acupuncture at non-acupuncture points, or usual care (including advice on lifestyle and self-management) over eight weeks.
Over the next 12 weeks, the researchers compared changes in migraine days and migraine attacks per four-week period from baseline.
Compared with sham acupuncture, manual acupuncture resulted in a greater reduction in migraine days and migraine attacks. Sham acupuncture resulted in a minor reduction in migraine attacks compared with usual care.
According to the researchers, no severe adverse events were reported.
"These results show that treatment with manual acupuncture compared to sham acupuncture or usual care, resulted in a significantly higher reduction in the frequency of migraine days and migraine attacks," the study authors said.
--IANS
Migraine is a neurological condition that can cause multiple symptoms. It’s frequently characterized by intense, throbbing pain or a pulsating sensation debilitating usually on one side of the head. Pain present in migraine can be so severe that it interferes with daily activities. Migraines often run in families and affect all ages. The diagnosis of migraine headaches is determined based on clinical history, reported symptoms, and by ruling out other causes. The most common categories of migraine headache are those without aura (previously known as common migraines) and those with aura (previously known as classic migraines).
Migraine: Signs & Symptoms
Prodrome Phase- Migraine symptoms may begin one to two days before the headache itself. This is known as the prodrome stage. Symptoms during this stage can include: fatigue or low energy, frequent yawning, hyperactivity, irritability, neck stiffness etc.
Aura- In migraine with aura, the aura occurs after the prodrome stage. During an aura, person may have problems with your vision, sensation, movement, and speech. Examples of these problems include: difficulty speaking clearly, feeling a prickling or tingling sensation in the face, arms, or legs, seeing shapes, light flashes, or bright spots.
Actual Migraine attack- The next phase is known as the attack phase. This is the most acute or severe of the phases when the actual migraine pain occurs. In some people, this can overlap or occur during an aura. Attack phase symptoms can last anywhere from hours to days. Symptoms of a migraine can vary from person to person. Some symptoms may include: increased sensitivity to light and sound, nausea, dizziness or feeling faint, pain on one side of your head, either on the left side, right side, front, or back, or in your temples, pulsing and throbbing head pain, vomiting.
Postdrome Phase- After the attack phase, a person will often experience the postdrome phase. During this phase, there are usually changes in mood and feelings. These can range from feeling euphoric and extremely happy, to feeling very fatigued and apathetic. A mild, dull headache may persist.
Migraine attacks last for hours to days.
Migraine treatment is aimed at reducing symptoms and preventing future attacks. Initial treatment includes avoidance of triggers, pain medication such as Paracetamol (acetaminophen), ibuprofen and medication for the nausea. When simple pain medications fail, specific medications such as triptans or ergotamines may be used.
Ayurveda lays emphasis on ‘’Head” (Shira) by terming it as the Uttamanga - The most vital part of the body because all the indriyas (Sense organs) are located in the head along with the Prana (life) of the individual. Shira being seat of Prana and Indriyas is considered under Dashvidha Pranayatanas and Pradhan Marma in Ayurveda. Various Ayurvedic Scholars have elaborated Shiro Roga with Shira Shoola as the chief symptom (Headache Disorders) which describes the prevalence of the diseases from ever since and need of requiring their proper management. Shirashula is collectively used for all the aches and discomfort in the region of cranial vault .Many dietetics, personal, environmental and behavioural factors are responsible for causing headache. It may manifest a disease as whole or it may be a symptom of other disease.
Acharya Shushruta has explained 11 types of Shiro Rogas, namely -
1. Vatika,
2. Pittaja,
3. Kaphaja,
4.Raktaja,
5. Sannipataja,
6. Kshayaja,
7.Krimija,
8. Suryavarta,
9. Anantavata,
10. Ardhavabhedaka,
11. Shankhaka.
Migraine can be correlated to Ardhavbhedaka disease mentioned under Shirogat Vyadhi in Ayurvedic system of medicine. According to Acharya Shushruta the Shiro Roga in which intense pain occurs in half part of head for a period of multiple days days has been termed as Ardhavabhedaka. The nature of the pain in this type of Shiro Roga has been described of pricking nature - like that of a piercing needle and tearing pain and the pain is mainly present in forehead, eyebrow, ear, eye and temporal region. The severe pain is associated with mental confusion. Vitiation of all the three Doshas is chiefly responsible for Ardhavabhedaka
Ayurvedic Treatment of Migraine:
Avoidance of precipitating factors whenever possible, consuming compatible diet and modification in lifestyle are recommended. Panchakarma treatments include Snehana (Oleation) with Balaguduchyadi Taila, Swedana (Nadissweda and Upanaha Sweda), Virechana (medically induced purgation), Anuvasana Basti (Medicated enema), Shirovirechana / Nasya (instillation of medicines in nostrils) with Kshira and Ghrita or Anutaila or shunthi with milk, Raktamokshana (Bloodletting), Shiroabhyanga (head massage) and Shiro Lepa (application of medicine on scalp, head). Shunthi, Yashthimadhu, Godanti Bhasma, Pravala Pisthi are useful in migraine. Ayurvedic preparations like Swarna Sutashekhara Rasa, Laghusutashekhara Rasa and Kalyanaka Ghrita are useful.
Many patients suffering from migraine benefitted and most of them have got full cure from customized Ayurvedic treatment coined by Dr. Kohli. Migraine episodes and their severity have been found to be significantly reduced in the first month of treatment. It takes around 3-4 months for a complete cure.
( Courtesy - http://www.kohliayurveda.com)
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