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Migraine – Ayurvedic Approach

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Raghav Rachit Sharma

Introduction

Migraine is defined as a type of headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It’s often accompanied by nausea, vomiting, and extreme sensitivity to light and sound.

Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities.

In some people, the warning symptom occurs known as the aura effect. It includes the flashes of the light which causes visual disturbances, blind spots, or may include some other disturbances like tingling sensation on one side of face or neck, shivering of body parts like legs, arms, etc. In Ayurveda texts, it can be compared with the Ardhavabhedaka (

References in the texts like Charaka Samhita, Sushruta Samhita, Ashtanga Haridyuama, etc. can be seen.

According to Acharya Sushruta,

“यस्योत्तमाङ्गर्धमतीव जन्तोः सम्भेदतोदभ्रमशूलजुष्टम् ।

पक्षाद् दशाहादथवऽप्यकस्मात्तस्यार्द्धभेद त्रितायाद् व्यवस्येत्” || (सु.उ.त. 25/15)

According to Ashtanga Haridyuama,

“अर्धेतुमूर्ध्नः सोऽर्धावभेदकः ॥ पक्षात्कुम्यतिमासाद्वास्वयमेव च शाम्यति ।

अतिवृद्धस्तु नयनश्रवण वा विनाशयेत् ॥ (अ.हृ.उ.त. 23/8 )

Symptoms

It affects children and teenagers as well as adults. It mainly occurs in 4 stages.

  1. Pro-drome.
  2. Aura.
  3. Attack.
  4. Post-drome.

Also, these four stages are not seen in everyone who has a migraine.

  1. Pro-drome

These appear one or two days before the onset which can be noticed. These include:

  • Mood changes
  • Neck stiffness
  • Food cravings
  • Increased urination
  • Fluid retention
  • Aura

An aura might occur before or during migraines. Auras are reversible symptoms of the nervous system. They’re usually visual but can also include other disturbances. Each symptom usually begins gradually, builds up over several minutes, and can last up to 60 minutes. Aura associated with migraine include symptoms like:

  • Flashing lights
  • Bright or Dark spots
  • Vision Loss
  • Numbness or weakness on one side of the face
  • Difficulty in speaking
  • Attack

A migraine attack usually lasts from 4 to 72 hours if untreated. How often migraines occur varies from person to person. Migraines might occur rarely or strike several times a month. During a migraine attack, a person might notice all or some of the following symptoms. These include:

  • Pain with throbs or pulsation
  • Pain in one side of the head
  • Sensitivity to light and sound
  • In some cases, sensitivity to touch and smell is also seen
  • Nausea
  • Vomiting
  • Post-drome

After a migraine attack, you might feel drained, confused, and washed out for up to a day. Some people report feeling elated. The sudden head movement might bring on the pain again briefly.

Causes

Exact causes aren’t fully understood, genetics and environmental factors appear to play a role.

The hypersensitivity to sensory stimuli may be due to the dysfunction of the monoaminergic sensory control system located in the brainstem and thalamus. 

The trigeminal nerve fiber supplying the arteries and veins in the duramater are hyperactivated, so they release vasoactive neuropeptides as CGRP (Calcitonin Gene-Related Peptide) in the duramater. Thus, hyperactivated blood vessels produce pain by pressure.

            Some researchers proved that the calcium channel gene CACN-1-A is responsible for familiar hemiplegic migraine and thus establishes hereditary factors for some types of migraines. Excess of serotonin and dopamine can also trigger migraine attacks and some antagonists against these hormones prevent migraine episodes.

Migraine Triggering Factors

There are a number of migraine triggers, including:

  • Hormonal changes in women. Fluctuations in estrogen, such as before or during menstrual periods, pregnancy and menopause, seem to trigger headaches in many women.

Hormonal medications, such as oral contraceptives, also can worsen migraines. Some women, however, find that their migraines occur less often when taking these medications.

  • Drinks. These include alcohol, especially wine, and too much caffeine, such as coffee.
  • Stress. Stress at work or home can cause migraines.
  • Sensory stimuli. Bright or flashing lights can induce migraines, as can loud sounds. Strong smells — such as perfume, paint thinner, second-hand smoke, and others — trigger migraines in some people.
  • Sleep changes. Missing sleep or getting too much sleep can trigger migraines in some people.
  • Physical factors. Intense physical exertion, including sexual activity, might provoke migraines.
  • Weather changes. A change of weather or barometric pressure can prompt a migraine.
  • Medications. Oral contraceptives and vasodilators, such as nitro-glycerine, can aggravate migraines.
  • Foods. Aged cheeses and salty and processed foods might trigger migraines. So might skipping meals.
  • Food additives. These include the sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods

Risk Factors

Several factors make you more prone to having migraines, including:

  • Family history. If you have a family member with migraines, then you have a good chance of developing them too.
  • Age. Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during your 30s and gradually become less severe and less frequent in the following decades.
  • Sex. Women are three times more likely than men to have migraines.
  • Hormonal changes. For women who have migraines, headaches might begin just before or shortly after the onset of menstruation. They might also change during pregnancy or menopause. Migraines generally improve after menopause.

Complications

Taking painkillers too often can trigger serious medication-overuse headaches. The risk seems to be highest with aspirin, acetaminophen, and caffeine combinations. Overuse headaches may also occur if you take aspirin or ibuprofen (Advil, Motrin IB, others) for more than 14 days a month or triptans, sumatriptan (Imitrex, Tosymra) or rizatriptan (Maxalt, Maxalt-MLT) for more than nine days a month.

Medication-overuse headaches occur when medications stop relieving pain and begin to cause headaches. You then use more pain medication, which continues the cycle.

Treatment

There is no specific treatment for migraine. The drugs used aim to prevent symptoms.

  1. Drink fluids to avoid dehydration.
  2. Painkillers like ibuprofen, aspirin, etc. are helpful
  3. Ergotamine 1mg + Prochlorperazine 2.5mg tablets during the headache under medical supervision. (Contraindicated in pregnant and lactating women)
  4. For Severe cases, Triptans are used under medical supervision (Serotonin agonists).
  5. Ayurvedic Drugs like Cepharaine tablets under medical supervision.
  6. Get a regular diet.
  7. Avoid food that can increase the Vata dosha.
  8. Do regular exercise.
  9. Yoga asanas like pranayama for relaxing the mind should be done.

Treatment Mentioned In Ayurvedic Texts

In Charka Samhita:

“चतुःस्नेहोत्तमा मात्रा शिरःकायविरेचनम् ।

नाडीस्वेदो घृतं जीर्ण वस्तिकर्मानुवासनम् ॥

उपनाह: शिरोवस्तिर्दहन चात्र शस्यते ।

प्रतिश्याये शिरोरोगे यचोद्दिष्ट चिकित्सितम्” ॥ (च. सि. 9/77-78)

In Sushruta Samhita:

“तथाऽर्द्धभेदके वयाधौ प्राप्तमन्यच्च यद्भवेत ।

अवपीडो हित पात्र वचामागधिकायुतः” ॥ (सु. उ.त. 26 / 31-32 )

In Ashtanga Haridyuma:

“शिरीषबीजापामार्गमूल नस्य विडान्वितम् ।

शिरीषमूलकफ लैरवपीडोऽनयोर्हितः ॥

वशमूलककर्पूरैरवपीड प्रयोजयेत् ।

स्थिरारसो वा लेपे तु प्रपुन्नाटोऽम्लकल्कितः” ॥ (अ.हृ. उ. त. 24/9-10)

FOR TREATMENT OF MIGRAINE

CONTACT

Dr. Raghav Rachit

[The author is currently an Ayurveda Scholar at GAMC-Jammu]

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