• Generally Adolescent or young adult.
• Family history of similar attacks may or may not be there.
• Complaints of recurrent paroxysm of unilateral, but rarely it may be bilateral also.
• Spreading head pains, photophobia and biliousness may be preceded by transitory visual Aura.
• Each attach lasts 4 to 48 hours or longer.
Typical migraine: Two phases can often be distinguished (1) The Aura (2) The head ache.
• The Aura lasts 15-20 minutes.
• The common aura is visual & consist of glittering Zig Zag lines curved or straight figures often in movement.
• Paraesthesia constitute a less frequent aura.
• Transigent difficulty in speaking words (Dysphasia)
• Writing difficulty may be there (dysgraphia).
• Much less commonly transient vertigo or double vision lasting 2-3 minutes are met as a migraineous Aura.
• Head Ache succeeds or is contemporary with Aura.
• Head Ache never precedes aura.
• Head Ache typically starts in one frontal region spreading to the opposite side of the head.
• Some times it remains to one half of the head (Hemicrania).
• Accompanied by photophobia, flushing, pallor, vomiting or faint feeling.
• The attack may leave the patient exhausted if the attack has been prolonged.
• During an attack unequal pupils may be observed.
• Attacks may be heralded by bouts of euphoria, anxiety or depression.
• Attack may be precipitated by menstruation, eye strain or dietetic indiscretions.
• Paroxysm may occur at varying intervals and may consists of recurrent head ache.
• Re-current head ache with vomiting.
• The Aura with a subsequent head ache.
• The Aura Alone.
SPECIAL TYPE OF MIGRAINE
Abdominal migraine:
• Attack of colicky pain due to spasm of the colon, manifest alone or alternate with classical migraine headaches.
Trigeminal migraine: The pain radiates to face or supra orbital region, some times on one side, sometimes on the other.
• Pain may be retro orbital and accompanied by suffusion of the eye or ptosis.
• Such cases if pain is always on one side raise the suspicion of retro orbital aneurism or tumor.
• First attack may simulate the pain of glaucoma, iritis, or trigeminal neuralgia.
• Transient hemi paresis is very rare.
Status migrainosus: The head ache in such cases may last for days and there may be evidence of emotional upset.
Etiology: No definite cause has been find out.
• Hereditary and familial in many cases and may be associated also with allergy or epilepsy in sibling.
• Exciting causes of attacks are (i) Psychological stress (ii) anoxia (iii) fatigue (iv) uncorrected refractive errors (v) Cervical spondylosis.
• Chronic infection or anemia are precipitating factors, these are extremely variable.
• Dietetic indiscretion, driving at night, prolonged eye strain are mentioned as triggers; by those who suffer from the malady.
• Anxiety is the commonest cause of a sudden increase in the severity or duration of attacks.
• There is often an exacerbation of the menopause.
TREATMENT
Modern: No redical treatment is possible, only symptomatic and supportive management is possible.
AYURVEDA VIEW
• The detail of migraine in Ayurveda text is compatible with Ardhavbhedak or Anant Vata.
• It is Vata dominant vyadhi.
• We have to manage disease according to holistic principles i.e. many patient be found suffered from other diseases e.g. hypertension, obesity, hypothyroidism, joint pain, abdominal problem etc.
• There are various medicines for eradication of migraine along with other bodily sufferings.
• There is no need to consult with different doctors.
• Vata Shaman Chikitsa with pain relieving treatment acts to strengthen nervous system.
• There are lot of medicines to control the acute symptom like pain, vomiting, nausea, vertigo nervousness, etc.
• It is unfortunate that patient come to us in the chronic and later stage of the disease.
• Patients get so many complication regarding other system e.g. abdomen, thyroid, heart, skin, joints, musculo skeletal etc.
• But we are happy that even in the later and chronic stage of the disease, patient get perfectly healthy with our self prepared Ayurvedic Medicine.
• Shirodhara along with our medicinal management is very effective in this disease.