Migraine is one of the leading causes of disability among all diseases. The word “Migraine” is derived from a Greek word ‘hemikrania’ in which ‘hemi’ stands for ‘half’ and ‘kranion’ stands for ‘skull’. So Migraine is defined as the self limiting, recurring severe headache affecting mostly one half of the head which is pulsating in nature with some autonomous symptoms.
Triggers which may induce migraine attacks:
-Dehydration: Loss of water & electrolytes especially sodium can trigger migraine. Less intake of water is also responsible for dehydration. Drink atleast 2.5 or 3 litres of water in a day. Avoid Caffeine rich drinks like iced tea, cold coffee, alcoholic drinks (red wine) and soda as it causes dehydration.
Over-hydration can also disturb the balance of electrolytes.
-Eating habits: Irregular eating habit is one of the triggering factor so take proper meals at regular time intervals. Avoid fried, hot & spicy food. Intake of chocolates should be avoided as it dehydrates your system. Increase fibres or roughage & add plenty of seasonal fruits to your diet.
-Sun exposure: Direct sunlight is one of the major triggers. Avoid stepping outside in the sun & don’t forget to carry a head wrap, scarf, hat or umbrella so that it can help you in avoiding headaches.
-Humidity: As the humidity increases, the sensitivity to odours also increases. Strong odours trigger migraine so avoid using strong smelling perfumes, oils, sunscreen etc. Fragrance free products to be used.
-Sleep Patterns: Too much sleep & too less sleep should be avoided. You should follow a regular sleep pattern.
-Exercise: Strumous physical exercises should be avoided to avoid excessive sweating which can lead to dehydration. It is better to do light exercises, yoga, dance etc.
Signs & symptoms
Migraine occurs in 4 phases, although not all phases are necessarily experienced, it may vary individual to individual.
1) The Prodrome stage (40-50%); occurs hours or days before headache. Symptoms may comprise of altered mood, irritability, depression or euphoria, fatigue, yawning, excessive sleepiness, neck muscles stiffness, constipation or diarrhoea, increased urination. This stage acts as an alarm that a migraine attack is near.
2) The aura (20-30%); immediately precedes the headache. It can be visual, sensory or motor in nature.
Symptoms may include photophobia, photopia, scintillating scotoma, paresthesias, a feeling of pins and needles, hallucination, temporary dysphagia, vertigo, tingling, numbness or hypersensitivity to touch.
3) The pain stage: Typical migraine pain is unilateral; may be bilateral at the onset or become generalized. The character of pain is throbbing. The onset is usually gradual, lasts for 4-72 hours; aggravated by physical activity.
Accompanied symptoms may include nausea (90%), photophobia, nasal stuffiness, polyuria, feeling of faintness.
There may be localized oedema of scalp or face, scalp tenderness, prominence of vein or artery in temple, stiff neck. Impairment of mood and concentration is common.
4) The postdrome stage: After an attack of migraine, patient may feel tired, cognitive difficulties, weakness, malaise or depression
Diagnosis
Many a times the headaches like sinus headache or tension headache are frequently misdiagnosed as Migraine. So it is important to know how to form correct diagnosis.
Migraine with Aura: if the headache fulfils the following criteria.
-5 or more attacks
-4 hours to 3 days in duration
-2 or more symptoms – unilateral location, pulsating or throbbing pain, severity- moderate to severe, aggravation by or avoidance of regular physical activities
-1 or more accompanying symptoms- nausea, vomiting, photophobia
Migraine with Aura: Only 2 attacks are required to justify the diagnosis
Investigations
-MRI- Important diagnostic tool
-CT Scan
-Angiogram
-EEG- Useful in complicated migraine cases
Case Study
Introduction
Mr RAY aged 35years, belongs to a Sikh family came to me on 22nd April 2021 & complaints about his recurrent headache with which he had been suffering since 4 -5 years. He was a software engineer working with a multinational company, living a sedentary lifestyle.
Presenting complaints
The chief complaint of the patient was headache mostly right sided since 4- 5 years
History of presenting complaints
The patient was apparently well 4-5 years back then he started complaining of right sided headache which aggravates at night, after sleep specifically 2 am. At the time of headache, he has desire for hot drinks, he felt better by drinking tea.
He also complaint of recurrent sneezing which also aggravates at night.
Past history
He was a diagnosed case of sinusitis for which he had taken allopathic treatment in the past.
Family history: Nothing significant found
Physical generals
Appetite increased, can’t tolerate hunger leads to headache occassionally
Thirst is good
Likes fried food & sweets
Perspiration is more over the palms++, little offensive
Mental generals– Irritable, fastidious, punctuality is marked
Symptoms considered for Repertorial totality were:
Headache, right sided++
Headache, ameliorated by drinking tea+++
Headache, aggravation at 2am++
Headache, aggravates after sleep+
Perspiration more over palms++
Repertorial Result
Selection of the remedy with justification
The repertorial result of the above case showed that the highest ranked remedy which covers the totality of the symptoms of the patient was Kali bichromicum. Kali bi is known as one of the useful remedy for migraine cases. After considering Materia Medica, it was found that the physical & mental make-up of the patient was also similar to this remedy.
Therefore, Kali bi 30CH was selected considering the symptom picture & the susceptibility of the patient.
Prescription
Kali bichromicum 30 CH / 3 Doses OD
Followed by Placebo, TDS for 1 Week
Follow up
The follow up was taken after 1 week. The patient was very happy as he was relieved from the very next day & didn’t experienced any migraine attack.
One more follow up was taken a month later & the patient was found to be doing very well with no subsequent migraine attacks.
Conclusion
Migraine is one of the most disabling illness which can have extremely incapacitating neurological symptoms. Painkillers can temporarily alleviate the condition but cure is not possible with them. Homeopathy proved itself very effective in migraine cases. The basis of selection of homeopathic simillimum is Individualization; treats the patient as a whole.
Constitutional treatment not only helps to alleviate the pain but also prevent its recurrence.
ABOUT AUTHOR
Dr Shweta Singh, MD (HOM)
Senior Consultant: Orbit Clinics
Medical Director: Muskan Foundation, India
Assistant Professor: Organon of Medicine & Homeopathic Philosophy
Chief Administrator: KHA Homeopathy Study Group, USA
Vice President: Delhi Homoeopathic Medical Association, India