MIGRAINE – WAY TO TREAT RECURRENT DISTRESSING HEADACHE

Migraine is a primary headache disorder characterized by recurrent headaches that are moderate to severe. The word Migraine is a corrupted form of the word ‘hemicrania’, which meant one sided headaches. Therefore it is usually thought of as one sided headaches. Typically, the headaches affect one half of the head, are pulsating in nature, and last from two to 72 hours. At times, the pain is one sided or may involve the whole head. It is often wrongly thought that all migraine headaches are one sided. It is often so but this does not in any way mean that Migraine headaches are always one sided. Associated symptoms may include nausea, vomiting, and sensitivity to light, sound, or smell. The pain is generally made worse by physical activity. Up to one third of people have an aura as typically a short period of visual disturbance which signals that the headache will soon occur. Occasionally, an aura can occur with little or no headache following it.

Etiology

The exact cause of migraines is not known. Changes in neurotransmitter levels within the brain are thought to play a role.

Trigger factors - Many factors have been identified as migraine triggers.

The normal hormone fluctuations which occur with regular menstrual cycles may predispose some women to experience migraine headaches.

Some types of oral contraceptives (birth control pills) can trigger migraines.

Various foods such as: Red wines, Aged cheeses, Preservatives used in smoked meats (nitrates), Monosodium glutamate, Artificial sweeteners, Chocolate, Dairy products, Alcohol beverages, Oversleeping, Stress, Exposure to strong stimuli such as bright lights, loud noises, or strong smells.

Changes in barometric pressure have been described as leading to migraine headaches.

Another common trigger is staying hungry more than usual. If the eating routine of a patient is disturbed, it can cause migraine. Not every individual who has migraines will experience a headache when exposed to these triggers. If a person is unsure what his or her specific triggers might be, maintaining a headache diary can be beneficial to identify those individual factors which lead to migraine.

Clinical Manifestations

The most common clinical symptoms of migraine are severe, often "pounding," pain, usually on one side of the head, Nausea and/or vomiting, Sensitivity to light, Sensitivity to sound and Eye pain.

The International Headache Society defines episodic migraine as being unilateral, pulsing discomfort of moderate-to-severe intensity, which is aggravated by physical activity and associated with nausea and/or vomiting as well as photophobia and/or phonophobia. A migraine headache typically lasts for several hours up to several days.

Many patients describe their headache as a one-sided, pounding type of pain, with symptoms of nausea and sensitivity to light, sound, or smells (known as photophobia, phonophobia, and osmophobia). In some cases, the discomfort may be bilateral. The pain of a migraine is often graded as moderate to severe in intensity. Physical activity or exertion (walking up stairs, rushing to catch a bus or train) will worsen the symptoms.

Up to one-third of patients with migraines experience an aura, or a specific neurologic symptom, before their headache begins. Frequently, the aura is a visual disturbance described as a temporary blind spot which obscures part of the visual field. Flashing lights in one or both eyes, sometimes surrounding a blind spot, have also been described. Other symptoms, including numbness or weakness along one side, or speech disturbances, occur rarely.

Some people describe their visual symptoms of loss of vision, which lasts for less than an hour, and may or may not be associated with head pain once the vision returns, as an ocular migraine. These symptoms are also known as retinal migraine, and may be associated with symptoms similar to those described as an aura, such as blind spots, complete loss of vision in one eye, or flashing lights. If a patient experiences these symptoms regularly, evaluation to exclude a primary retinal problem is needed.

Eye pain which is different from sensitivity to light is not a common component of migraine. If eye pain is a persistent symptom, or if eye pain is present and accompanied by blurred vision or loss of vision, then prompt evaluation is recommended.

Types of Migraine

·        Migraine without aura, or "common migraine", involves migraine headaches that are not accompanied by an aura.

·        Migraine with aura, or "classic migraine", usually involves migraine headaches accompanied by an aura. Less commonly, an aura can occur without a headache, or with a nonmigraine headache.

·        Two other varieties are familial hemiplegic migraine and sporadic hemiplegic migraine, in which a person has migraines with aura and with accompanying motor weakness. If a close relative has had the same condition, it is called "familial", otherwise it is called "sporadic".

·        Another variety is basilar type migraine, where a headache and aura are accompanied by difficulty speaking, world spinning, ringing in ears, or a number of other brainstem related symptoms, but not motor weakness. This type was initially believed to be due to spasms of the basilar artery, the artery that supplies the brainstem.

·        Childhood periodic syndromes that are commonly precursors of migraine include cyclical vomiting (occasional intense periods of vomiting), abdominal migraine (abdominal pain, usually accompanied by nausea), and benign paroxysmal vertigo of childhood (occasional attacks of vertigo).

·        Retinal migraine involves migraine headaches accompanied by visual disturbances or even temporary blindness in one eye

Diagnosis

The diagnosis of a migraine is based on signs and symptoms.  Neuroimaging tests are not necessary to diagnose migraine, but may be used to find other causes of headaches in those whose examination and history do not confirm a migraine diagnosis. It is believed that a substantial number of people with the condition remain undiagnosed.

The diagnosis of migraine without aura, according to the International Headache Society, can be made according to the following criteria, the "5, 4, 3, 2, 1 criteria":

·        Five or more attacks—for migraine with aura, two attacks are sufficient for diagnosis.

·        Four hours to three days in duration

·        Two or more of the following:

·        Unilateral (affecting half the head); Pulsating; Moderate or severe pain intensity; Worsened by or causing avoidance of routine physical activity

·        One or more of the following: Nausea and/or vomiting; Sensitivity to both light (photophobia) and sound (phonophobia)

·        If someone experiences two of the following: photophobia, nausea, or inability to work or study for a day, the diagnosis is more likely.

·        In those with four out of five of the following: pulsating headache, duration of 4–72 hours, pain on one side of the head, nausea, or symptoms that interfere with the person's life, the probability that this is a migraine is 92%. In those with fewer than three of these symptoms the probability is 17%.

Prevention

Preventive treatments of migraines include medications, nutritional supplements, lifestyle alterations, and surgery. Prevention is recommended in those who have headaches more than two days a week, cannot tolerate the medications used to treat acute attacks, or those with severe attacks that are not easily controlled.

The goal is to reduce the frequency, painfulness, and/or duration of migraines, and to increase the effectiveness of abortive therapy. Another reason for prevention is to avoid medication overuse headache. This is a common problem and can result in chronic daily headache.

MANAGEMENT

Home Managements

• Apple Cider Vinegar - Being a nutritional powerhouse, apple cider vinegar helps reduce migraines. Apple cider vinegar also offers health benefits like aiding detoxification,controlling blood sugar, regulating high blood pressure, reducing bone pain, promoting weightloss and relieving constipation.Add one tablespoon of organic apple cider vinegar to a glass of water. Mix in one tablespoon of honey. Drink this daily to prevent as well as treat migraines. If you are not used to taking apple cider vinegar, start by taking one teaspoon and gradually increase the amount. During migraine attacks or when you feel them coming on, you can take two or three tablespoons.
• Ice Pack - Using an ice pack is perhaps the most popular home remedy to get rid of tension as well as migraine headaches. It has a numbing effect that alleviates pain. Wrap a few ice cubes in a clean towel and place it on your temples, forehead and/or the back of your neck for 10 to 15 minutes. Repeat as needed. You can also try alternating hot and cold compresses for about 15 minutes, as needed. For better results, add lavender and/or peppermint essential oils to the water for the compress.
• Peppermint - The anti-inflammatory property of peppermint helps soothe the nerves. Plus, it has an antispasmodic and calming effect. A study published in the International Journal of Neuroscience in 2008 found that the fragrance of this herb induces the feeling associated with headache relief. Simply drink peppermint tea sweetened with honey. Repeat as needed. You can also massage each of your temples with one drop of peppermint essential oil or a combination of peppermint and lavender oils. Leave it on for at least 20 to 30 minutes. Do this a few times a day until you get relief.
• Cayenne Pepper - Cayenne pepper is a great home remedy for migraines because it stimulates circulation and improves blood flow. Plus, it contains capsaicin, a compound that works as a natural painkiller. Mix onehalf to one teaspoon of cayenne pepper in a cup of warm water.Optionally, add some lemon juice and honey to improve the taste as well as health benefits.Drink this as needed.
• Chamomile - Chamomile has antiinflammatory, antispasmodic, and soothing properties that help relieve migraines. Regularly drinking chamomile tea can also help prevent the problem. When dealing with migraines, you’ll get best results using German chamomile. Steep two to three teaspoons of dried chamomile flowers in a cup of hot water for a few minutes. You can also add some lemon juice and honey. Strain and drink this tea three or four times a day for relief from migraine symptoms. Alternatively, prepare an herbal tea by steeping equal quantities of chamomile, horehound and meadowsweet in a cup of hot water for at least five minutes. Strain and drink it. Repeat as needed.
• Ginger –  a study published in Phytotherapy Research indicates that ginger may prove effective in the treatment of common migraines. It blocks prostaglandins, which are chemicals that promote muscle contractions, impact hormones and regulate inflammation in blood vessels in the brain. Most nonsteroidal anti-inflammatory drugs (NSAIDs), too, work by reducing the production of these chemicals. Drink ginger tea a few times throughout the day until you get relief. Make sure to drink it at the onset of your headache.  Simply chewing on a piece of raw ginger root will also help treat the problem and relieve symptoms like nausea and digestive distress.

HOMOEOPATHIC MANAGEMENT

Homoeopathic philosophy does not favour the use of temporary painkillers or short cuts for the treatment of migraine or for that matter any disease. Homoeopathy tries to go deep down into the cause of the problem and completely eradicate the tendency of a patient to have these migraine headaches now and then. That is why it takes some time for the medicines to show results. They do not have a short term or temporary effect like the allopathic painkillers. On the contrary, homoeopathic medicines have long term effects and work to completely cure the migraine problem. After a couple of months of homoeopathic treatment for migraine headaches, patients are pleasantly surprised to experience a completely pain free or headache free life. This is the beauty of Homoeopathy. Homoeopathy has been found to be very successful in treating migraine and medicines are perfectly safe. These natural homoeopathic remedies do not have any side effects at all. Safety of the medicines is a major issue when you are to give any medicine to your child. Therefore it is of utmost importance that the medicines should be completely safe. Homoeopathic remedies are known to be perfectly safe and have been tried by millions of patients all over the world over the last 2 centuries.

Indicated Remedies:

Belladonna:

one of the most frequently used medicines for migraine headaches. Throbbing is the great keynote, but violent shooting pains in the head, driving the patient almost wild, are scarcely less characteristic. The patient cannot lie down, must sit up, nor can he bear light, a draft of air, noise or jarring; this last is most characteristic. The location of the ache is mostly in the frontal region or right side, flushed face, dilated pupils accompany. 

Glonine:

When the headache is congestive in nature, Glonoine is very suitable homeopathic medicine for migraine with congestive headaches. There is a rush of blood to the head. Heat and redness of the face and head is seen. Pain is usually throbbing in character. There is a feeling of shocks in the head and this is in sync with the pulse. This headache is aggravated by going out in the sun or heat in any other form. The patient cannot tolerate any warmth around the head. He feels better from uncovering the head.

Natrum Mur:

It is very commonly used for migraine that arises from any mental grief or stress. It is also good for anaemic headaches. Such headaches are often seen in young girls. There is temporary blindness with the headaches. The pain is as if there are thousands of small hammers beating inside the head. The pain increases during the day and is better after sunset. Paleness of the face accompanies the headache. The pain may be triggered by eyestrain.   


Sanguinaria:

It is a very commonly used medicine for right sided migraines. The pain often starts in the back of the head ie the occiput and settles into the right eye. There is distention of the veins of the head and the temporal region. The headaches are periodic in nature and occur on every seventh day. One gets relief from lying down and from sleeping.

Spigelia:

It is very useful remedy for migraine headaches that occur on the left side. In this medicine the pain settles over the left eye. There is a feeling as if there is a tight band around the head. The pain is aggravated by touch or motion. 

Nux vomica:

Headache from the excessive use of alcohol, the morning “big head,” tobacco, coffee, headache from digestive troubles, constipation, and specially auto-“intoxication” and hepatic insufficiency. These are all common causes of the Nux vomica headache. It suits the gouty and haemorrhoidal, which makes up four-fifths of all migraines. The ache is situated over one or the other eye, usually the left, or else in the occiput. It is apt to being in the morning with giddiness on first rising, and last all day until night, and is accompanied with sour taste or perhaps nausea and violent retching. The dull, wooden, bursting feeling of the head following a debauch is most characteristic of Nux vomica.  


Iris versicolor:

it is especially a remedy for gastric or bilious headaches. Blurring of the sight may be preceded by drowsiness and the head begins to ache as soon as the blurring disappears. The pains are mostly located over the eyes in the supra-orbital ridges, usually in one side at a time, mostly the right. The dental nerves are frequently affected. The pains are throbbing or sharp, and when at their acme vomiting occurs, which is apt to be copious, bitter or sour. Especially characteristic is vomiting of matters so sour that the teeth are set on edge. The headache of Iris is aggravated by violent motion, cold air and coughing; moderate exercise in the open air relieves. In sick headache with continuous nausea it is one of our most useful remedies.


Gelsemium:

Headache commencing with blindness, and especially is it a remedy for headaches due to eye strain. The ache commences in the occiput or nape of the neck, comes up over the head settles in the eye. There is a feeling as if a band were about the head, the patient is dull and apathetic, and there is great soreness in the eye when moving them. Occipital headaches, which are dull and dragging.

Onosmodium:

dull aching extending down back of neck or over on one side, generally the left; there is a strained stiff sensation in the corresponding eye. 


Cocculus:

the ache occurs in the lower part of the occiput and extends to the nape, and it is intense and nearly always associated with vertigo there is constant nausea. Causes of headache may be mentioned riding in the cars and a carriage. A peculiar symptom of the sensation as if the occiput were opening and shutting.