Author: Dr. Vikram Chauhan

Abstract

Migraine is an episode of headache that causes throbbing pain and pulsating usually on one side of the head. These Migraines can last for hours and days. Pain during Migraines is so bad that it interferes with daily life activities. Triggers in migraines may vary person to person. They are recurrent and complex neurological events. Migraines are mainly of 2 types. Migraine with aura (Warning sign) and migraine without aura (Warning sign). Migraines without aura account for 75% of cases. Here, we will discuss this in detail.

Introduction

Migraines are genetically influenced by complex neurological disorders. It is characterised by episodes of moderate to severe pain in the head. It is usually unilateral. They are accompanied by nausea and sensitivity towards light and sound. These episodes are known as Migraine attacks. In some patients, there is a warning symptom called Aura. it occurs with or before the headache. Aura can include visual disturbance like flashes. Black spots and tingling sensation on one side of face, difficulty in speaking.

Causes

Its causes are not known but genetics and environmental factors play a major role.

• Changes in the brainstem and its interaction with terminal nerves.
• Imbalances in brain chemicals that include serotonin, which helps to regulate pain in the nervous system.

Migraine Triggers

1. Hormonal changes in females: Estrogen fluctuation during pregnancy, menstrual periods, menopause triggers the attack in many females.
2. Drinks: Such as alcohol, wine, excessive caffeine.
3. Stress
4. Sensory stimuli: Such as bright and fleshy lights, loud noise, strong smell.
5. Sleep: Disturbance in sleep, irregular sleeping pattern.
6. Physical strain: Physical exertion (Intense).
7. Weather changes: A change of weather or barometric pressure can prompt a migraine.
8. Medications: Such as oral contraceptives, vasodilators such as nitroglycerin.
9. Foods: Food that contains cheese and salt might trigger migraines. Skipping meals can also be the reason.
10. Food additives: These include the sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods.

Symptoms

Migraine affects children, teenagers, and adults. It mostly affects females. Migraines can progress into 4 stages. These 4 stages are:

Every migraine patient does not go through all 4 stages.

1. Prodrome

In this stage the patient feels changes 2 to 3 days before the migraine that warns about migraine attack. These include:

• Constipation
• Mood swings
• Food craving
• Neck stiffness
• Increased urination
• Fluid retention
• Frequent yawning

2. Aura

In some people aura might occur before or during migraine. Aura is reversible. Aura is usually visible and includes other disturbances. It usually lasts for 60 minutes. Auras may include:

• Visual phenomenon, such as seeing various shapes, bright lights, and flashes
• Vision loss
• Pricking and tingling sensation in the arms and legs
• Weakness or numbness in the face or one side of the body
• Difficulty in speaking

3. Attack

Migraine usually lasts for 4 to 72 hours if left untreated. It varies from person to person how often it occurs. Migraines can strike several times in a month or rarely. Symptoms during migraine are:

• Pain in one side of head
• Pain is like throbbing and pulsating
• Sensitivity towards light, smell, noise
• Nausea and vomiting

4. Postdrome

After the attack of migraine patients feel drained and confused for up to several hours. Sudden movements can bring the pain again.

Risk Factors

1. Family history: If parents have a history of Migraine then there are more chances.
2. Age: It can occur at any age, but mostly peaks at the age of 30s.
3. Sex: Females three times more prone to migraine than men.
4. Hormonal changes: Migraine attacks can come before or after menstruation. They might also change during menopause and pregnancy. Usually migraine improves after menopause.

Diagnosis

The international classification of headache disorder has a criteria to diagnose migraine without aura. That is “5,4,3,2,1.” These numbers stand for:

• 5 or more episodes, each lasting 4 hours to 3 days
• A headache with at least 2 of the following qualities:
  • Occurring on one side
  • Pulsating
  • Causing moderate-to-severe pain aggravated by activity
• And at least 1 additional symptom like:
  • Nausea
  • Vomiting
  • Sensitivity to light
  • Sensitivity to sound

The international classification of headache disorder has a diagnostic criteria for migraine with aura:

• Headache attacks that last for 4 to 72 hours if left untreated.
• Headache that has at least 2 of the following:
  • Unilateral location
  • Pulsating quality
  • Moderate to severe pain
  • Aggravation by or causing avoidance of daily physical activity
• During headache one of the following:
  • Nausea, vomiting
  • Photophobia, phonophobia

A healthcare professional recommends imaging and other tests like MRI, CT scans to exclude other causes of the symptoms, such as a tumor, meningitis, or a stroke.

Treatment

There is no permanent cure for migraines. But healthcare providers can help you manage these symptoms:

1. Taking medications
2. Avoiding triggers
3. Using alternative migraine remedies

Medications include:

• Beta blockers
• Anticonvulsants, like valproate
• Antidepressants, like amitriptyline
• Botox injections
• CGRP antagonists, like Erenumab (Aimovig) and Fremanezumab (Ajovy)

Long term use of these medicines can cause serious harm to the body. Patients might get addicted to these drugs. These medications have some side effects like nausea, vomiting, generalized weakness, muscle cramps and sometimes diarrhea.

Ayurvedic Overview

According to Ayurveda, migraine is correlated with “Ardhavbhedaka”. It is described as Vataj or Vatakaphaj by most of the acharyas but Acharya Sushrut described it as Tridoshaj shiro Roga. In this disease there is a severe cutting and churning pain in one side of the head and face. It is a unilateral type of headache. It commonly lasts for 2 to 72 hours accompanied by nausea, vomiting.

Causes (NIDANA)

Ardhavbedhaka is more common in females than in males. This usually affects the second or third decade of life. The cause of migraines is unknown but it can be related to environmental factors and family history. Ayurveda acharyas have described the causes. They are classified into the following groups:

1. Aharaja Nidana (Dietary causes)

• Adhayashana (Excessive eating during indigestion)
• Intake of Ruksha bhojana (Dry and coarse food)
• Skipping meals
• Atiambupana (Excessive intake of water)
• Atimadhyapana (Excessive intake of alcohol)

2. Viharaja Nidana (Habitual or occupational causes)

• Diva swapna (Day sleeping)
• Ratri jagarana (Overnight awakening)
• Ayasa (Excessive exercise or fatigue)
• Vega dhahran (Suppression of natural urges)
• Atibhasya (Excessive talking)
• Excessive exposure to sun or bright light
• Excessive exposure to frost

3. Mansika Nidana (Psychological causes)

Stress can trigger the attack of Migraine.

4. Shiroabhyanga (Injury on head)

Signs and Symptoms (Rupa)

Rupa (Symptoms) of ardhavbedhaka (Migraine) are grouped into 2 categories:

1. Pratyatma Linga (Cardinal symptoms)

All the acharyas have described one common symptom and that is Vedana (Pain) in Ardhashira which means pain in one half region of the head.

2. Samanya lakshana (General symptoms)

According to different acharyas:

• Cutting and churning pain in the region of Manya (Cervical region), Bhru (Eyebrows), Akshi (Eyes), Lalata (Forehead).
• Tearing and throbbing type of pain with Bharam (Delusions).
• Shankhamoola Darana (Tearing pain in temporal regions).
• Gandashotha (Swelling over Zygomatic area).
• Chakshu-Virajyata (Redness of Eyes).
• Ardhashira Vikara (Unilateral headache) is elevated with the rise of sun.
• If this disease lasts for an advanced stage, it can cause sight and hearing problems.

Management as per Ayurveda

1. Nidana parivarjana (Avoidance of causative factors)

The factors which are known to produce Ardhavbedhaka should be avoided. It is the first and most useful method to prevent Ardhavbedhaka.

2. Aushad chikitsa

In this both oral medications and Panchkarma in the form of shaman Chikitsa (Pacificatory therapy) and shodhana Chikitsa (Purification therapy) are indicated.

Shamana chikitsa (Pacificatory therapy)

Drugs that are used in Ardhavbedhaka are:

1. Ras aushadhi:
   • Chandrakanta Ras
   • Mahalaxmivilas Ras
   • Shirovarja Ras
2. Kwatha (Decoction):
   • Dashamoola kwatha
   • Dhatryadi kwatha
3. Ghritapana (Oral administration of ghee):
   • Mayuradhya ghrita
   • Mahamayuradhya ghrita
4. Shirolepa (Applying medicated paste on head):
   • Kumkum ghrita lepa
   • Sarivadi Lepa
5. Shiro Abhyanga (Massage on Head):
   • Dashmool taila
   • Mahamayura ghrita
   • Prapaundarikadi taila

Shodhan chikitsa (Purification therapy):

1. Shiro Virechana karma (Nasya procedure)
2. Basti karma (Medicated enema)
3. Upanaha (Poultice)
4. Shiro Basti

Herbal Remedies for Migraine by Planet Ayurveda

Planet Ayurveda is an ayurvedic herbal medicines manufacturing unit and company. They offer a wide range of natural remedies made from 100% organic herbs, free from chemicals and preservatives, and manufactured in GMP-certified facilities. All the formulations are prepared under the supervision of highly experienced MD (Ayurveda) scholars and expert practitioners. The formulations are crafted with careful attention to detail and in accordance with traditional Ayurvedic principles, ensuring their efficacy and safety. They deal with complicated, serious and chronic health problems. Planet ayurveda’s medicines are 100% pure. They provide the best combination of effective herbal remedies such as Migraine Care Pack for ayurvedic treatment of migraine. The Migraine Care Pack is a natural, effective approach to managing migraines, offering relief without the side effects associated with conventional treatments. It is ideal for individuals seeking a holistic, Ayurvedic alternative for migraine management.

1. Ashwagandha Capsules
2. Medhya Churna
3. Pitta Balance
4. Arogyavardhini Vati
5. Brahmi Capsules

Products Description

1. Ashwagandha Capsules

These capsules are pure extract of Ashwagandha (Withania somnifera). Due to their adaptogenic, stress relieving properties they are effective in neurological disorders and improve memory and sleep. It is best known for its ability to balance cortisol levels in the body. Ashwgandha (Withania somnifera) helps to stabilize the nervous system which can be crucial for the individual with migraine. It may also promote better blood circulation, which is essential for reducing the frequency and intensity of migraines.

Dosage: Take 1 capsule twice a day after meals.

2. Medhya Churna

This herbal powder is pure extract of Vacha (Acorus calamus), Brahmi (Bacopa monnieri), Ashwgandha (Withania somnifera), Shwet Jeerak (Cuminum cyminum), Ajmoda (Carum roxburghianum) etc. This formulation is inspired by the classical Ayurvedic formula “Sarawat Churna”. It is a wonderful supplement as it improves memory and concentration. It is very effective on the nervous system. It is also effective in Epilepsy. Brahmi (Bacopa monnieri) is known for its cognitive enhancing properties which helps to improve concentration and mental clarity. All these herbs help to reduce mental fatigue, support brain health and boost cognitive functions.

Dosage: ¼ tsp twice a day with lukewarm water after meals.

3. Pitta Balance

Pitta balance capsules are standardised pure extract of many herbs. The key ingredients of this capsule are Praval Pishti (Coral), Akik Pishti (Agate), Jawar Mohra Pishti (Natural calcium compound), Giloy Satva (Tinospora cordifolia), Mukta Pishti (Natural calcium compound from pearl), Kushamand Ras. This capsule helps to balance the pitta in the body, when pitta increases in body it causes symptoms like headache, nausea. Pitta balance has a cooling effect on the body thus, it helps to give relief in Migraine.

Dosage: 1 capsule twice a day with normal water after meals.

4. Arogyavardhini Vati

Arogyavardhini vati is in the form of tablets. This is standardised pure extract of Haritaki (Terminalis chebula), Bibhitaki (Terminalia bellerica), Amlaki (Emblica officinalis), Chitrak Mool (Plumbago zeylanica) etc. It helps to remove toxins from the body by improving digestion. It has a healing effect. And it detoxifies the body. This tablet helps to reduce pitta and calm the overstimulation of the nervous system that contributes to migraine pain.

Dosage: 2 tablets twice a day with lukewarm water after meals.

5. Brahmi Capsules

This capsule is a pure extract of Brahmi (Bacopa monnieri). It consists of alkaloids and saponins. It balances tridosha in the body and enhances learning skills. It is very effective on the nervous system. It improves blood circulation in the brain. Brahmi is renowned for its brain-boosting, calming, and rejuvenating properties, making it especially beneficial in the management of migraine.

Dosage: 2 capsules twice a day with normal water.

Conclusion

Migraine can be cured but overdose of painkillers and other medicines can lead to serious side effects. It may worsen the headache in future. Ayurveda offers a holistic and natural approach to managing migraines by addressing the root causes rather than just alleviating symptoms. Ayurvedic management of migraines are 100% safe; they not only reduce the symptoms but also prevent further side effects. Panchkarma therapies and Planet Ayurveda’s migraine care pack have amazing results in the patients of migraine.