Migraine or Hemi crania
The exact cause of migraine is unknown. There are some precipitating factors like anxiety, overwork, emotional upsets, menopause, hypertension, cerebral tumors, premenstrual tension, head injury, spondylosis, noise, fumes, depression, fasting state, some foods e.g. orange or chocolate etc may precipitate an attack.
Women and Migraine:
Women of childbearing age are up to three times as likely to suffer from migraines as men of the same age are. This clearly shows that changes in hormone levels during the menstrual and other hormonal cycles are a major triggering factor of migraines among women. Some 14 % of women who suffer from migraines only experience them during or around menstruation, underlying the role played by oestrogen and progesterone withdrawal during the menstrual cycle in migraines among female patients.
Just about every event in a woman’s reproductive development has the potential to change the frequency, severity, or duration of migraine headaches including menarche, pregnancy, and menopause.
As if the pain of the migraine weren’t debilitating enough, migraines are often associated with a broad set of physical & neurological disorders – including complaints such as asthma, chronic fatigue, depression, anxiety and epilepsy. The symptoms of migraines are:
1. Prodromal symptoms: Weakness, lassitude, depression, etc may be complained of for few days.
2. Aura: The actual attack starts usually after waking from sleep. At first this aura may take the form of some visual disturbances e.g. dazzles, colored lights, ocular pain, lacrimation and photophobia. Sometimes tingling and numbness in the face and upper extremities may be seen. This state of aura lasts for about 15 minutes to half an hour.
3. Headache: After the aura passes off, headache starts. This may be uni or bilateral or may even be generalized. Often there may be localized spots on the head from where it starts. This pain is usually very severe (splitting headache) gradually increasing in intensity having a throbbing or spreading character. The side which is affected is constant in each attack. At the height of headache there may be vomiting, photophobia, sweating, pallor and exhaustion. Patient prefers to lie in a dark room and refuses all foods. The headache may last for 12-14 hours usually, but shorter and longer attacks may also occur.
4. After attack is over sometimes there may be increased urine flow. At times patient becomes very sleepy.
Effective treatment should focus on finding the underlying causes of the patients’ pain and providing permanent treatment that prevents progressive migraines and avoids the overuse of medication.
1. General Treatment: Patient should regulate their life so as to avoid both physical and mental fatigue. Precipitating factors as mentioned before should be corrected or avoided whichever is possible. Reassurance is very valuable.
2. Acute Attack: This may be treated with painkillers like aspirin, paracetamol or codeine tablets if the attack is mild. Ergotamine tartrate is the most useful medicine and can be given orally, parenterally or even as suppository or by aerosol.
3. Prevention of attack: Sedative like barbiturates, tranquillizers like chlordiazepoxide, antihistamines e.g. prochlorperazine etc may be used. The most effective drug is prophylactic use of dimethysergide given in a dose of 1 mgm - 3mgm thrice daily.
4. Hormone therapy may provide relief to women whose migraine attacks are linked to their menstrual cycles.
Allium cepa: It is good remedy for migraines with neuralgic pains in head and other parts of body; shooting pain like a fine, long thread; Coryza (cold) associated with tearing, bursting and throbbing headache; Headache ceases during menses and returns soon when flow disappears.
Anacardium ori: Good remedy for migraine; used for gastric and nervous headaches; dull pressure over vertex, as from a plug. Headache worse by mental exertion, motion, work and long after eating and relived after eating; headache aggravates on lying down and at night; associated symptoms are impaired memory, aversion to work, etc.
Arsenic Alb: Migraines with periodic headaches which is better by cold application. Throbbing, burning, congestive headache with anxiety and restlessness; Chronic headaches which aggravates from light.
Belladonna: Violent, throbbing, congestive headache which comes suddenly and goes suddenly; head hot, face flushed, throbbing of carotids; used mainly in right sided headache; Migraines starts in the back of the skull or upper neck and spread to the forehead and temple; headache from draft of air, heat of sun, from having the hair cut, suppressed catarrhal flow; headache associated with inflammatory conditions.
Iris versicolor: Intense migraines caused due to overeating and due to indigestion and acidity; blurry vision and pain extends to the face and teeth; pain with vomiting and a burning feeling in the throat and stomach; Symptoms become worse from rest and better from motion.
Lac Defloratum: Migraine with throbbing headache accompanied by constipation.
Bryonia: Congestive or neuralgic headache; mainly frontal or occipital; headache due to exposure to heat of sun or being overheated or due to constipation; headache worse from slightest jar or motion (even movements of eyelids, talking, even effort of thinking), in the morning, when stooping and better from pressure, lying down quietly and from hot fomentation, etc.
Gelsimium: Congestive type of headache; violent pain in the occipital region; pain begins in the nape of neck and passing over the vertex, settles over the eyes; headache preceded by dimness of vision or even blindness; headache with vertigo, patient seems intoxicated, with closed eyes and becomes motionless; neuralgic headache with nausea and vomiting; headache is relieved by urination, hot application and it aggravates from heat of sun and motion.
Natrum mur: Headaches in girls and women who are anaemic, chlorotic; headache due to emotional causes such as grief; headache begins with sunrise and goes off with sunset; throbbing headache from eye strain associated with nausea and vomiting; headache better by perspiration, in open air and after sleep, worse 10-11 am, from noise, music, motion, light and from warm room; periodical headaches; headache from bad effects of malaria, emotional excitement, mental exertion, eye strain and head injuries, etc.
Other medicines used in headaches & migraines are Ammon carb, Aconite, Arnica, Cedron, Cimicifuga, Cyclamen, Chionanthus, Coffea, Damiana, Glonoine, Helleborus, Ignatia, Kreosotum, Kali bich, Lachesis, Lycopodium, Natrum mur, Nux vom, Menispermum, Opium, Picric acid, Pulsatilla, Ruta G, Sangunaria, Sulphur, Scutellaria, Silicea, Spigelia, Sepia, Tarentula, Tobaccum, etc,