AYURVEDIC TREATMENT PROTOCOL FOR MIGRAINE

MODERN DISEASE EXPLANATION

Migraine is a primary headache disorder characterized by recurrent headaches that are moderate to severe.Typically, the headaches affect one half of the head, are pulsating in nature, and last from two to 72 hours. 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: 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.

Migraines are believed to be due to a mixture of environmental and genetic factors.  About two-thirds of cases run in families. Changing hormone levels may also play a role, as migraines affect slightly more boys than girls before puberty and two to three times more women than men. The risk of migraines usually decreases during pregnancy. The underlying mechanisms are not fully known. It is, however, believed to involve the nerves and blood vessels of the brain.

STAGES OF MIGRAINE

Migraine can be divided into five distinct phases:

1. Early Warning Symptoms (prodromol)

A significant number of migraineurs experience warning symptoms for up to 24 hours before the attacks start but may not recognise these signs until they know what to look for.  These symptoms include:changes in mood, varying from feeling elated, on top of the world and full of energy, flying through the day’s work and accomplishing twice as much as usual, to feeling depressed and irritablegut symptoms, nausea, changes in appetite (intense hunger or sugar craving: may consume a whole packet of biscuits or chocolates), lack of appetite, constipation, diarrhoeaneurological changes, drowsiness, incessant yawning, difficulty finding the right words (dysphasia), dislike of light and sound, difficulty in eye focuschanges in behaviour, hyperactive, obsessional, clumsy, lethargicmuscular symptoms, general aches and painsfluid balance changes, thirst, passing more fluid, fluid retention. All these symptoms arise in the hypothalamus, the deep-seated part of the brain.

2. Aura 

Aura accompanies migraine attacks for about 20 – 30% of migraineurs.  The most common aura symptoms are visual disturbances such as bright zigzag lines, flashing lights, difficulty in focusing or blind spots.  Aura affects the visual field of both eyes despite often seeming to affect one only and lasts 5-60 minutes then the vision normally restores itself.  Less commonly aura affects sensation or speech.  When several aura symptoms are present, they usually follow in succession.

3. Headache

Those experiencing classical migraine (migraine with aura) may or may not have a gap of up to an hour between the end of the aura and the onset of the head pain and may feel a bit ‘spaced out’ during the gap.  Regardless of whether one experiences migraine with aura, or common migraine (migraine without aura), the headaches are similar. The headache phase can last up to three days.  It is often throbbing and on one side of the head, but can affect both.  It can be on the same or opposite side to the aura.  Movement makes it worse.  The most common accompanying symptoms in this phase are nausea, vomiting and sensitivity to light, sound and smell.  Eating can help especially starchy foods.  The symptoms can be more distressing than the headache itself.

4. Resolution

The way an attack ends varies greatly.   Sleep is restorative for some.  Being sick can make children feel much better.  For others effective medication can improve attacks.  For a few nothing works except the headache burning itself out.

5. Recovery (postdromol)

A feeling of being drained may exist for about 24 hours, others may feel energetic or even euphoric.

There are several types of migraine, including:-

o migraine with aura – where there are specific warning signs just before the migraine begins, such as seeing flashing lights

o migraine without aura – the most common type, where the migraine occurs without the specific warning signs

o migraine aura without headache, also known as silent migraine – where an aura or other migraine symptoms are experienced, but a headache doesn't develop

DISEASE- AYURVEDA CONCEPT

In Ayurveda this condition is referred as ‘Sooryavarta’ . Soorya means ‘Sun’ and avarta means ‘affliction’ or ‘blockage’. The headache gets worsened on sunrise, peaks during noon hours and reduces after evening. Even though this is the typical feature of this illness, it may not be true in all cases. Symptoms may vary based on body types and habits.The traditional science of Ayurveda does not regard Migraine as a case of prolonged headaches. On the contrary, it considers this condition to be caused by deep-rooted problems, including a sensitive nervous system and impaired digestion. Improper diet and lifestyle causes aggravation of Pitta (Ayurvedic humor representing Fire) in the body. In an aggravated state, Pitta impairs digestion, leading to production of digestive impurities (known as ama). This ama gets stored in the manovahi strotas (mind channels), thereby becoming the cause for pains in migraine.

TREATMENT PROTOCOL

Ayurvedic therapies for migraine: 

1. Shirolepa – Application of herbal pastes which pacify Pitta Dosha like Sandalwood, camphor, Jatamansi.

2. Shiro Dhara – pouring of thin stream of liquid over scalp.

3. Taila dhara with oils like ksheerabala taila, chandanadi taila is carried out where Vata involvement is high.

4. ksheera dhara (cow milk) is done when Pitta involvement is more

5. Takra Dhara (buttermilk) is done when there is obstruction to Vata passage is to be removed.

6. Kavala graha – Oil pulling, with chandanadi taila, mahanarayana taila

7. Shirovasti – Retaining the medicated oils over the leather cap fitted over the scalp. Any vata-pitta pacifying oils are beneficial for this purpose.

8. Sneha nasya – Instillation of medicated oils can be carried to the nostrils. Shadbindu taila or Anu taila yield significant benefits in this condition.

CLASSICAL MEDICINES

• PATHYAKSHADATHRYADHI KASHAYM

• GUGGULUTIKTHAKAM KASHAYAM AND GRITHAM

• KAISHORA GUGGULU

• HINGUVACHADI CHOORNAM

• ANU THAILAM 

• SHADBINDU TAILAM

• VARANADI KASHAYAM

• VARANADI GRITHAM

• AROGYAVARDHINI VADI

AHARA VIHARAM

A number of factors may trigger migraines including:-

• Hormonal changes in women. Fluctuations in estrogen seem to trigger headaches in many women. Women with a history of migraines often report headaches immediately before or during their periods, when they have a major drop in estrogen.

• Others have an increased tendency to develop migraines during pregnancy or menopause.

• Hormonal medications, such as oral contraceptives and hormone replacement therapy, also may worsen migraines. Some women, however, find their migraines occur less often when taking these medications.

• Foods. Aged cheeses, salty foods and processed foods may trigger migraines. Skipping meals or fasting also can trigger attacks.

• Food additives. The sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods, may trigger migraines.

• Drinks. Alcohol, especially wine, and highly caffeinated beverages may trigger migraines.

• Stress. Stress at work or home can cause migraines.

• Sensory stimuli. Bright lights and sun glare can induce migraines, as can loud sounds. Strong smells — including perfume, paint thinner, secondhand smoke and others — can trigger migraines in some people.

• Changes in wake-sleep pattern. Missing sleep or getting too much sleep may trigger migraines in some people, as can jet lag.

• Physical factors. Intense physical exertion, including sexual activity, may provoke migraines.

• Changes in the environment. A change of weather or barometric pressure can prompt a migraine.