Migraine (Ardhavebhedak) Written by Sushma

Migraine

Just about everyone has a headache. But Migraine differs from other types of headaches. It is often described as a severe recurring headache with an intense throbbing pain on one side of the head, although 1/3 of the attacks can affect both sides. Attacks last between 4 and 72 hours and are often, but not always, accompanied by: Visual disturbances/ nausea, .vomiting, dizziness, extreme sensitivity to sound and light; and tingling or numbness in the extremities or face. In 15-20% of cases, neurological symptoms occur in advance of the actual headache. Of course, everyone is different, and symptoms vary by person and sometimes by attack.

Many people who suffer from Migraine begin by treating themselves with over-the-counter medications Sufferers sometimes consult their doctor as symptoms become more severe and disabling. Migraine is a moving target: symptoms are hard to evaluate and can change from one attack to the next.

Migraine ranks in the top 20 of the world's most disabling medical illnesses. Amazingly, over 10% of the populations, including children, suffer from Migraine. Unfortunately, Migraine is also very common in children and has been reported in children as young as 18 months old. About 10% of school-age children suffer from Migraine. Half of all Migraine sufferers have their first attack before the age of 12.

Before puberty boys suffer from Migraine more often than girls; as adolescence approaches, the incidence increases more rapidly in girls than in boys.
The illness often goes undiagnosed in children because their attacks can follow a different pattern than those in adults. In childhood Migraine, head pain is often less dramatic or severe than other symptoms, such as unexplained nausea or vomiting, abdominal pain, or severe vertigo. Moreover, it is not uncommon for attacks to occur with only minor or even no head pain, making it even harder to diagnose. Motion sickness is an early warning of the predisposition to childhood Migraine, perhaps revealing a special vulnerability to dizziness and vertigo (spinning) attacks. In childhood, the non-headache symptoms are often referred to as Migraine equivalents.

While symptoms of childhood Migraine may be different from those typically found in adults, children are just as disabled. Such children lose an average of 7-8 days of school each year, compared to 3-7 days lost for children without Migraine.

Migraine treatment has changed dramatically over the years. In the past, doctors often diagnosed patients with disabling head pain as neurotic and dismissed their complaints as psychiatric in nature. Later, researchers believed that the dilation and constriction of blood vessels in the head were the primary source of the pain; early Migraine medications focused on the blood vessels as the principal target for treatment. The Migraine pain reflects the advances in technology that help us understand how the brain works.

Researchers now believe that Migraine is a brain disorder involving nerve pathways and brain chemicals. There is also evidence that links a number of genes to Migraine, so that genetics is undoubtedly involved .

Migraine can often, but not always, be managed with proper diagnosis and treatment. There are three principle approaches to treatment: acute, preventive, and complementary. Acute treatment uses drugs to relieve the symptoms of attacks when they occur. Preventive treatment uses drugs taken daily to reduce the number of attacks and lessen the intensity of pain; although in some patients, life-style changes, biofeedback and other complementary treatments can help avoid the triggering or provocation of attacks. Complementary treatment, which does not use drugs, includes biofeedback, relaxation techniques, exercise, and proper rest and diet. '

Ayurvedic Perspective

From Ayurveda perspective, migraine headaches are due to a disorder in tridosha - the mind-body constitution. Although it is possible to get headaches from disorders in vata, phta, or kapha, migraines frequently occur when systemic pitta moves into the cardiovascular system, circulates, and affects the blood vessels around the brain. The blood vessels dilate due to the hot, sharp quality of pitta. This, in turn, creates pressure on the nerves, resulting in migraines. Pitta disorders are characterized by the red complexion and eyes, light sensitivity, burning sensation, anger, irritability, and nose bleeds. Liver and blood toxicity are often associated with these symptoms.

Types and symptoms

Classical migraine- It starts with irritability followed by an aura in the form of fortification spectra, shimmering silvery zigzag lines which march across the visual field for over 20 minutes, at times leaving transient visual fieldloss, vomiting, paroxysmal headache and focal neurological events. The patient prefers to sleep in a quiet and dark room during the headache phase. The headache may persist for several days. The frequency and severity of the disease may subside gradually with age.

Common migraine - The clinical features are same as classical type. Vomiting may or may not be there but zigzag lines across the visual field are not felt.

Complicated migraine - In addition to headache, feeling of pricking sensation over the face, palm, foot etc, speech difficulty, fatigue are the complaints made by the patient in his type.

Cluster migraine - There is a 5:1 predominance in men, with the onset usually in the third decade. Severe unilateral periodic pain in eye orbit and around ear, nasal congestion, lacrimation, redness over face and neck are characteristic features. Typically the pain starts in early hours of the day and lasts for 30-90 minutes. The syndrome may occur repeatedly for a number of weeks, followed by a respite for a number of months before another cluster. Avoidance of precipitants is vital in the line of treatment of the disease.

Phases of migraine

• Prodrome Phase
• Headache Phase
• Termination Phase
• Postdrome Phase

Causes of migraine

Instability of the vascular system

One of the theories suggests that certain arteries in our brain contract and cause a reduction blood flow to the visual area of our brain. It is suggested that this reduction of blood flow results in the visual and other symptoms that accompany a migraine, (piitaj ardhavebhedak)
Then, when blood vessels expand and put pressure on the nerves in the artery wall, there is pain. The underlying causes of these contractions and dilations of the; carotid arteries are more obscure. Susceptibility tends to run in families and affects more women than men.
Migraine patients are more prone to fainting when standing up suddenly than other people, and they are also more sensitive than other people to the vasodilatory effects of physical and chemical agents.

Magnesium Deficiency

Another theory proposes that nerve cells in the brain begin to lose function which causes a reduction in blood flow, which reduces levels of magnesium, which in turn adds to decreasing nerve cell function and that this dysfunction spreads in a wave like fashion to all effected areas, (vataj ardhvebhedak)

Blood platelet disorder

Blood platelet disorder has also been implicated, with the platelets of migraine sufferers aggregating more readily than normal platelets in response to neurotransmitters such as serotonin and adrenaline, the "stress" hormone. (raktaj ardhvebhedak)

Serotonin-nervous system disorder

Many researchers feel that serotonin; an important brain chemical may fuel migraines. Platelets (components of, our blood) contain all of the serotonin normally present in blood, and, after they aggregate, (clump together) serotonin is released, resulting in a potent constricting effect on the arteries.

Serotonin release triggered by eating certain foods, drinking certain beverages, stressing out or sometimes just oversleeping. When this happens, the blood vessels in head narrow. The ache can last for hours or days because the swelling lingers after the blood vessels return to normal, (vataj ardhvebhdak)

Food

Certain foods like tea, coffe, mushroom, peas, artificial sweetners precipitate an attack.

Low Blood Sugar or Hypoglycemia

For most people, low blood sugar caused by fasting or irregular meals often brings on a headache; but it quickly disappears following a meal. But/or people prone to migraines, the low blood sugar may start off a chain reaction that a belated meal will not stop.
Balanced meals eaten on a regular schedule are a must for those suffering from migraines. Many migraine sufferers find that they must eat something every few hours to prevent headaches. Chromium can help stabilize the blood sugar.

Estrogen Level Fluctuation in Women

Women suffer from migraines much more frequently than men. Recent research has pointed to fluctuating levels of estrogen as a factor in their development. For these women, headaches can disappear during pregnancy, when estrogen levels are constant. If you get a headache every month just before your period, it could be because your blood-sugar levels are dropping. Take chromium as supplement to remedy this. Muscle cramping can also contribute to period related headaches. Calcium and evening primrose oil are helpful. Menopause can bring complete relief from headaches, or, for some women, make them worse. Birth control pills affect migraines as well.

Stress, Anxiety and Excitement

Stress, anxiety, and excitement promote the release of hormones and neurotransmitters, which can provoke a migraine attack. Factors In Combination Identifying the factor responsible for your migraine may be complicated by the fact that there may be more than one. For instance, skipping breakfast may not affect you most days, but it may trigger a headache if you are also tired and under stress. Getting up unusually early may normally be no problem, but if you rise before dawn on the day before your period, it may plunge you into a migraine. Keeping a diary of activities, including what and when you eat, is really the best way to pinpoint the causes of your migraines, (tridoshaj ardhvebhedak)

Other Triggers for Migraine Triggers for migraines are highly individual but strong emotions of anger, excitement or anxiety are common. Whiplash, sleep deprivation, jet lag, oversleeping, excessive smoking and strong odors like perfumes and tobacco can also cause migraine. An iron deficiency often causes migraine headaches due to insufficient oxygenation of the brain.

Treatment

The treatment involves following the recommendations for pitta pacifying foods, herbs and lifestyle. Avoid hot, spicy foods, fermented foods, and sour or citrus fruits. A pitta-soothing diet is effective both for migraine relief and as a preventive measure. First thing in the morning, take 1 ripe banana. Peel it, chop it into pieces, and add 1 teaspoon warm ghee, 1 teaspoon date sugar, and a pinch of cardamom on top. This is delicious, and it will help to reduce pitta and prevent a headache from arising. Juice of Bhringaraj or Apamarg, ghee or misri mixed with milk may be used as nasal drops.ghee cake, ghee jalebi with milk are helpful as diet. 
Many patent and classical medicines like;sirsuladivjra ras,laghu sutshekar ras,avipattikar, Suvarna Sutashekhara, godanti bhasm etc, if taken correctly, can Cure the diseaseThe patient should take care of indigestion, constipation, mental worries, anxieties excessive heat, excessive cold ad rain.

Triphala powder, one teaspoonful at bed_timeif the patient is having nauseating sensation, it will be better to allow the patient to vomit out. Often indigestion precipitates the attacks of this disease. Vomiting relieves ingestion and thus, the patient is relieved of his headache. Even if there is no nausea, the patient should be made to drink tumberfuls of water and vomit out.
In a tumbler of water about half a teaspoon of salt should be added. It works better if lukewarm .water is used for this purpose. After drinking water as much as possible, the throat of the patient should be tingled with the help of his own finger to induce vomiting and relive the patient of hi£ headache.

Irregularities of diet and excessive exertion must be avoided. The diet should have low. content of fats and oilsAvoid hot. spicy foods, fermented foods, and sour or citrus fruits.Exposure to hot cold- should be avoided. Fried things and spicy food articles are harmful to the patient. Curd and other sour things " are also to be avoided.Cow's milk and cows ghee are very useful for the patient suffering from migraine.Ginger (Zingiber officinale) contains constituents that inhibit platelet aggregation. Ginger tea works, for a migraine headache in the front of the head. 500 to 600 mg of ginger powder mixed with water every four hourse for four days provides relief.

1 cup of Fenugreek infusion during the day, relieves pain.
Long-term healing includes chyvanprash, brahmi, and Ashwagandha

Other Treatments

Avoid Direct Sun

Because migraine headaches are predominantly a pitta disorder, they are affected by the hot sun. When the sun rises, its hot, sharp, penetrating rays increase pitta in the cardiovascular system and cause the dilation of the blood vessels in the brain, which results in the painful headaches. So avoid direct exposure to the sun. If you have to go out, use an umbrella or wear a hat or other protection from the sun.

Nature walks

Walks in the full moon and by water; and flower gardening reduce Pitta causes of migraines.

Soothing Nose Drops

Once a headache has developed, putting about 5 drops of warm brahmighee in each nostril will help relieve the pain. Else cinutaiJ nasya, shadbindu tail is recommended in epics.

Head Massage

Shiro dhara (hot oil head massage) is also beneficial. Hot massage with brahmi cooked in coconut oil is highly essential.

Recommended Yoga Postures

Moon Salutation is especially good for migraines..Yoga postures such as the Hidden lotus, boat pose ,Bow pose, Spinal twist' Palm Tree pose, and Standing on the Toes are also good to combat migraines.Do a cooling breathing exercise such as shkaii To do it, curl your tongue into a tube. Inhale slowly through the curled tongue, swallow, and then exhale normally through the nose, keeping the mouth closed. You will feel the incoming air cool your saliva, your tongue, and the oral mucous membranes.This breathing exercise will lower the body temperature, and make the saliva cool. It also helps to quench thirst, and improves digestion, absorption, and assimilation.