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MIGRAINE

Causes and Triggers

Ocular Migraine

Vertebrobasilar Migraines

Symptoms

Home Remedies

Prevention

Ayurvedic Treatment

Panchakarma and Rasayana Therapies

 
Migraine (from the Greek words hemi, meaning half, and kranion, meaning skull) is a debilitating condition characterized by moderate to severe headaches, and nausea. Migraine headache is caused by vasodilatation (enlargement of blood vessels) that causes the release of chemicals from nerve fibres that coil around the large arteries of the brain. Enlargement of these blood vessels stretches the nerves that coil around them and causes the nerves to release chemicals. The chemicals cause inflammation, pain, and further enlargement of the artery. The increasing enlargement of the arteries magnifies the pain.

The typical migraine headache is unilateral (affecting one half of the head) and pulsating in nature and lasting from 4 to 72 hours; symptoms include nausea, vomiting, photophobia (increased sensitivity to light), phonophobia (increased sensitivity to sound); the symptoms are generally aggravated by routine activity. Some people who get migraines have warning symptoms, called an aura, before the actual headache begins. An aura is a group of symptoms, including vision disturbances that are a warning sign that a bad headache is coming.

This vascular headache is most commonly experienced between the ages of 15 and 55, and 70% to 80% of sufferers have a family history of migraine. It is about three times more common in women than in men.

Migraine is often misdiagnosed as sinus headache or tension-type headache.

Causes and Triggers
A migraine is caused by abnormal brain activity, which is triggered by stress, certain foods, environmental factors, or something else. However, the exact chain of events remains unclear. Today, most medical experts believe the attack begins in the brain, and involves various nerve pathways and chemicals. The changes affect blood flow in the brain and surrounding tissues.

Migraine attacks may be triggered by:

  • Acidity, indigestion or constipation
  • Alcohol
  • Allergic reactions
  • Bright / flickering lights
  • Certain odours / perfumes
  • Changes in hormone levels (which can occur during a woman's menstrual cycle or with the use of birth control pills)
  • Exercise
  • Fasting / missed meals
  • Loud noises
  • Low blood sugar, low blood pressure
  • Physical or emotional stress
  • Sleep disturbances
  • Smoking or exposure to smoke
  • Stress
Certain foods and preservatives in foods may trigger migraines in some people. Food-related triggers may include:
  • Aspartame
  • Any processed, fermented, pickled, or marinated foods or foods containing monosodium glutamate (MSG)
  • Baked goods
  • Caffeine
  • Chocolate
  • Dairy products
  • Foods containing tyramine, which includes red wine, aged cheese, smoked fish, chicken livers, figs, and certain beans
  • Fruits (avocado, banana, citrus fruit)
  • Meats containing nitrates (bacon, hot dogs, salami, cured meats)
  • Nuts
  • Onions
  • Peanut butter

The interval between exposure to a trigger and the onset of headache varies from hours to two days. Exposure to a trigger does not always lead to a headache. Conversely, avoidance of triggers cannot completely prevent headaches. Different migraine sufferers respond to different triggers, and any one trigger will not induce a headache in every person who has migraine headaches

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Ocular Migraine
Ocular migraine refers to a neurological syndrome which is characterized by abnormal visual sensations followed by nausea, vomiting and headaches. In some extreme cases, a patient may feel heightened sensitivity to light and sound at the early stage of the attack. It is a temporary problem and there is high possibility that you may lose vision for few minutes. You may experience lines or bright spots that float slowly across your vision field.

Patients suffering from ocular migraine experience a wide variety of visual symptoms. Generally, you will see a small and enlarging scotoma (a blind spot) in your central vision with shimmering zigzag lines, flickering and bright lights inside the blind spot. The complete migraine pain ends within few minutes, however, it normally lasts for 30 to 45 minutes.

Generally, they are harmless and painless. Moreover, they do not cause any permanent brain or visual damage. Tiredness, particularly after extended periods of watching television, computer work, reading or any other work that requires focus also leads to Ocular Migraine
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Vertebrobasilar Migraines
Vertebrobasilar migraines are characterized by dysfunction of the brainstem (the lower part of the brain that is responsible for automatic activities like consciousness and balance).  

The symptoms of vertebrobasilar migraines include:
  • Fainting
  • Vertigo (dizziness in which the environment seems to be spinning)
  • Double vision

Hemiplegic Migraines

These migraines are characterised by paralysis or weakness of one side of the body often mimicking a stroke. The paralysis or weakness is usually temporary, but sometimes it can last for days.

Silent Migraines

Silent migraines are a medical oddity. How can you have a migraine "headache" without headache pain? Some people have "silent migraine" -- a migraine without the symptom of headache pain.  The symptoms of silent migraine include any of the typical signs and symptoms of a migraine- but without the pain

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Symptoms

Vision disturbances, or aura, are considered a "warning sign" that a migraine is coming. Not every person with migraines has an aura. Those who do usually develop one about 10 - 15 minutes before the headache. However, it may occur just a few minutes to 24 hours beforehand. A headache may not always follow an aura.

Migraine headaches can be dull or severe. The pain may be felt behind the eye or in the back of the head and neck. For many patients, the headaches start on the same side each time. The unilateral headaches typically change sides from one attack to the next. (In fact, unilateral headaches that always occur on the same side should alert the doctor to consider a secondary headache, for example, one caused by a brain tumour). The headaches usually:

  • Feel throbbing, pounding, or pulsating
  • Are worse on one side of the head
  • Start as a dull ache and get worse within minutes to hours
  • Last 6 to 48 hours

Physical symptoms include:

  • Appetite loss
  • Chills
  • Diarrhoea
  • Fatigue
  • Food cravings
  • Increased urination
  • Nausea and vomiting
  • Thirst
  • Vomiting

Emotional and mental symptoms include:

  • Confusion
  • Euphoria
  • Irritability

Aura symptoms include:

  • Auditory hallucinations
  • Temporary blind spot
  • Difficulty in concentrating, remembering or trouble finding words
  • Disruptions in hearing
  • Distortions in smell or taste
  • Dots or spots in vision
  • Flashing lights
  • Numbness, a pins-and-needles feeling, or other unusual body sensations
  • Tunnel vision
  • Seeing stars, wavy or zigzag lines
  • Sweating

Even without the pain of migraine, the other symptoms can be temporarily disturbing and can disrupt your normal day.

 Symptoms may linger even after the migraine has gone away. Patients with migraine sometimes call this a migraine "hangover."

Symptoms can include:

  • Feeling mentally dull, like your thinking is not clear or sharp
  • Increased need for sleep
  • Neck pain
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Home Remedies
  • Almonds are good for migraines. Eat 10-12.
  • Juice of ripe grapes is also effective against migraine. Consume the juice in small doses several times a day.
  • Add half teaspoon mustard seeds powder to three teaspoons water and put in the nostrils. It helps to decrease the migraine headache.
  • The old therapy for treating migraine include cabbage leaf compress. Take few leaves of the cabbage crush them, and then place in a cloth and bind on the forehead at bedtime, or when convenient during the day. The compress should be renewed when the leaves dry out. It is very effective in migraine relief.
  • The rind of lemon is also very beneficial in the treatment of migraine headache. The rind should be pounded into a fine paste in a mortar. Plaster the paste on the forehead. It is very helpful in migraine cure.
  • Carrot juice, in combination with spinach or beet and cucumber juices, is also very effective in the treatment of migraine. In the first combination, 200 ml of spinach juice may be mixed with 300 ml of carrot juice to prepare 500 ml or half a litre of the combined juices. In the second combination, 100 ml each of beet and cucumber juices may be mixed with 300 ml of carrot juice.
  • Aromatherapy is considered to be one of the best migraine remedy. Take some aromas that stand out of rest of all. These include peppermint, sandalwood, lavender and eucalyptus. These all herbs as essential oils are best for treating migraines. Put them in cold or warm water and then take a cloth, dip it into the solution and then place it at affected area i.e. head.
  • Lukewarm water enema cleans up the bowels and hence removes the toxins. This is also found to be useful in treating the migraine.
  • Niacin improves the condition in migraine. Opt for a diet rich in niacin. The diet includes green leafy vegetables, nuts, sunflower seeds, whole wheat, yeast, tomatoes etc. The recommended dose is about 100 gm daily.
  • Primrose oil is considered to be one of the best home remedies for treating migraine. It is also potent anti-inflammatory agent that keeps the blood vessels from constricting.
  • Garlic is potent detoxifier and also best for treating migraine. You can go for taking raw garlic and can also go for cooked garlic in various forms.
  • Vitamin C with bioflavonoids helps reducing the attack of migraine. This is also good for cardiovascular headache and numbness in the body.
  • Chamomile - one of the best natural sedatives, chamomile can relieve migraine and tension headaches, and can alleviate symptoms such as irritability and nervousness.Drink chamomile tea everyday as this will reduce migraine symptoms and is one of the simple home remedies for migraine.
Four to five leaves of fresh feverfew (Tanacetum parthenium) or in dried form has been known to reduce symptoms of migraine. This is one of the well liked home remedies for migraine. ·Make a paste of freshly ground sandalwood and apply to the forehead, let it dry and rub off it by hand and wash it. .
  • Dandelion Root (Taraxacum officinalis, Simhadanti, Dudal, Kanphul) - an important liver tonic, dandelion can cleanse the liver and help remove toxins which may be the root of migraine headaches and similar conditions.
  • Ginkgo Biloba (Maiden Hair Tree, Balkuwari) - one of the oldest herbal remedies, ginkgo has been shown to increase oxygen and blood flow to the brain. It can help dilate blood vessels therefore easing migraine pain.
  • Gotu Kola (Centella asiatica, Brahmamanduki, Mandukaparni, Indian Pennywort) - similar in action to ginkgo, gotu kola can help improve circulation in the brain and increase blood vessel strength.
  • Rosemary - used in many culinary dishes, rosemary has antioxidant capabilities and can increase your sense of well-being.
  • Yucca Root - also a treatment for arthritis pain, yucca can relieve high blood pressure and can relieve migraines and other types of headaches.

Ginger (Zingiber officinale) contains constituents that inhibit platelet aggregation. Ginger tea works, for a migraine headache in the front of the head. Take 500 to 600 mg of ginger powder mixed with water every four hours for four days at the onset of visual aura. Improvement is seen within 30 minutes of consuming it.

Make a tea from equal proportions of ashwagandha (Withania somnifera, Indian ginseng) and brahmi (Bacopa monnieri, Coastal Waterhyssop), about 1/3 to 1/2 teaspoon each, steep in a cup of water for about 10 minutes, and drink 2 or 3 times a day.

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Prevention
There are two ways to prevent migraine headaches:

1.By avoiding factors ("triggers") that cause the headaches, and

2.By preventing headaches with medications (prophylactic medications). Neither of these preventive strategies is 100% effective. The best one can hope for is to reduce the frequency of headaches.

Understanding your headache triggers can help you avoid foods and situations that cause your migraines. Keep a headache diary to help identify the source or trigger of your symptoms. Then modify your environment or habits to avoid future headaches.

Other tips for preventing migraines include:

  • Avoid smoking
  • Avoid alcohol
  • Avoid artificial sweeteners and other known food-related triggers
  • Get regular exercise
  • Get plenty of sleep each night. Disturbances during sleep, too much sleep, poor quality of sleep, and frequent awakening at night are associated with both migraine and tension headaches, whereas improved sleep habits have been shown to reduce the frequency of migraine headaches. Sleep also has been reported to shorten the duration of migraine headaches.
  • Fasting possibly may precipitate migraine headaches by causing the release of stress-related hormones and lowering blood sugar. Therefore, migraine sufferers should avoid prolonged fasting.
  • Bright lights and other high intensity visual stimuli can cause headaches in healthy subjects as well as patients with migraine headaches, but migraine people who suffer from migraines seem to have a lower than normal threshold for light-induced headache pain. Sunlight, television, and flashing lights all have been reported to precipitate migraine headaches.
  • Caffeine is contained in many food products (cola, tea, chocolates, and coffee) and OTC analgesics. Caffeine in low doses can increase alertness and energy, but caffeine in high doses can cause insomnia, irritability, anxiety, and headaches. The over-use of caffeine-containing analgesics causes rebound headaches. Furthermore, individuals who consume high levels of caffeine regularly are more prone to develop withdrawal headaches when caffeine is stopped abruptly.
  • Chocolate has been reported to cause migraine headaches, but scientific studies have not consistently demonstrated an association between chocolate consumption and headaches. Red wine has been shown to cause migraine headaches in some migraine sufferers, but it is not clear whether white wine also will cause migraine headaches.
  • Tyramine (a chemical found in cheese, wine, beer, dry sausage, and sauerkraut) can precipitate migraine headaches, but there is no evidence that consuming a low-tyramine diet can reduce migraine frequency.
  • Monosodium glutamate (MSG) has been reported to cause headaches, facial flushing, sweating, and palpitations when consumed in high doses on an empty stomach. This phenomenon has been called Chinese restaurant syndrome.
  • Nitrates and nitrites (chemicals found in hot dogs, ham, frankfurters, bacon and sausages) have been reported to cause migraine headaches.
  • Aspartame, a sugar-substitute sweetener found in diet drinks and snacks, has been reported to trigger headaches when used in high doses for prolonged periods.
  • Some women who suffer from migraine headaches experience more headaches around the time of their menstrual periods. Other women experience migraine headaches only during the menstrual period. The term "menstrual migraine" is used mainly to describe migraines that occur in women who have almost all of their headaches from two days before to one day after their menstrual periods. Declining levels of oestrogen at the onset of menses is likely to be the cause of menstrual migraines. Decreasing levels of oestrogen also may be the cause of migraine headaches that develop among users of birth control pills during the week that estrogens are not taken.
  • Learn to relax and reduce stress.
  • Avoid being out in the sun: Migraine headaches are predominantly a pitta disorder and is affected by the hot sun. When the sun rises, it’s hot 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.
  • Do a cooling breathing exercise such as shitali. 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.
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Ayurvedic Treatment
There is no specific cure for migraine headaches in modern medicine. The goal in modern medicine is to prevent symptoms by avoiding or changing your triggers. Migraine headache is a risk factor for stroke in both men and women. Migraine headaches generally represent no significant threat to your overall health. However, they can be a long-term (chronic) problem and may interfere with your day-to-day life.

Ayurvedic treatment includes therapies that may or may not involve medications. Patients suffering from migraine generally complain of constipation. If such a symptom is diagnosed, immediately take steps to cure it.

To avoid constipation, mix one teaspoon of Triphala powder in a cup of hot milk and drink at bedtime.

More often than not, prior to having the migraine pain the patients experience nausea. This happens mainly because of indigestion. Indigestion precipitates migraine.

The best way to get instant relief from the migraine pain is vomiting. Ayurveda also recommends that in such situations, the patient must vomit. What is more, even if the patient does not have the nauseating sensation, Ayurveda prescribes forced vomiting.

The technique: The patient must drink as much water as possible. Normally, 10 large glasses of lukewarm water should suffice. Add a teaspoon of salt to each glassful of water.

To induce forced vomiting, sit down on your haunches with the body weight balanced on the legs. Insert the index and middle finger of the right hand deep inside the throat. Simultaneously, put pressure deep inside the tummy. This will aid the forced vomiting process.

After successful vomiting, gargle and wash your face. The migraine pain will disappear.

The following herbal compound is beneficial in managing migraine.

  • Shatavari (Asparagus racemosus, Indian Asparagus) 5 parts
  • Brahmi (Bacopa monnieri, Coastal Waterhyssop, Brahmi, Thyme-leafed gratiola) 4 parts
  • Jatamamsi (Nardostachys jatamansi, Muskroot, Indian Spikenard) 3 part
  • Musta (Cyperus rotundus, nutgrass) 3 parts

Prepare this mixture, and take 1/2 teaspoon twice a day, morning and evening, after breakfast and dinner, with a little lukewarm water. This formula is designed to pacify the aggravated pitta and help relieve migraine headaches.

Shadbindu Tailam: This Ayurvedic medicated oil is quite effective in treating migraine. This medication irritates the nasal mucous membrane. However, it effects instant relief. This drug is to be taken with mustard oil. Only six drops are to be taken in each nostril daily and till the symptoms persist.

Anu Tailam: Proper use of this oil brings about instant relief to acute and chronic migraine instances. This medicated oil needs to be inhaled deeply to induce forced sneezing. It removes the nasal blockages from the sinuses and their passages. The nerves in the nasal routes are soothed.

Even as the mental strain is removed, the heaviness in the head is also relieved. The patient will be able to sleep soundly. Above all, there are no side effects.

Ingredients: It is prepared from 26 medicinal plants. The definite proportions of these plants are then boiled in goat's milk and gingili oil.

Dose: One needs to drop at least 15 drops of this oil in each nostril to induce sneezing. This medicated oil needs to be inhaled at least thrice daily

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Panchakarma and Rasayana Therapies
The treatment for migraine would include the appropriate Panchakarma treatment and Rasayana therapies. The Panchakarma treatment is meant to flush out the toxins. They are classified as purvakarma (pre-purification), pradhanakarma (main purification) and paschatakarma (post purification) phases and include various types of therapies like oil massages, fermented liquid massages, medicinal enemas and herbal purification methods.

The Rasayana Therapies are meant to nourish the body, to bring the doshas back to balance and to regenerate the body. These therapies include diet regulations, intake of oral medicines and Ayurveda tonics. The benefits and results of the treatment are seen only after the Rasyana Treatment is over. The results will manifest after 3 to 4 weeks as the body takes time to regenerate itself. 

Panchakarma Therapies

Purvakarma (Pre-purification) Therapies: These therapies are done to loosen the toxins, open up the circulation channels and get the body ready for discarding these wastes.  These methods are highly relaxing for the body and mind. The following pre-purification methods are usually adopted for treating migraines:

Shirodhara: In this process herbal oil, medicated milk, medicated butter milk etc, are poured on the forehead in an oscillating manner for about 35 to 45 minutes.  This is very effective in providing both temporary and permanent relief from migraines and headaches.

Thakradhara: This treatment involves continuous pouring of medicated buttermilk on the forehead. It cools the head and gives immediate relief from headaches. It also has a soothing effect on the eyes.

Thalam: Special powder mixed with medicated oil is applied on the crown of the head vertex and retained for 20 to 45 minutes. 

Lepam: This is a process in which medicated herbal paste is applied on the head or forehead and has been found to offer immediate relief to persons suffering from severe headaches.

Thalapothichil: Various medicinal herbs are made into a paste, applied smoothly on the scalp and then covered with leaves. The pack remains for about 40-50 minutes for effective healing. 

Pradhanakarma (Main Purification) Therapies: Main purification therapy is the phase of elimination of toxins that were loosened at the pre purification treatment stage. The Panchakarma treatments for migraine are:

Nasyam: This Ayurvedic therapy is one of the most powerful remedies for migraine. This is the instillation of medicated oil through the nose. An excess of humours accumulated in the human body is eliminated by Nasyam.  It improves blood circulation, reduces nerve stretching and inflammatory pains in the head.

Virechanam: This is purgation through oral intake of herbal medicines. This eliminates poisonous wastes through the anal route.

It is advised to take rest for about 7 to 14 days after the Panchakarma treatment as the body needs to recoup.

Rasayana Therapies

These are body nourishing therapies to rejuvenate the body and mind after the Panchakarma treatments. They keep the enzymes in the tissue cells in their normal functioning condition, restore and balance the body functions and maintain the overall health and well being of an individual for much longer periods after the Panchakarma course.  Rasayana includes oral medicines and diet regulation.

Oral Medication

As headaches are a result of the imbalance in the Vata Doshas, the oral medicines administered are meant to rectify this imbalance. Kashayams (for example, Maharasnadi Kashyam) and Lehyams are generally prescribed after a careful study of the patient’s metabolism. These Kashayams and Lehyams are very effective in curing headaches and also in immunising one from periodic headaches.

Re-establishing a person's constitution is always an essential part of the therapy. Therefore, it is also important to follow a diet and lifestyle that helps to regain the humour balance. 

Diet

Good dietary habits would help an individual maintain good health and offer immunity from recurring bouts of headaches. Consuming cooked vegetables without oil should be encouraged. Vegetable juices and soup, fruits and fruit juices including apple, mango, should be taken. Rice, salad and buttermilk can always be consumed.  

Give up pickled food, cheese, smoked fish and chocolate. These are the first to be avoided. Alcohol and non-vegetarian diet may lead to migraines occurring more frequently. One can include salads into the diet. Green leafy vegetables containing roughage will be beneficial as they prevent constipation that often leads to headache.

Ayurveda believes one has to restrict food that aggravates Vata Dosha or Pitta Dosha. Spicy, oily and stale food are strictly to be avoided.

Yoga and Lifestyle

Simple Yoga asanas have been found to serve both as an alternative and as a supplement for dealing with migraine. Yoga is known to offer both cure and immunity from headaches.

Headaches caused due to tension and worry can be alleviated through deep breathing and relaxation, especially in a lying down position in a quiet place. Inverted postures, or those where the head is lowered briefly, increase oxygen to the brain and can reduce headache-causing strain.

Avoid strenuous exercise, late nights, too much television, and other stimulating experiences.
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