Aswathy T.R.  &  Dr. Salini D.N.

Migraine, the chronic neurovascular disorder is one of the major disabling diseases. According to the National Headache Foundation, more than 37 million people suffer from migraine. The disease is characterized by episodes of headache which has complex neurologic and environmental manifestations. The symptoms include a characteristic pain at the front or one side of the head accompanied by nausea, vomiting and increased sensitivity to light and sound. Usually migraines are initiated by aura – visual disturbances. These disturbances can be blind spot in front of eyes, blurred vision, seeing bright light, zig zag lights, lines etc. Some may get pre-migraine signs such as yawning, mild confusion, vomiting sensation etc. Fluctuating levels of several hormones are reported to be closely linked to migraine. Alcohol consumption, caffeine intake, reading in dim light, excessive work etc. can induce migraine.

According to Ayurveda, migraine is caused due to vitiation of Tridoshas (the three biological factors) with the predominance of either Pitta or Vata dosha. It can be compared with either Vatika sirasoola or Ananthavata. Pathophysiology of this condition is deep-rooted in the aggravation of Vata and Pitta due to Mithya (improper) ahara (diet) and vihara (regimen). Aggravating factors which vitiate these doshas include exposure to cold, increased mental stress, over strain, lack of sleep, poor diet, untimely intake of food, improper food habits etc. Improper dietary habits lead to vitiation of agni and hence improper digestion. This leads to the production of ama (digestive impurities) resulting in srotorodham (obstruction in channels) and causing inadequate circulation of impurities in the body as well as brain resulting in the manifestation of the disease. Symptoms of migraine have good similarity with that of vatika sirasoola. Ayurvedic line of treatment gives importance to a holistic approach in management of migraine including medicines as well as dietary and life style recommendations. Treatment is focussed on pacifying the vitiated doshas in digestive and nervous system.  First step in management lies in abstinence from aggravating factors - “nidana parivarjanam”. Vata can be pacified using ushna (hot) snigdha (unctuous) gunas and pitta by seeta (cold) guna.

Samana oushadhas (Internal medicine) for migraine:

• Pathyadi khada – used in the treatment of headache, earache, pain in temporal region, migraine etc.
• Shirashooladi vajra rasa – used in the Ayurvedic treatment of headache, migraine, tension headache, vascular headache etc.
• Bhoonimbadi khada – Used in fever, cold, sinusitis, headache.
• Kumaryasava- Kumaryasav is used in the treatment of abdominal distention, bloating, respiratory conditions like cough, cold, wheezing, piles, vata balance diseases and certain neurological conditions.
• Suthasekhara rasa – used in alleviating pitta.
• Sitopaladi choorna - used in alleviating pitta.
• Rasonaadi vati – Pacifies vata dosha.
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Medicines for external applications:

• Shirolepa – Application of herbal pastes like kushtaadi pralepam, prapunnada lepam, which pacify vata and paste of Sandalwood, camphor, Jatamansi etc for pitta dosha.
• Shiro Dhara – Pouring of thin stream of liquid over scalp.
  • Taila dhara - Oils like ksheerabala taila, chandanadi taila is carried out where vata involvement is high.
  • Ksheera dhara - Using medicated milk (bala ksheera kashayam and dasamoola ksheera kashayam) when there is vata and pitta involvement.

Panchakarma( Elimination therapy):

• • Nasyam –  Varanaadinasyam, karpasaadi nasyam, sireeshabeeja apamarga     moola nasyam.

 Home remedies:

• Apply a paste of ground clay or sandalwood powder mixed with rose water on the forehead.
• Mix ¼ teaspoon of clove powder with 1 teaspoon of cinnamon oil. Apply this paste on the affected area for 20-30 minutes.

Diet and tips:

• Avoid hot, spicy foods, fermented foods, white sugar, white flour products, and sour or citrus fruits, because they aggravate the Pitta in your body.
• Drink more water and add more fiber, fruits, vegetables, and whole grains in the diet.
• Avoid direct exposure to the sun, as migraine headaches are predominantly a Pitta disorder and can be triggered by hot sun.

It is estimated that globally, approximately 15% of people are affected by migraine. An early description consistent with migraine is contained in the Ebers papyrus, written around 1500 BCE in ancient Egypt. In 200 BCE, writings from the Hippocratic school of medicine described the visual aura that can precede the headache and a partial relief occurring through vomiting. Thus migraine is a medical disorder which has deep roots in the history of humanity.

(About the authors: Ms.Aswathy T.R. is a Research Scholar at Dept. of Computational Biology and Bioinformatics, University of Kerala, Trivandrum and Dr. Salini D.N. is Junior Scientist, AiCADD, Dept. of Computational Biology and Bioinformatics, University of Kerala, Trivandrum)