Migraine is a severe type of headache characterised by recurrent attacks of unilateral headache usually associated with nausea, vomiting and/or photo-phonophobia. The attacks are variable in nature i.e., intensity, frequency and duration etc. It has been observed that, generally due to lack of knowledge or awareness, the patients consider migraine as a simple headache and use pain killers frequently to obtain relief which is not a permanent solution. Therefore, an observational clinical study was undertaken with an objective to ascertain the efficacy of homeopathic treatment in the cases of migraine. Homeopathy is based upon holistic concept that guides to treat the patient as a whole, and for each case of migraine, the holistic picture includes mental and physical makeup, rare, peculiar, strange symptoms and miasmatic expressions to complete the totality of symptoms to individualise the patient. With homeopathy, not only the patient gets relief in the symptoms but recurrence/tendency of the illness is also reduced.
Materials and Methodology
Total 89 cases of migraine were registered at Homeopathic Migraine Clinic, Jaipur, India. Out of these, according to the inclusion and exclusion criteria, 76 cases were enrolled for this study from the age group of 11 to 60 years. Each case was studied individually and follow up was done according to the Homeopathic principles. The study was undertaken for a period of 18 months w.e.f. 1 January 2012.
A detailed case taking along with review of clinical history was undertaken. Investigations were advised, wherever required, such as X-ray PNS, CT scan, MRI in doubtful cases to rule out any other diagnosis for the symptoms. Diagnosis was made following the criteria given by the International Headache Society (IHS) in International Classification of Headache Disorders, 2nd edition (ICHD- 2) 2004. Case taking was done, following the principles of Homeopathy as per the guidelines given by Dr Hahnemann in the 6th edition of Organon of Medicine. Aspects like the characteristics of headache and associated features, temporal profile, identification of probable triggers and understanding of clinical presentation was also considered. Selection of the medicine was done on the basis of repertorial analysis (using RADAR version 10.1 software), considering the totality of the case and final selection made through Materia Medica reference. The patients were prescribed symptomatic or constitutional medicine depending on whether the patient presented with an acute episode of headache or had tendency for the same. Medicines were prescribed on the basis of totality of symptoms arrived at after considering the mental and physical generals and particular symptoms including the underlying miasm. Anti-miasmatic remedies were given as intercurrents to clear the miasmatic blockage.
The therapeutic response was graded as:
- Marked improvement depending on the feeling of mental and physical well-being with disappearance of all signs and symptoms in terms of frequency and intensity of migraine attacks and its associating symptoms for which the patient initially approached, without any relapse (at least for a period of 6 months);
- Improvement depending on the feeling of mental and physical well-being with relief in all signs and symptoms in terms of frequency and intensity of migraine attacks and associated symptoms for which the patient initially approached.
- Status quo in case of no change in any complaint of the
- patient inspite of taking the medicine.
- Worse in case of no change in the condition of the patient and instead his/her condition got worse.
Majority of cases were in between 11-40 years age groups. The female: male ratio was 4:1 which is similar to the earlier studies on migrane. 4-7
80.26% females, 19.74% were males; female to male ratio being 4:1.
Positive family history in 32 cases i.e., 42.10%. It is generally found that there is a family history of migrane, but it was not found in this study.
Common Triggering Factors
Emotions and stress was observed affecting maximum cases i.e., 51 cases (67.10%); exposure to sun affecting 42 cases i.e., 55.26%, menstruation affecting 34 cases i.e., 44.73%, exertion/outing 22 cases i.e., 28.94% whereas, minimum cases were affected by exposure to cold i.e., 12 cases (15.78%).
Out of 76 cases, 69 cases i.e., 90.78% were suffering from migraine without aura whereas, only 7 cases i.e., 9.22% from migraine with aura.
Out of the 76 patients, (61 males and 15 females), majority of them fell in the age group of 11-40 years. Migraine without aura was the most common presentation. Emotional disturbance/stress was observed as the most common triggering factor. 47 cases (61.85%) showed marked improvement of their ailments, 21 cases (27.63%) showed improvement, whereas only 8 cases (10.52%) remained status quo.
Treatment- Medicines Prescribed
In the present study, the medicines were prescribed on the basis of totality of symptoms arrived at after considering the mentals, physical generals and particular symptoms including the underlying Miasm. For every case, the medicine was prescribed after proper repertorisation considering the totality of symptoms and final selection of medicines through Materia Medica. When the patient approached with acute episode, the acute medicine was prescribed on the basis of the acute totality to give symptomatic relief to the patient. After relieving the acute condition or when the acute condition got over, constitutional medicine was prescribed in each case in order to check the recurrence. Anti-miasmatic remedies were given as intercurrents to clear the miasmatic blockage. In few cases medicines were prescribed on the basis of their acute complaints. (See Table 1)
Scope for Further Study
The outcome of the study is encouraging. It is proposed that a more detailed study including various parameters like pain score, Migraine Disability Assessment (MIDAS), Headache Impact Test etc. could be done.
|Cyclamen, Epiphagus, Ignatia, Iris versicolor, Lac defloratum, Niccolium Onosmodium, Sanguinaria canadensis, Scutelaria, Spigelia, Theridion
||Sulphur, Thuja, Tuberculinum
||Calcarea carbonica, Calcarea phosphorica, Lachesis, Lycopodium, Natrum muriaticum, Nux vomica, Pulsatilla, Sepia
A case study of a case of migraine has been presented below.
Mr GD, 58 yrs, a Bank Manager, complained of headache since many years which got more troublesome since the last 2-3 years. Throbbing type of pain in left side of forehead occasionally radiating to left temple associated with photophobia and occasional nausea.
Frequency: 2-3 episodes/week; mild to moderate intensity. Used to take allopathic treatment without much relief. Headache triggered and aggravated from eye strain (working on computer, reading, after watching television, driving for about 15-20 minutes, etc.), mental stress, feels temporary relief after rest or from closing eyes. Occasional headache in the morning when awakens from sleep. Sensation of pressure in the left eye during headache. Recent episode since the last two days.
Patient was using bi-focal glasses since long time, consulted ophthalmologist several times for the headaches but on eye examination no ocular cause of the headache was found.
Hemorrhoids, surgery done 5 years back
No family history of any major illness
- Thermal Reaction – Ambithermal
- Appetite – Normal
- Thirst – for cold water; 3-4 litre/day
- Bowel – Regular, constipated, takes time in evacuation, stool soft or hard
- Urine – Clear and normal flow
- Sleep – Sound and refreshing sleep for 6 hrs at night
Workaholic, cautious, ambitious, disciplined, sensitive, reserved, brooding, irritable during head-ache.
General Physical Examination
B P: 128/86 mm Hg
Pulse: Regular, 78/ min.
Patient’s ophthalmic examination, X-ray PNS and CT Scan showed no abnormality.
Migraine without aura
Patient had a mixed miasmatic presentation. Psoric characters of the patient were sensitive, ambitious and disciplined, constipation, throbbing headache, headache associated with nausea, headache in morning and the most important is there is no pathology involved suggestive of psora. Whereas sycotic characters were workaholic, reserved, brooding, cautious and history of hemorrhoids.
See repertorisation sheet. (Fig. 6)
Nat- m: 18/11
Selection of Medicine
After analysis of case, Natrum mur was considered as constitutional medicine for this patient.
Acute Medicine – Onosmodium 30 (headache aggravated by
eye strain and left sided head-ache)
Onosmodium 30 TDS was prescribed for 7 days which relieved within 2 days as reported on next visit. Natrum mur 200/1 dose was prescribed as constitutional medicine followed by placebo. Natrum mur was raised from 200 upto 10M as per the need of the case (i.e., frequency and intensity of episodes) Onosmodium 30 was given for SOS. Patient remains under follow up for 13 months.
No recurrence was observed in last 7 months.
Here, in this case, the patient came with an acute episode in this state, it is better to give acute medicine first. For acute presentation i.e., headache due to eye strain Ruta and Onosmodium stand common medicines. Ruta has soreness, heat feeling in eyes, pain in and over the eyes whereas, here, in this patient, pain occurs in left eye and extends to left temple is in favour of Onosmodium for this case. Constitutional medicine is required to check the recurrence. On comparing the reportorial analysis, since the patient is reserved, brooding and disciplined, Calcarea carb is ruled out. Lycopodium is also ruled out – thirst for cold water and left sidedness of complaints. Ignatia is very close to the nature of the patient but in this case there is no history or ailments from grief or shock are present and also it doesn’t cover the important modalities/characteristics of the case i.e. headache from eyestrain. So, Natrum mur is selected as a remedy for the case. Natrum mur also covers the miasmatic background of the case i.e., psora-sycotic.
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- RADAR 10 Software