Abstract
This is a case of migraine with aura and associated with depression who despite receiving antidepressants and antiepileptic was not relieved. Individualised Homoeopathic Medicines helped to manage his acute episodes followed by constitution thereby preventing recurrence of further episodes. Needless to say that all previous therapies were stopped in a short time.
Keywords: Migraine, Acute phase medicine, Constitutional Medicine, Cure
Introduction
Migraine is defined as a recurring, episodic neurological syndrome of headache associated with other symptoms of neurological dysfunction. It is the second most common cause of headache and is characterised by an attack that can last from 4 to 72 hours and often includes unilateral throbbing pain, nausea, vomiting, and increased sensitivity to light(photophobia). A family history is often present and attacks can be triggered by various stimuli such as stress, hormonal fluctuations, physical exertions and lack of sleep1 .
Case
A 52 year old married man presented with terrible complaints on 15th June 2025. He complained that his trouble starts with a sudden vertigo accompanied by blurring of vision that lasts about for 25 minutes which he termed as Aura. Thereafter it is followed by a terrific headache which lasts the whole day, the pain is strongly felt in the occipital region. It mostly involved the right eye but no radiation from the site.
Past History
This trouble for the last 2 years and consumes Past medication Dicopril 500mg PR. During the headache his scalp is very painful to touch as if he has taken a shower then he can’t wipe his head due to tenderness of the scalp. The headache is so terrible that he has to retreat home and sleep. No nausea or vomiting. He is incapacitated by the headache and unable to go to work. He has a known case of hypertension for the last 5 years. He was on anti depressants for the last 5 years Venpad 100mg. His appetite is lost during headaches. Desire for spicy things. No thirst. Thermally hot patient. He is worried that if something happens to him, he will take care of his son. He is anxious about his health and fears early death.
He had a troubled first marriage. Once his earlier wife got 50 lakhs from inheritance, she walked away from the marriage. He has 1 bother and 1 sister. They used to live in a joint family in Gujarat. He was brought up in Gujarat. However, originally, he is a Keralite. After his father’s death his brother took over and made the house on his name and promised him to give money in return but nothing of this happened. When he was in crisis he asked for money from his brother but his brother flatly denied. His earlier work life was in Chennai and he married a second time with a women from Kerala and has a son studying in class 4. Presently he has a lot of financial issues. He lives on rent. His sister also doesn’t offer him any help. While he was young he squandered his savings on friends and today he regrets it. His eyes looked sad. But face had a smile. Occasionally he likes to outdoor for a walk in the garden but generally his headache makes him restricted. He tried to let go but grief has become a part of him. The Neurologist has advised him an MRI and angiogram of arteries of the occiput but he doesn’t have the money to go for the investigation.
Case Analysis and Therapeutic administration
I consulted Kent’s Repertory edited by Dr R.P Patel in the chapter:
Vision Rubric: Blurred headache before. Gels, hyos, Iris, Kali-bi, podo, sep2 .
We are dealing with a case where a sudden appearance of migraine brings about complete arrest of all the normal functioning and that too for the whole day. With help of Materia Medica references by consulting Dr M.L Dhawale’s symposium volume 1, I confirmed under monogram of Gelsemium that the kind person that Gelsemuim is Anxious, Sensitive, migranous, headaches with visual disturbances.
Ailments from emotional tension. Migraine: hemicrania (Rt), Pin occiput. So, the cause and effect (Manifestations) match that of Gelsemium3 . I tried to ask the patient is cold application, passing urination or warm appilication relieve the headache but he replied in negative, saying that he has observed no difference. I prescribed him Gelsemium 1 M, 1 single dose on 15th June 2025.
Follow up after 3 days 19th June 2025: Not a single episode of migraine and his outlook to life has changed. He now visits his neighbour in the evening for a chat. Taking more interest in life. Placebo continued.
Follow up 23rd June 2025: Patient felt slightly vertigo sensation but no migraine, however head and eyes felt heaviness. He associated it with extra work that he executed at night hours and delay in sleeping. He was given Gelsemium 1M, 1 single water dose.
Follow up 27th June 2025: He noticed that after the water dose he got deep sleep and ever since no heaviness nor any unwell feeling. Stopped all allopathic drugs except for hypertension. Mild depressive episode. Placebo.
Follow up 15th July 2025: His wife’s relative expired so he had to visit hometown Kerala and do expenditure for the funeral in addition to the loss of work that month. Was tense and my headache has reappeared since the last 4 days. The intensity is the same. Completely incapacitates him. Gelsemium 10M, 1 single dose given.
Follow up 8th August 2025: No single episode of headache. Doing good. Placebo.
Follow up 31st August 2025:Feeling of slight vertigo while going for work in the morning, returned back home and rested due to fear of death. Says that feels as if his present wife may leave him and go away like the previous wife & cant trust. Always tends to think negative things like “will I reach home?” and suffers from flatulence. The more he thinks the more gaseous distention of abdomen is observed. The relapsing nature of vertigo suggested need for more chronic remedy. A humble man not desiring to bother even his doctor when he suffers. With depression of Natrums. Grief which is not accepted, it takes it and holds it deep inside. Grudge that remains reflects a sort of anger. ‘This had to happen to me’, it keeps nurturing it inside. A great symptom of Natrum Mur. This is what happened and now he takes it and messes it up inside turning it into a mountain out of a mole. They think of the two bad things that happened to them rather than the many nice things that came their way generating a kind of irritation inside it. Eyes oversensitive to car lights at night. Dislikes noise4 . Considering this I prescribed him Natrum-Carb 200, 1 single dose. (Remedy selected non-repertorially)
Follow up 6th September 2025: No single attack of migraine headache. Appetite improved. Can work better and enjoy life like before. Very grateful.
Follow up 25th October 2025: No migraine headache episode. He is coping up with all the financial issues and family issues without his health being affected. Like to drink beer with friends on occasions.
Follow up 10th November 2025: No migraine problem. Placebo
And had the complaint of eruption in the next follow up.
FOLLOW UPS
| Date | Symptoms | Remedy |
| 15/06/2025 | First Prescription | Gelsemium 1M, 1 single dose |
| 19/06/2025 | >>> | Placebo |
| 23/06/2025 | << | Gelsemium 1M, water dose |
| 27/06/2025 | >> | Plabebo |
| 15/07/2025 | Tense with extra expenditure, Migraine reappeared | Gelsemium 10M, 1 single dose |
| 08/08/2025 | >> | Placebo |
| 31/08/2025 | Dizziness reappeared, No migraine | Natrum-carb 200, 1 single dose |
| 06/09/2025 | >> No episode of migraine | Placebo |
| 25/10/2025 | >> | Placebo |
| 10/11/2025 | >> | Placebo |
| 21/11/2025 | Herpes Zoster on Left lateral aspect of chest | Kali-Bich 200, 1 Single dose |
| 28/11/2025 | No pain anymore, eruptions in process of healing. No episode of headache or acidit | Placebo |
Before Treatment
After Treatment
DISCUSSION
The differential diagnosis for migraine with aura includes conditions like transient ischemic attack (TIA), epilepsy, and retinal migraine. Other considerations are less common neurological events like cervical artery dissection, intracranial hemorrhage, and posterior reversible encephalopathy syndrome (PRES). A thorough medical history, neurological exam, and sometimes imaging like an MRI or CT scan are used to distinguish these from migraine aura
Neurological conditions: Transient Ischemic Attack (TIA): A temporary blockage of blood flow to the brain that can cause visual and neurological symptoms similar to aura.
Epilepsy: Particularly occipital lobe seizures, which can present with visual disturbances.
Ophthalmological conditions: Retinal Migraine; A rare form of migraine with aura that affects only one eye. Symptoms are unilateral (in one eye only).
Other Ophthalmological Causes: Conditions like acute glaucoma or other primary eye issues that can cause visual symptoms.
Other headache disorders:
Tension-type headache– Typically characterized by a squeezing or pressing pain, but does not typically involve aura.
Cluster headache: Severe, one-sided headaches that are not typically preceded by auras, but rather by other symptoms.
How to differentiate? A detailed symptom analysis: The duration, progression, and quality of symptoms are key.
Unilateral vs. bilateral symptoms: Retinal migraine affects only one eye, while migraine with aura typically affects both eyes as observed in this given case.
CONCLUSION
He was a blocked personality. He never could share family problems with anyone. Gelsemium was his sector remedy but the constitutional remedy was Natrum-Carb that helped to achieve deeper healing. Natrum-carb has the delusion that there is a division between himself and others. That he is forsaken and deserted. Hence they have difficulties in connecting to others, even with intimate friends or family. Aversion to family members and to society as well as aversion to company. Natrum-carb is a combination of lycopodium physically and Natrum-mur emotionally. Noise creates tremendous panic! His reactivity is also expressed in the weak digestive system which creates sadness from errors of diet; a chronic dyspepsia. Especially sensitive to the sun’s heat which causes headache, vertigo and exhaustion. Kali-Bichromium aspect of this patient had surfaced earlier while he craved for beer, and at present the profuse perspiration, nightly fever and Herper itself in its pathophysiology indicates towards the same drug. The disease also found its way to the surface. From Neurological Level to Dermatological level.
REFERENCES
1. Forte Vincent, Hopcroft Keith. Symptom sorter. Fifth edition, published by Jaypee Brothers Medical Publishers Ltd; 2014, pp 77,78
2. Patel P. R. Repertory of the Homoeopathic Materia Medica by Dr J.T Kent 6th American Edition corrected, revised and improved. Publisehed by Dr R.P Patel Institute of Homoeopathy for research and education in Homoeopathy, Vadodara; 2003, pp 271
3. Dhawale L. M. Hahnemannian Totality Symposium. Third edition, published by Dr M.L Dhawale Memorial trust; 2003, pp 50
4. Currim A. Ahmed. J.T Kent unpublished Materia Medica. Second edition, published by B.Jain Archibel s.p.r.l Belgium; 2010, pp 1347
