Abstract
Chronic migraine is a debilitating clinical condition that can significantly impact the quality of life of a person. It is a neurological health problem that is present in episodes of pain in the head, which may be the mild-moderate-severe type of headache with nausea, vomiting, and sensitivity to light and sound. It is present in any age of life but is commonly present in females compared to males. Due to migraine life of the patient is very affected and produces vibration in daily work. There are various treatment options in the world, some patients may not respond to conventional treatment.
The patient, a 39-year-old woman, had suffered from chronic migraine for 10 years, characterized by severe, debilitating headaches several times per week, especially in the forehead and above the eyes. These episodes were accompanied by severe nausea, sometimes vomiting, and cutting and twisting pain in the stomach. After starting homeopathic treatment with Chionanthus virginicus mother tincture, the patient experienced a marked reduction in both the frequency and severity of migraine symptoms. Improvements in associated symptoms such as nausea, photophobia, and phonophobia were also seen, leading to a significant change in the patient’s overall quality of life.
This case report describes the successful use of Chionanthus virginicus homeopathic mother tincture in the management of chronic migraine. The total symptom score decreased from 13 to 1, demonstrating the potential effectiveness of this remedy. This suggests that Chionanthus virginicus homeopathic mother tincture may be a viable treatment option for chronic migraine patients, especially those who are unresponsive to conventional treatments. Further studies are required to validate these findings on a larger scale.
Keywords: Homoeopathy Mother Tincture, Headache, Chronic Migraine, Case report, Chionanthus virginicus, Homeopathic Treatment.
Introduction: Migraine is a complex central nervous system problem.[1] It is usually found before the middle age of life and rarely found in the late stage of life.[1] It is generally found in females compared to males.[3] It presents as mild to severe head pain, often accompanied by nausea and vomiting, with heightened sensitivity to noise and light. During a migraine episode, the individual typically avoids conversation and prefers silence. [3]
There is an unknown cause of migraine. However, some evidence shows the cause of migraine is dysfunction of ions. There are trigger factors for causing migraines like stress, tension, anxiety, hunger, fatigue, menses, menopausal changes, pregnancy, etc. [3] Some dietary factors that also trigger migraine attacks are chocolate, alcohol, cheeses, processed meats, etc.[3] However, some environmental factors are responsible for triggering migraine. [4] Genetic factors and family history are also causes of migraine. [3]
There are various classifications of migraine. But the first classification was in 1988.[3] International Headache Society update in classification in 2004.[3] In 2018 there was also an update in classification. [3] According to migraine classification, it is associated with a primary headache disorder. It is subclassified into 6 classes. [3]
- A migraine without aura is also called common migraine.
- A migraine with an aura is also called a classic migraine.
- Childhood periodic syndromes
- Complications of migraine
- Probable migraine
- Chronic migraine
The diagnosis of migraine is based on clinical symptoms and signs. [1,3] There is no demand for neuroimaging tests to diagnose migraine problems. [1,3] Symptoms include self-limited headache, unilateral (affecting one side of the head), throbbing pain, moderate or severe pain intensity, nausea, vomiting, sensitivity to light (photophobia), sensitivity to light sound (phonophobia), interference with the person’s life, etc. [1,3]
Allopathic and other treatments offer various medications to treat migraine symptoms and signs, but they often do not provide complete relief from migraine symptoms and allopathic medications may have side effects that affect the patient’s health for the rest of his life. There is a need for a safe, effective, and simple treatment approach in homeopathy to avoid the harm caused by these. This study aims to determine the effect of Chionanthus virginicus homeopathic mother tincture.
Case Presentation
Age: 39 years
Gender: Female
Date of Visit: December 2023
Occupation: Teacher
Location: Dr. Bhavesh Bisen Homeopathic and Diet Clinic Kohe Fiza, BHOPAL, MP
Chief Complaints at the Time of Visit: She has suffered from Very severe headaches in the forehead and just over the eyes for 10 years. She presented symptoms of heavy and dull feelings in the frontal headache accompanied by nausea and sensitivity to light and sound. She suffered recurrent attacks of head pain 3-4 times a week, each lasting 1-3 hours. She feels sore and bruised all over the head. She is drawing and pressing at the root of her nose with a headache. Pain is aggravated by motion, light, talking, and walking. Pain is ameliorated by lying down, and rest. Along with cutting and twisting pain in the stomach and Uneasy sensations in the region of the spleen and liver.
Assessment Criteria for Migraine Case
This is the table for Subjective Criteria of Migraine, which covers different aspects of migraine symptoms
Table 1 – Severity of headache
S.no. | Criteria | Score |
1 | No headache | 0 |
2 | Tolerable headache | 1 |
3 | Do not disturb the routine work | 2 |
4 | Disturb the routine work | 3 |
5 | Intolerable headache | 4 |
Table 2 – Frequency of headache
S.no. | Criteria | Score |
1 | Nil | 0 |
2 | Once in 30 days | 1 |
3 | Once in 15 days | 2 |
4 | Once in 5 days | 3 |
5 | Once in 3 days | 4 |
Table 3 – Duration of headache
S.no. | Criteria | Score |
1 | No headache | 0 |
2 | 1-3 hours | 1 |
3 | 4-12hours | 2 |
4 | 13-24hours | 3 |
5 | Over 24hours/ continuous | 4 |
Table 4 – Nausea
S.no | Criteria | Score |
1 | Nil | 0 |
2 | Occasionally | 1 |
3 | Moderate, but does not disturb the routine work | 2 |
4 | Severe, disturbing routine work | 3 |
5 | Severe enough, small amount of fluid regurgitating from mouth | 4 |
Table 5 – Photophobia
S.no. | Criteria | Score |
1 | No photophobia | 0 |
2 | Photophobia only during mild exposure to light | 1 |
3 | Photophobia only during exposure to light | 2 |
4 | Continuous photophobia throughout the day | 3 |
5 | Continuous photophobia throughout the day and night | 4 |
Table 6 – Phonophobia
S.no | Criteria | Score |
1 | Nil | 0 |
2 | Mild (does not interfere with usual activities) | 1 |
3 | Moderate (inhibits, but does not prevent usual activities) | 2 |
4 | Sever (sometime prevent all activities) | 3 |
5 | Very severe (unbearable) | 4 |
Past History of Patient
- No major illness in the past life of the patient
- No surgical history
Family History
- The father is suffering from high blood pressure and piles
- Mother is suffering from thyroid problems
Treatment History
- Pain kills and Anti-vomiting medicine
Patient as a Person
- Appetite – Good
- Thirst – Good
- Craving – Sweet
- Aversion – Fatty food
- Sleep – Disturbed due to pain in the head
- Bowel habits – Regular, soft, once/day, sometimes hard stool
- Urine – 4 -5 times /day, once at night
- Allergy – Nil
- Addiction – Tea, Coffee
General Physical Examination
- Pulse – 78/min, regular.
- Temperature – Afebrile during case taking
- Resp. rate – 16/min
- B. P – 110/76 mm of Hg.
- Weight – 55 kg
Systemic Examination – NAD (No Abnormality Detected)
Homeopathic Therapeutic Interventions
Chionanthus virginicus is known for its affinity with the digestive and hepatic systems and has shown promising results in the management of chronic migraines, especially migraines associated with biliary or hepatic disturbances. Severe, throbbing pain in the forehead and above the eyes, often worse in the morning or after mental exertion.
Prescription Details:
- Remedy: Chionanthus Virginicus Mother Tincture
- Dosage: 15 ml of mother tincture
- Dilution: 15 ml of Chionanthus Virginicus mother tincture mixed in 30 ml of water
- Administration: Orally, BD daily
- Duration: 4 months
- This dosage of Chionanthus Virginicus mother tincture is considered safe according to the homeopathic pharmacopeia and the Homoeopathic Materia Medica.
- First prescription 10/12/2023
Follow-ups and Outcomes
Table .7 Follow-up evaluations
Date | Symptoms observed on follow up | Prescription |
17/12/2023 Second Visit | Severity of headache Minimal Relief Frequency of headache no relief Duration of headache Minimal Relief Nausea no relief Photophobia no relief Phonophobia no relief | Chionanthus Virginicus `mother tincture 15 drops in 30 ml of water twice daily before meals for 14 days Rubrum 30/TDS for 14 days (6 globules at a time 30 size) |
2/1/2024 Third Visit | Severity of headache Moderate Relief Frequency of headache Minimal Relief Duration of headache Minimal Relief Nausea Minimal Relief Photophobia Minimal Relief Phonophobia Minimal Relief | Chionanthus Virginicus `mother tincture 15 drops in 30 ml of water twice daily before meals for 14 days Rubrum 30/TDS for 14 days (6 globules at a time 30 size) |
17/1/24 Fourth Visit | Severity of headache Moderate Relief Frequency of headache Moderate Relief Duration of headache Moderate Relief Nausea Moderate Relief Photophobia Moderate Relief Phonophobia Moderate Relief | Chionanthus Virginicus `mother tincture 15 drops in 30 ml of water twice daily before meals for 14 days Rubrum 30/TDS for 14 days (6 globules at a time 30 size) |
1/2/24 Fifth Visit | Severity of headache Significant Relief Frequency of headache Significant Relief Duration of headache Moderate Relief Nausea Significant Relief Photophobia Significant Relief Phonophobia Significant Relief | Chionanthus Virginicus `mother tincture 15 drops in 30 ml of water twice daily before meals for 14 days Rubrum 30/TDS for 14 days (6 globules at a time 30 size) |
16/2/24 Sixth Visit | Severity of headache Near Complete Relief Frequency of headache Near Complete Relief Duration of headache Near Complete Relief Nausea Near Complete Relief Photophobia Near Complete Relief Phonophobia Near Complete Relief | Chionanthus Virginicus `mother tincture 15 drops in 30 ml of water twice daily before meals for 14 days Rubrum 30/TDS for 14 days (6 globules at a time 30 size) |
2/3/24 Seventh Visit | Severity of headache Complete Relief Frequency of headache Near Complete Relief Duration of headache Complete Relief Nausea Complete Relief Photophobia Complete Relief Phonophobia Complete Relief | Chionanthus Virginicus `mother tincture 15 drops in 30 ml of water twice daily before meals for 14 days Rubrum 30/TDS for 14 days (6 globules at a time 30 size) |
16/3/24 Eighth Visit | Severity of headache Complete Relief Frequency of headache Near Complete Relief Duration of headache Complete Relief Nausea Complete Relief Photophobia Complete Relief Phonophobia Complete Relief (Shown in Table 8) | Placebo 15 drops in 30 ml of water twice daily before meals for 14 days Rubrum 30/TDS for 14 days (6 globules at a time 30 size) |
30/3/24 Ninth Visit | Relief in All Symptoms | Placebo 15 drops in 30 ml of water twice daily before meals for 30 days Rubrum 30/TDS for 30 days (6 globules at a time 30 size) |
30/4/24 Tenth Visit | Relief in All Symptoms The patient is stable | Placebo 15 drops in 30 ml of water twice daily before meals for 30 days Rubrum 30/TDS for 30 days (6 globules at a time 30 size) |
30/5/24 Eleventh Visit | Relief in All Symptoms Patient stable | Placebo 15 drops in 30 ml of water twice daily before meals for 30 days Rubrum 30/TDS for 30 days (6 globules at a time 30 size) |
30/6/24 Twelfth Visit | Relief in All Symptoms Patient stable No episodes of headache | No Medicine |
Table 8 – Before and After Homoeopathic Treatment of Migraine
S.No. | Parameter | Before Homeopathic Treatment | After Homoeopathic Treatment |
1. | Severity of headache | 3 | 0 |
2. | Frequency of headache | 4 | 1 |
3. | Duration of headache | 1 | 0 |
4. | Nausea | 2 | 0 |
5. | Photophobia | 1 | 0 |
6. | Phonophobia | 2 | 0 |
Total | 13 | 1 |
Table 9 – Assessment of outcome of treatment by Modified Naranjo Criteria for Homeopathy
Domains | Yes | No | Not sure or N/A |
1. Was there an improvement in the main symptom or condition for which the homeopathic medicine was prescribed? | +2 | ||
2. Did the clinical improvement occur within a plausible timeframe relative to the drug intake? | +1 | ||
3. Was there an initial aggravation of symptoms? | 0 | ||
4. Did the effect encompass more than the main symptom or condition (i.e., were other symptoms ultimately improved or changed)? | 0 | ||
5. Did overall well-being improve? (suggest using validated scale) | +1 | ||
6A Direction of cure: did some symptoms improve in the opposite order of the develop- ment of symptoms of the disease? | 0 | ||
6B Direction of cure: did at least two of the following aspects apply to the order of improvement of symptoms: –from organs of more importance to those of less importance? –from deeper to more superficial aspects of the individual? –from the top downwards? | 0 | ||
7. Did “old symptoms” (defined as non-seasonal and non-cyclical symptoms that were previously thought to have resolved) reappear temporarily during the course of improvement? | 0 | ||
8. Are there alternate causes (other than the medicine) that—with a high probability— could have caused the improvement? (Consider known course of disease, other forms of treatment, and other clinically relevant interventions) | +1 | ||
9. Was the health improvement confirmed by any objective evidence? (e.g., laboratory test, clinical observation, etc.) | +2 | ||
10. Did repeat dosing, if conducted, create similar clinical improvement? | +1 |
Note: Maximum score= +13, Minimum score= -6
There is a total score = +8
Discussion
This is the case of a 39-year-old female. Based on the literature migraine is very commonly found in females. It is susceptible to migraine because there are various triggering factors like stress, tension, anxiety, hunger, fatigue, menses, menopausal changes, pregnancy, etc [3]
Homeopathy is a therapeutic system of treatment that treats the patients as a whole, not disease. Chionanthus virginicus homeopathic mother tincture can be selected based on the keynote symptoms of the patient. Based on the keynote of symptoms Homeopathic medicine Chionanthus virginicus was selected as it covered more symptoms and follows Materia medica, which suggests its efficacy in relieving migraine. There is an improvement in migraine symptoms indicating the efficacy of Chionanthus virginicus mother tincture in the treatment of migraine. In this case report, the total outcome score as per Modified Naranjo Criteria was +8, close to the maximum score of +13. That indicates there is a significant relation between the treatment of migraine by Chionanthus virginicus homeopathic mother tincture and outcome score as per Modified Naranjo Criteria [Table 9].
Conclusion
This case report describes the successful use of Chionanthus virginicus homeopathic mother tincture in the management of chronic migraine in one patient. The patient’s symptoms improved dramatically during treatment, as evidenced by a significant reduction in the total symptom score from 13 to 1. Headache severity was eliminated (from 3 to 0), headache frequency was significantly reduced (from 4 to 1), and headache duration also improved (from 1 to 0, indicating no headache after treatment. gives). Other associated symptoms such as nausea (from 2 to 0), photophobia (from 1 to 0), and phonophobia (from 2 to 0) were also completely resolved [Table 8]. This result suggests that Chionanthus virginicus homeopathic mother tincture may be a viable treatment option for chronic migraine patients, especially those who have not responded well to conventional treatments. However, further studies and clinical trials are needed to confirm its efficacy.
Patient perspective
The patient was satisfied during and after the homeopathic treatment.
Informed consent
The consent to publish the information obtained from the patient.
Conflict of interest
None.
Sources of funding
None.
References
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Author
Dr.Bhavesh Kumar Bisen1 M.D.(Hom)
Dr.Anoop J. Katyayan2 M.D. (Hom)
Dr.Mahesh Mishra3 M.D. (Hom)
1 Associate Professor, Department of Practice of Medicine Ram Krishna College of Homoeopathy & Medical Sciences, RKDF, University Campus, Bhopal MP
2. Principal And Professor, Department of Anatomy Ram Krishna College of Homoeopathy & Medical Sciences, RKDF, University Campus, Bhopal MP
3. Professor, Department of Community Medicine Ram Krishna College of Homoeopathy & Medical Sciences, RKDF University Campus, Bhopal MP
https://orcid.org/0009-0008-1601-3689
