Migraine headache

Clinic

• A migraine is a primary headache disorder characterized by recurrent headaches that are moderate to severe.
• Typically, the headaches affect one half of the head, are pulsating in nature, and last from a few hours to 3 days.
• Associated symptoms may include
  • Nausea, vomiting
  • Sensitivity to light, sound, or smell
  • Fatigue and irritability
• Pain is generally made worse by physical activity.
• Aura (33%): typically a short period of visual disturbance that signals that the headache will soon occur.

Sign / Symptoms

Migraine has three stages

• Aura phase

• Pain phase

• Postdrome

Aura phase

Symptoms can be visual, sensory or motor

• Visual effects
  • Flickering animation a scintillating scotoma. The scintillations are of a zigzag pattern starting in the center of vision, surrounded by a somewhat larger area with distortion of shapes
  • Hemianopsia or Blurring
  • Sensory aura (30–40%) Feeling of pins-and-needles begins on one side in the hand and arm and spreads to the nose–mouth area on the same side.
  • Numbness usually occurs after the tingling has passed with a loss of position sense.
  • Speech or language disturbances: World spinning and less commonly motor problems.
  • Motor symptoms: Hemiplegic migraine, weakness often lasts longer than one hour unlike other auras.
  • Auditory hallucinations or delusions have also been described.

Pain phase

• Unilateral, throbbing + Moderate to severe intensity.
• Usually comes on gradually
• Agg by physical activity
• Pain may be bilateral (40%)
• Neck pain is commonly associated with it.

Basilar migraine

A migraine with neurological symptoms related to the brain stem or with neurological symptoms on both sides of the body, common effects include a

• Sense of the world spinning /Light-headedness /Confusion
• Nausea (90%) / Vomiting (33%).
• Dark and quiet room amel
• Blurred vision, Nasal stuffiness, Diarrhea, Frequent urination, pallor, or sweating.
• Swelling or tenderness of the scalp may occur as can neck stiffness.

Acephalgic migraine

• Aura occurs without a subsequent headache
• Also known as silent migraine

Postdrome

• for a few days after the headache has passed
• Feel tired or "hung over"
• Cognitive difficulties / Impaired thinking
• Gastrointestinal symptoms,
• Mood changes
• Weakness
• Feel unusually refreshed / Euphoric
• Depression / Malaise

Related disease

• Migraines are associated with MDD, bipolar disorder, anxiety disorders, and OCD. These psychiatric disorders are approximately
• 2–5 times more common in people without aura
• 3–10 times more common in people with aura

Migraine Miasms

• Is migraine a seizure with autonomic presentation. Its aura is due to seizure and its angiospasm is due to autonomic presentation
• If so then, SAHF is the best miasm, since it covers Seizure + Headache + Vasoconstriction

Aura	Visual	Sensory	Speech	Motor	World spinning	Hallucinations Delusions
Entities Rubrics	Retinitis Visual field deficit	Paresthesia Hyperstasia	Aphasia	Hemiplegia Hemiparesis	Vertigo Dizziness	Auditory hallucination

Basilar migraine

	World spinning	Blurred vision	Nasal stuffiness	Diarrhea	Frequent urination	Pallor	Sweating
Entities Rubrics	Vertigo Dizziness

Retinal migraine remedies

		Aura / Pain Quality	Concomitants/ Modalities
Top remedy	Nat-m	Episodes of blindness followed by a headache. Zig-zag dazzling, like lightning in eyes before the headache. Throbbing or hammering type and is marked in the forehead and top of the head. Burning sensation on the top of the head	Nausea and vomiting
Blindness before Headache	Gels	Pain is most felt in the forehead and temples. Fullness/ Heaviness in head appears and head feels as if enlarged in size. with headache. Dimness of vision comes with a headache.	Amel by shaking the head Agg from tobacco smoking Slight nausea/ Giddiness/ Drowsiness
Blurring before Headache	Iris	Headache is throbbing or shooting Mostly on the right side. Intense and constant nausea is a characteristic attending symptom	Sleeplessness from headache (Maybe) Exertion agg
Blurred / Blindness before Headache	Kali-bi	Blindness appears before a headache. (Maybe) As the headache intensifies the vision becomes normal Aversion to light and noise along with	Desire to lie down.
Dimness + Headache	Bell	Headache is majorly throbbing in nature and is marked in the temporal region. Nausea and vomiting may accompany headache. Light and noise make the headache worse.	Face is red, flushed, congested during headache.\ Pressure amel
Dimness before Headache	Phos	Mostly in the temple region May be pulsating, shooting or boring type. Head and face feel congested Flashes of light before the eyes (Maybe)
Flickering/ Flashes + Headache	Cycl	Mostly experienced in the morning upon rising. Darting or boring pains in temples Headache + Obscuration of vision
Blindness Before/ During Headache	Lac-d	Headache usually begins in the forehead and extends to occiput. It is mainly throbbing Nausea and vomiting with Headache.	Tight bandage around the head amel