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