Clinical Cases

Effect of Constitutional Medicine on Migraine:  A Case Study

Written by Nitiksha Sharma

Dr. Nitiksha Sharma shares a case of migraine in a man of 24. Timidity, aggravation from consolation and lack of confidence were among the symptoms leading to the simillimum.

Abstract: A crippling neurological condition, migraines have a significant negative impact on the individual.  Headaches that occur at least 15 days a month and at least 8 of those days that meet the criteria for migraine are referred to as chronic migraine.

Episodic migraine usually develops into chronic migraine due to an increase in the frequency of attacks and/or multiple other risk factors associated with migraine chronification. Despite this development, chronic migraine is likely to become a separate clinical entity with distinct symptoms and a different pathogenesis from episodic migraine. Migraine attacks are intricate brain processes that frequently last from several hours to several days.

Other symptoms that frequently accompany migraine headache include nausea, vertigo, intense sensitivity to lights, sounds, and odors, anorexia, irregular bowel movements, and so forth. The International Classification of Headache Disorders (ICHD) refers to persons who experience regular headaches as having chronic migraine. Chronic headache sufferers have in the past been adversely affected by a lack of knowledge about headaches and therapeutic nihilism.

Keywords: Migraine, Case Study, Pathological condition.

Migraine is considered as a neurological disease1:

It is believed that migraine is a brain illness. Pain is the result of inflammatory changes in the cranial and meningeal blood vessels that are brought on by changes in the brain. It is best to understand the premonitory phase in terms of central nervous system dysfunction because it is characterized by changes in mood, behavior, and autonomic function.                             

       Case Study:

Date of case definition: 04/04/23

A 24-year-old man, D. K. was coming to the OPD suffering with pain on one side of his head, along with sensitivity towards light, and sound for 1 year,

Presenting Complaint:

Onset of pain:  

Onset of pain is gradual.

Causative or triggering factor: Loud sound, bright light was triggering the pain in the head.
Type of pain: Chronic type of pain for 1 year.
Nature of pain: Pulsating nature of pain.
Location of pain: Pain is located on the right side of head.
Sensation in head: Burning sensation in head.
Extension of pain: There is no specific extension for pain.
Modalities: Pain is (<) aggravated from eye straining.

Pain is (>) ameliorated from pressure and rest.

 

Intensity: Severe intensity of pain

History of presenting complaint: Patient was quite well 1 year back, then he starts overthinking about financial issues facing through long days, starts suffering from pain on one side of head (right side) with sensitivity towards light and sound.

Past- History: Not specific.

 Mental symptoms:

Patient is timid, shy during presenting himself in front of others.

There is a lack of confidence in patient (during observation)

Does not want to talk to anyone when he is angry, consolation aggravate him.

Yielding disposition.

Physical- Generals:

Appetite: 2 times meals/day.

Thirst: normal, 1 lt/ day

Desire: Spicy food.

Aversion: not specific.

Stool: Regular in morning but having constipation. [D1]

Urine: Clear [D4-5] [N0-1]

Perspiration: Increased on palms. (No staining, not offensive)

Sleep & dreams: Sound and refreshing sleep

Hours of sleep: 6 hours of sleep

Decubitus: On one side

Dreams are not specific.

Addiction: not specific.

Thermal reaction: Patient is thermally chilly.

 Physical- Examination:

Systemic Examination:

Consciousness: Patient is conscious.

Orientation: Patient was well oriented, alert.

Gait: Patient having proper walking pattern. There is no abnormality.

Trembling: not present.

Vertigo: not present.

Vomiting: not present.

Vision: perfect vision, no abnormalities in eye power. (Photophobia only during head pain)

Speech: Well oriented in words, speech is perfect.

 Analysis of case (According to Kent)

Mental General Physical general Particulars
Patient is timid, shy during presenting himself in front of others.

There is a lack of confidence in patient (during observation)

Does not want to talk to anyone when he is angry, consolation aggravate him.

Carry yielding disposition.

Desire: Spicy food.

Perspiration: Increased on palms

Stool: Regular in morning but having constipation. [D1]

Pain on the right side of head.

Pulsating nature of pain.

Gradual onset of pain.

Burning sensation of head.

Pain is triggered from noise, light.

Pain is aggravated from eye strain.

 Evaluation of symptoms:

Mental symptoms:

Will: Does not want to talk to anyone when he is angry, consolation aggravate him.

Intellect: Patient is timid, shy during presenting himself in front of others.

Intellect: There is a lack of confidence in patient (during observation)

Intellect: Yielding disposition.

Physical Symptoms:

Desire: Spicy food.

Stool: Regular in morning but has constipation. [D1]

Perspiration: Increased on palms

Particulars:

Pain on the right side of head.

Pulsating nature of pain.

Gradual onset of pain.

Burning sensation of head.

Pain is triggered from noise, light.

Pain is aggravated from eye strain.

 Totality of symptoms:

Does not want to talk to anyone when he is angry, consolation aggravate him.

Patient is timid, shy during presenting himself in front of others.

There is a lack of confidence in patient (during observation)

Carry yielding disposition.

Desire: Spicy food.

Stool: Regular in morning but having constipation. [D1]

Perspiration: Increased on palms

Pain on the right side of head.

Pulsating nature of pain.

Gradual onset of pain.

Burning sensation of head.

Pain is triggered from noise, light.

Pain is aggravated from eye strain.

Repertorization Sheet:

 Rubrics:

Mind-timidity-public, about appearing in

Mind-confidence-want of self confidence

Mind- consolation- agg

Mind- yielding disposition

Generals- food & drinks- spices- desire

Extremities- perspiration- hand- palm

Rectum- constipation

Head- pain- sides- right

Head- pain- light- general; from light in

Head- pain- exertion-eyes; of the

Head- pain- Burning

Head- pain- pulsating

Head- pain- noise, from

 Repertorial analysis:

Silicea 29/12                     Natrum mur 24/12

Lycopodium 23/12             Arg. Nit. 14/12

Phos. 22/11                      Sep 22/11

Cal. Sil 11/11

 Prescription:

04/04/23   Silicea 30/ 1 Dose (on the basis of symptom similarity)

Sac lac 200/ T.D.S.

Follow- up:

Date Changes in Symptoms Prescription
 

19/04/23

Slight changes in his behavior, and in his confidence too, he feels happy nowadays.

Slight relief in pain on the right side of the head along with sensitivity towards light and sound, in burning sensation too.

Slight relief in constipation.

Perspiration on the palm is still present in the same amount.

Rubrum30/ T.D.S.

For 15 days

 

03/05/23

Mentally patient is happy.

Now (70%) relief in pain on the right side of the head along with sensitivity towards light and sound.

Relief in constipation too.

Perspiration is still the same.

Rubrum 30/ T.D.S.

For 1 month

 

04/06/23

Relief in pain on the right side of the head along with sensitivity too.

Perspiration on palm is slightly decreased.

Rubrum 30/ T.D.S.

For 1 month

 

06/07/23

Relief in pain in the head along with all complaints.

Perspiration on palm is slightly decreased.

Rubrum 30/ T.D.S.

For 1 month

 

08/08/23

Patient is relieved in all complaints.

Perspiration on palm is decreased.

Rubrum 30/ T.D.S.

For 1 month

 

10/09/23

Relief in all complaints.

No concomitants.

Rubrum 30/ T.D.S.

For 1 month

12/10/23 No attacks of pain on the right side of head.

Sensitivity towards light, sound is not present.

Patient is cheerful nowadays.

  

Conclusion: This patient suffering from a migraine, a condition that negatively affects a person’s quality of life, found relief with Silicea 30.

Consent Form

References:

  • O’Hare M, Cowan RP. Sleep and Headache. In: Sleep and Neurologic Disease. Elsevier; 2017. p. 201–25.

About the author

Nitiksha Sharma

Dr. Nitiksha Sharma (M.D. Scholar), Department of Materia Medica, SKHMC, Jaipur (Raj.)

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