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.
