Introduction
Migraine, a neurovascular disorder ranks as the second most disabling disease globally, affecting the quality of life of patients and their family 1, 2. It also is difficult to manage conventionally 2, as NSAIDs and triptans can only relieve the pains during the acute phase and there is no real permanent solution 3. Further, each has its own unwanted adverse effects 3 which make an alternative desirable.
Homeopathy has shown considerable efficacy in migraine and many times has provided complete resolution of the problem4, 5. In the case reported below, we see the nuances of treating a case in detail. It is hoped that the process involved in classical homeopathic treatment of migraine will be demonstrated.
Case report
Case presentation:
A 39-year-old female presented to homeopathic consultation for treatment of migraine on 14/10/2021. She complained of severe migraine attacks for the past 15 years, each attack lasting 3 days. She also had hypertension. She took Atenolol 25 mg 1 tablet in the morning, Amitriptyline 10 mg 1 tablet before bed, Ergotamine tartarate and Naproxen for migraine.
Past medical history:
She suffered high fever from influenza and was admitted in the hospital for 3 days, 5 years ago. During the admission, she had skin rashes from drug allergy.
At 30 years’ age, she was diagnosed of bilateral multiple ovarian cysts by the gynaecologist and was given adjusted oral contraceptive pills regularly to control ovarian cysts.
No menstruation for 4-5 years at that time. Caesarean section and appendectomy 10 years ago, Oral contraceptive pills used from 23-24 years’ age. Had headache before menses 1-2 days and disappeared when the menses came, now no more headache before menses, as she was continuously on hormonal pills from the age of 27 and didn’t have menses till starting homeopathy.
Acute pyelonephritis at 22 years age, treated conventionally.
Family history:
Father was 65 years old and healthy. Mother was 65 years old and suffered hypertension and heart disease. Her daughter was 10 years old and suffered asthma.
Homeopathic case:
When the details were investigated to determine the origin of migraines, the story told was this. The patient worked as judicial secretary in the Civil Court from her 22nd to 29th year. Her duty was typing the testimony being given in the court for all the cases.
While doing this work, if she came across arguments and fights between the parties in court, she experienced palpitations, trembling of hands, perspiration, and nearly fainted sometimes. After these frightful experiences she developed the throbbing pains in the head.
She was terrified as she had to use the same exit door as clients, but the judge had the special exit door behind the Chair. She had to, therefore, confront the parties during such altercations even till she left the court premises.
The headache occurred once to twice a month, was mainly left sided, starting from the temporal region, extending to orbital and occipital area. They would aggravate from high pitched loud noises, light, movement, and arguments. Cold application ameliorated the headaches.
There was a specific pattern to the headaches – It would begin as throbbing pain on left side of the head and last for 3 days. First day: throbbing pain, aggravated by movement, she had to apply ice pack to the head until falling asleep. Second day: there would be more pain, even light from her phone screen would be intolerable. Vomiting did not ameliorate. Third day: the pain would reduce.
Other complaints: Sneezing every morning. Itching in mouth – soft palate, gums, corners of the eyes – occurring just before the rain. High myopia both eyes.
Generalities: She liked fast food, sweet, sour from lemon, egg, and milk. She did not like vegetables, fat, and salty food. She was allergic to shellfish: shrimp, crab, squid etc. they would cause difficulty in breathing, urticaria and swelling of eyelids.
She preferred cold weather and did not like sweating. But she could tolerate the sun.
She slept well, but it was unrefreshing. She lay on her back, and both sides. She snored in her sleep and drooled when she had aphthous ulcers. She uncovered her feet. She usually napped in the afternoon for 1-2 hours and felt generally good thereafter.
Mentals: Fear of violence, fear of being attacked. She couldn’t breathe in crowded places. Anxiety about her daughter’s future. She was generally a patient person. Communicated her feelings only to close people. Sometimes had feelings of unforgiveness towards her husband.
Repertorisation: The repertorisation on Vithoulkas Compass yielded the following results.
Fig. 1 Repertorisation at first consultation
Differentiation of remedies:
As seen in the repertorisation, the following remedies were indicated:
Aconitum: headache after fright, fainting after fright, headache cold application amel, headache before menses.
Pulsatilla: headache after fright, headache – menses – suppressed, wet weather agg, ovarian cyst.
Nitric acid: headache left side, wet weather agg, headache – noise and jarring agg.
Level of health and case analysis:
Aliments from fright caused her severe migraine and her family history is quite light. However, there have been other health issues which were suppressed with conventional medicine (hormones), with the effect that for 5 years she had no high fever.
Therefore, Patient is understood to be in upper/mid-level of Group C. In this group, a considerable time will be needed to see overall betterment in health, many times needing a few remedies in proper sequence. The appearance of old suppressed conditions and/or return of high fever are necessary to consider the chronic condition as resolved.
Prescription on 14/10/2021:
Aconitum 200C one dose. Based on the causation and the response to fright, the remedy aconite was chosen. She was advised to stop the oral contraceptives and any conventional medicine, which she did.
Follow up:
| Date | Response to previous prescription | Prescription |
| 30/11/2021 | Throbbing headache after the remedy – could not sleep the first day. The second day had less pain and good sleep.
She could control her bearing while facing violent situations, no more trembling, but she had mild palpitation. Sneezing in the morning: the intensity and duration had reduced (without allopathic drugs) Refreshing sleep now No headaches after the initial aggravation and she felt energetic. She did not use any analgesic or antidepressants that she was used to. |
Wait |
| 06/01/2022 | Migraine – no episodes
Sneezing in the morning persists. Menstruation was regular, without pain or dark blood clots as used to occur before. The menses were not associated with headache. Refreshing sleep. |
Wait |
| 07/04/2022 | Patient took her Covid vaccination (Moderna) on 13/01/22. She had itchy skin rashes after this but no medication was given.
No migraine even in conflict situations. One episode of mild headache lasted for 2-3 hours and reduced with no medicine. The sneezing in the morning, allergy to shellfish and itching in gums before rains persist |
Wait |
Final outcome
At her last follow up a month ago, the patient said that she felt refreshed after homeopathic remedies. She occasionally got headaches still, but 10% of the usual intensity. The gynaecologist examined her and told that the ovarian cyst was gone. She is due for a gynaecological review in a year next.
Discussion
This case demonstrated how going against one’s nature can cause pathology, and how freeing the being at that level alone can help relieve the seemingly physical issues. The woman was extremely sensitive to violence/disharmony and that is the exact stress she was subject to.
This created terrible headaches and severe anxiety. Frightful situations causing issues is the keynote of aconitum and this helped her wonderfully. She may need another remedy in future to completely clear out the headaches and balance her hormones for good.
But by the dictates of classical homeopathy, we must wait for clear symptomatology to come up before we can do that. Further, we cannot claim cure in this case yet, not just because she gets mild headaches, but because there has not been a return of acute infections with high fever yet. When that happens, we may be sure she is cured.
Conclusions
Individualised classical homeopathy was beneficial in this case of migraine. The remedy Aconitum helped overcome the pathology that was established due to a frightful situation. While not yet cured, this case shows the importance of the strategy to prescription, viz., causation. Further treatment is required in this case to establish cure.
References
- Steiner, T.J., Stovner, L.J., Jensen, R. et al.Migraine remains second among the world’s causes of disability, and first among young women: findings from GBD2019.J Headache Pain 21, 137 (2020). https://doi.org/10.1186/s10194-020-01208-0
- Ashina M, Katsarava Z, Do TP, Buse DC, Pozo-Rosich P, Özge A, Krymchantowski AV, Lebedeva ER, Ravishankar K, Yu S, Sacco S. Migraine: epidemiology and systems of care. The Lancet. 2021 Apr 17;397(10283):1485-95.
- Ducros A, de Gaalon S, Roos C, Donnet A, Giraud P, Guégan-Massardier E, Lantéri-Minet M, Lucas C, Mawet J, Moisset X, Valade D. Revised guidelines of the French headache society for the diagnosis and management of migraine in adults. Part 2: Pharmacological treatment. Revue Neurologique. 2021 Sep 1;177(7):734-52.
- Ferla L, Madhusudhan A, Bosco MC, Mahesh S, Vithoulkas G. Retrospective Observational Study of Pediatric Headaches. Homeopathy for Everyone [internet]. 2021 Oct 18; Available from https://hpathy.com/homeopathy-papers/retrospective-observational-study-of-pediatric-headaches/
- Witt CM, Lüdtke R, Willich SN. Homeopathic treatment of patients with migraine: a prospective observational study with a 2-year follow-up period. The journal of alternative and complementary medicine. 2010 Apr 1;16(4):347-55.
