ABSTRACT– Migraine is a primary episodic headache disorder characterized by various combinations of neurological, gastrointestinal and autonomic changes. The recurrent attacks are variable in nature i.e. intensity, frequency & duration etc. 
It is usually an episodic headache that is associated with certain features such as sensitivity to light, sound or movement; nausea and vomiting often accompany the headache. 
Migraines are 3 times more common among women than among men. Migraine, the most common cause of headache, afflicts approximately 15% of women and 6% of men. 
CLASSIFICATION– The following types are: 
1. Migraine without aura (Common migraine)
2. Migraine with aura (Classical migraine)
Migraine with typical aura
Migraine with prolonged aura
Familial hemiplegic migraine
Migraine aura without headache
Migraine with acute- onset aura
3. Ophthalmoplegic migraine
4. Retinal migraine
5. Childhood periodic syndromes that may be precursors or be associated with migraine
- Benign paroxysmal vertigo of childhood
- Alternating hemiplegia of childhood
6. Migraine with complication
- Status migrainosus
- Migrainous infarction
- Unknown cause
- Genetic factor
- Physical (fatigue/ over- exertion/ relaxation)
- Psychological (depression/ worry/ shock/ anxiety)
- Other precipitating factors-
Alcohol, cheese, chocolate, coffee etc.
Certain odors or perfumes
Changes in sleep pattern
Skipping of meals
Hormonal factors (OCP, premenstrual tension, menopause, during puberty)
CLINICAL FEATURES – 
Migraine commonly exhibits four stages during the episode:
- Behavioural changes, irritability, food cravings, neck stiffness, frequent yawning, increased thirst and urination, malaise.
- Each symptom usually begins gradually, builds up over several minutes and lasts for 20 to 60 minutes.
- Ex.- Fortification spectra
Pins and needles sensations in an arms or legs
Weakness or numbness in the face or one side of the body
Difficulty in speaking, hearing noises or music
Uncontrollable jerking or other movements
3. HEADACHE (ATTACKS)-
- A migraine usually lasts from four to 72 hours if untreated.
- Pain usually on one side of your head, but often on both sides.
- The typical migraine headache is throbbing, pulsating, moderate to severe and can be aggravated by physical activity.
- Sensitivity to light, sound, sometimes smell and touch.
- Nausea and vomiting
- Drained out, exhausted and depressed feeling after headache and may have impaired concentration, scalp tenderness or mood changes.
o Status migrainosus
o Migrainous infarction
o Persistent aura without infarction
o Migraine- triggered seizure
DIFFERENTIAL DIAGNOSIS- 
o Tension headache
o Cluster headache
o Post- traumatic headache
o Headache associated with vascular, non-vascular, metabolic disorders and non-cephalic infection
o Reflex headache from eye, ENT, teeth, sinuses etc.
o Cranial neuralgias
DIAGNOSTIC CRITERIA- 
o Symptoms of headache that needs immediate attention
o Tracing the history of the patient
o International Headache Society (IHS) criteria
o Blood Chemistry and Urinalysis, CT scan, MRI, Sinus X-Ray, Eye test, Spinal tap
1. General Management– 
Avoidance of identified triggers or exacerbating factors
Healthful diet intake
Physiotherapy- regular exercise, yoga
2. Homoeopathic Treatment for Migraine Headache – Belladonna, Gelsemium, Glonoinum, Natrum mur, Spigelia, Sanguinaria can, Iris vers, Nux vomica, Ignatia etc.  
- Severe throbbing and heat, pain, fullness, especially in the forehead, occiput and temples.
- Great sensitiveness to the light; pain worse light, noise, jar, lying down and in the afternoon; better by pressure and in a semi-erect posture.
- Headache, congestive, with red face, throbbing of brain and carotids (Meli.)
- Headache: Preceded by blindness (Kali-bi), > by profuse urination.
- Vertigo, spreading from the occiput (Sil.); with diplopia, dim vision, loss of sight; seems intoxicated when trying to move.
- Heaviness of head; band- like sensation around the head and occipital headache.
- Throbbing, pulsating, headache; holds head with both hands; could not lie down, “the pillow would beat’’.
- Brain feels too large, full, bursting; blood seems to be pumped upwards; throbs at every jar, step, and pulse.
- < – In the sun, exposure to sun’s rays, gaslight, overheating, jar, stooping.
- Aches as if a thousand little hammers were knocking on the brain in the morning on awakening, after menstruation, from sunrise to sunset.
- Anaemic headache in school girls (Calc- p); nervous, discouraged, broken down.
- < – Noise; music; lying down, around 10 or 11 a.m., mental exertion, talking.
- Nervous headache; periodical, beginning in morning at base of brain, spreading over the head and locating in eye, orbit at temple of left side (right side, Sang; Sil.); pain pulsating, violent, throbbing.
- < – from touch, motion, noise, turning the eyes, concussion, shaking.
- Periodical sick headache; pain begins in the occiput, spreads upwards, and settles over the eyes, especially right (migraine).
- Veins is the temples are distended.
- < – sweets, right side, motion, touch > – sleep, darkness.
- Frontal headache with nausea (migraine); right temples especially affected.
- Sick headache, worse rest. Begins with a blur before the eyes, after relaxing from a mental strain.
- Vertigo with momentary loss of consciousness.
- Pressing pain in the vertex, as if a nail was driven in; headache in the sunshine (sunstroke) (Glon; Nat-c.).
- Oversensitive: To external impressions; to noise, odors, light or music (Nux- m); trifling ailments are unbearable (Cham.).
- Congestive headache following anger or grief; worse, smoking or smelling tobacco, inclines head forward.
- Headache as if a nail was driven out through the side. (Coff, Nux-v, Thuja)
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