ARDHAVABHEDAKA (MIGRAINE)

🔺CASE STUDY: ARDHAVABHEDAKA (MIGRAINE)

🔺NIDANAM (ETIOLOGY / CAUSATIVE FACTORS)
(Ref: Ashtanga Hridaya Uttara Tantra 23/12; Madhava Nidana Shiroroga Adhyaya 54)

• Ativyayama (excess exertion)

• Ruksha ahara (dry, non-unctuous food)

• Sheeta ahara (cold food and drinks)

• Vegadharana (suppression of natural urges)

• Exposure to cold wind or extreme weather

• Chinta, shoka, krodha (stress, grief, anger)

🔺PURVAROOPAM (PRODROMAL SYMPTOMS)
(General signs of Shiroroga)

• Stiffness or heaviness in neck and shoulders

• Irritability or mental restlessness

• Mild unilateral head discomfort or tightness

• Photophobia, phonophobia

• Pulsating or throbbing sensation

🔺LAKSHANA (SYMPTOMS / CLINICAL FEATURES)
(Ref: A.H. Uttara Tantra 23/12)

• Severe, pricking pain on one side of the head (typically temporal region)

• Pain may radiate to eye, ear, jaw

• Recurring, paroxysmal headache

• Associated features: nausea, vomiting, sensitivity to light and sound

• “Ardhavabhedakah shiroardhe vedanayah sada, Bhrusha tri-karne netre cha karoti dravam chaiva.” – intense, unilateral pain affecting eye, ear, and causing lacrimation

🔺GENERAL EXAMINATION

• History: Onset, periodicity, aggravating/relieving factors, aura

• Associated complaints: Nausea, vomiting, photophobia

• Lifestyle: Diet, stress, sleep pattern

• Vitals:

  • Pulse: May be elevated

  • BP: Rule out hypertension

  • Temperature: Rule out febrile illness

🔺SYSTEMIC EXAMINATION

• Nervous System:

  • Cranial nerve exam – rule out neurological deficits

  • Fundus exam – rule out papilledema

  • Neck rigidity – exclude meningitis

• ENT & Eyes:

  • Sinus tenderness – rule out sinusitis

  • Ear exam – to exclude ear infection

  • Eye exam – IOP, vision (glaucoma, eye strain)

🔺LABORATORY INVESTIGATIONS

• CBC – To detect infection or anemia

• ESR / CRP – Inflammatory markers (temporal arteritis)

• RBS / FBS – Rule out hypoglycemia

• Thyroid Profile (TSH, T3, T4) – Thyroid-related headache

• Serum Electrolytes – For metabolic imbalances

• MRI / CT Brain – Rule out SOL, aneurysm, stroke

• EEG – If seizure is suspected

• Lumbar puncture – If meningitis or raised ICP suspected

🔺DIFFERENTIAL DIAGNOSIS (DD)

• Cluster headache

• Sinusitis

• Tension headache

• Cervicogenic headache

• Temporal arteritis

• Intracranial mass lesion or pathology

🔺SAMPRAPTI (PATHOGENESIS)

• Nidana causes vitiation of Vata and Kapha dosha

• Vata leads to shoola (pain), Kapha leads to srotorodha (blockage)

• Unilateral vitiation of Vata affects the nerves/vessels of the head

• Kapha causes heaviness and dullness in the affected side

🔺SAMANYA CHIKITSA (GENERAL MANAGEMENT)
(Ref: A.H. Uttara Tantra 23/20; Charaka Chikitsa Sthana 26)

• Vata-Kapha hara line of treatment

• Snehana (oleation) – internal (ghrita) and external (abhyanga)

• Swedana (sudation therapy)

• Nasya – Anutaila, Shadbindu Taila

• Shirovasti / Shirodhara with Vatahara tailas

🔺UPASHAYA (PALLIATIVE FACTORS)

• Application of warm tailas on head and scalp

• Nasya with Vatahara tailas

• Staying in quiet and dark room

• Consumption of warm, unctuous (snigdha) food

🔺ANUPASHAYA (AGGRAVATING FACTORS)

• Cold exposure or wind

• Intake of ruksha, sheeta, or spicy foods

• Excess mental or physical strain

• Suppression of natural urges

🔺VISHESHA CHIKITSA (SPECIFIC MANAGEMENT)
(Ref: Bhaishajya Ratnavali – Shiroroga Chikitsa Adhyaya)

📌NASYA (NASAL THERAPY)

• Shadbindu Taila, Anutaila

• Course: 7–14 days

📌SHIROVASTI / SHIRODHARA

• Tailas: Ksheerabala taila, Mahamasha taila, Bala-Ashwagandhadi taila

📌INTERNAL MEDICATIONS