Migraine is a neurological disorder that can be very distressing and disabling. Typically, it is a one-sided throbbing or pulsating headache that is at least moderately intense and can be aggravated by physical activity. It is often associated with nausea and vomiting, as well as increased sensitivity to light, sound and even some types of smell.

In contrast, tension an another headache type, is usually felt on both sides of the head. It is a pressing or tightening sensation rather than a throbbing headache and is not made worse by activity or accompanied by nausea.

Apart from common migraine and migraine with aura, other types of migraine are:

Lower-half Headache or Facial Migraine-This migraine covers one-half of the face involving the nostril, cheek and jaw.

Migraine Aura without Headache- Where the headache of migraine with aura may become less severe over the years or may not occur at all, the attacks are referred to as migraine aura without headache.It is rare for attacks to have always occurred without a headache and a doctor should be consulted if this develops for the first time when over 50.

Status Migraineurs Abdominal Migraine (recurrent stomach pains in childhood)

Symptoms are periodic abdominal pains (experienced by about 20% of migraines children compared with about 4% of children who do not suffer from headache).

Rare types of migraine include:

Basilar Artery Migraine (with loss of balance and fainting)

Symptoms include visual disturbances, giddiness, loss of balance, slurred speech followed by aching mainly in the back of the head. Fainting can occur at the height of the attack.

Hemiplegic Migraine (with weakness on one side of the body)

Symptoms resemble a stroke and may progress until the arm and leg on one side are completely paralyses for a few hours. Repeated attacks may leave a residual weakness. Familial hemiplegic migraine occurs where there is a family history of hemiplegic migraine.

Ophthalmoplegic Migraine (with double vision)

Symptom is paralysis of one or more of the muscles moving the eyes resulting in the eyes moving out of alignment and the person seeing double.

Retinal Migraine (with loss of vision in one eye)

Symptom is loss of sight in one eye and normal vision in the other. The sight clears leaving an ache behind the eye or a generalised headache.

 Migraines Infarction

Symptoms range from permanent blind spots to a full stroke occurring during a typical migraine attack.

Triggers

Triggers are many and varied, not the same for everyone and not necessarily the same for different attacks in the same person. Identifying triggers may be complicated by the fact that it often takes a combination of triggers to set off a headache.

Dietary Triggers

• Missed, delayed or inadequate meals
• Caffeine (coffee and tea) withdrawal
• Certain wines, beers and other heavy drinks
• Monosodium glutamate (MSG)
• Dehydration

Environmental Triggers

• Bright or flickering lights, bright sunlight
• Strong smells e.g. perfume, gasoline, chemicals, smoke-filled rooms, various food odours
• Travel related stress, high altitude, flying
• Weather changes, changes in barometric pressure (likewise, decompression after deep-sea diving)
• Loud sounds
• Computers (overuse, incorrect use)

Hormonal Triggers

Hormonal fluctuations are implicated as a significant trigger for women as three times women suffer from migraine headaches as men, this difference being most apparent during the reproductive years. 

• Menstruation
• Ovulation
• Oral contraceptives
• Pregnancy (may worsen for first few months but in two thirds of women improves in latter part)
• Hormone replacement therapy (HRT)
• Menopause
• Physical and Emotional Triggers
• Lack of sleep or oversleeping
• Illness such as a viral infection or a cold
• Back and neck pain, stiff and painful muscles, especially in scalp, jaw, neck, shoulders, and upper back
• Sudden, excessive or vigorous exercise
• Emotional triggers such as arguments, excitement, stress and muscle tension

Ayurvedic perspective

Headache is also known as Shira (Head)Shula(Pain), Shira Shula is defined based on the dosha involved. In addition to categorizing headache into imbalance, the cause of the pain arising from nervous tissue or bone structures helps dictate the treatment of head pain. Depending on which dosha is being influenced, different headache types will manifest.

Vata type headaches are often located in the cervical/occipital regions and have a throbbing component to them. These headaches are generally not as severe in intensity and often do not have any associated features such as light sensitivity, smell sensitivity, nausea or vomiting associated with them. Sound sensitivity may be present, as it reflects an excitable nervous system. These headaches are most often induced by stress, especially when the daily routine of sleeping and eating are not followed in a regular fashion.

Pitta type headaches are often located in the retro‐orbital/temple regions and have a sharp, intense component to them. These headaches are often moderate to severe in intensity and associated with nausea, vomiting and light sensitivity. Pitta, the fire state, is often linked to the development of inflammation.

Kapha type headaches are often located in the frontal areas. This headache is often associated with congestion and allergies. These headaches can worsen with changes in season, especially in the spring season.

People with headache may present with combinations of doshic imbalances. For example, one may have a Pitta‐Vata headache or a Vata‐Kapha headache. These headaches need to be treated by balancing out both imbalanced states.

Ayurvedic treatment is not for the disease itself, but it is tailored for the condition of disease of the individual. Detox treatments are highly recommended for managing Migraine. In Migraine, toxins deposited in the head and can affect the function of the different sense organs. Panchakarma helps to remove these toxins and helps to strengthen the nerve system. Sirodhara, Shiroabhyanga, Sirovasti helps to nourish the nerve system and balance vata.

Nasya (administering of herbal preparations through the nostrils) is one of the treatments which directly acts on the nerves and removes the toxins accumulated in the sinuses. Mucus coating inside the nostrils are one of the areas where numerous nerve endings are exposed. The medicated oils applied through Nasya directly acts on these nerve endings, helping to pacify Vata, and draining the mucus deposited in the sinuses. Thus, the pressure in this area is relieved.

Basti (enema), and Virechana (purgation) also help to eliminate toxins from the body.

Oil Pulling: Another perfect substitute therapy for migraine is oil pulling or Kavala Garah.

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