INDIA  :   Health

Treating Migraine in India

Saturday , 06 February 2016
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The Migraine Trust fact sheet on migraine, states that around 1 in 7 people across the world suffer from migraine. This week, TGI takes a look at treatment options for migraine in India

Mayo Clinic has defined migraine as, “A headache that can cause intense throbbing or a pulsing sensation in one area of the head and is commonly accompanied by nausea, vomiting and extreme sensitivity to light and sound.” It is one of the most common neurological conditions and is known to be more prevalent than diabetes, epilepsy and asthma combined.

“Medical studies have shown that migraine remains undiagnosed and untreated in at least 50% of people, suffering from an attack,” said Dr Srinath Chandramani, physician at Somaiya Vidyavihar Hospital-Mumbai, who has conducted research on migraine headaches.

“Migraine attacks can affect daily life and normal functioning of a person, as it can cause significant pain for hours to days. It is recurrent in nature, and linked to other symptoms like sensitivity to light and noise, nausea, vomiting, dizziness and eyesight changes. However, less than 50% of patients think about seeking medical help,” said Dr Chandramani.

Cause and Symptoms

Migraine attacks can start at any age. Doctors say that children, who are in their early to mid-teens, can experience migraine attacks. A study by Migraine Trust in its fact sheet on migraine states, that over half (54%) of migraineurs experience one or more attacks per month, and 13% claim to suffer from one or more attacks per week. Symptoms of a migraine attack can vary from person-to-person.

Mayo Clinic classifies the progress of a migraine attack in four stages:

Prodrome; Aura; Attack and Postdrome

  1. Prodrome: This phase can be noticed a few hours or a day before the attack, when the person experiences irritability, unusual thirst, food cravings, constipation, excitability or depression, and sleepiness with frequent yawning.
  2. Aura: It may occur before or during the migraine attack, where the person may experience visual phenomena of ‘seeing’ various shapes, flashes of light or a bright spot, suffer temporary vision loss, have difficulty in speaking or writing and may feel a tingling sensation of pins and needles on the face, arms and legs. Very few migraneurs experience an ‘aura’. These symptoms begin gradually but can last for several minutes.
  3. Attack: This stage of migraine can last from 4 to 72 hours with a varying intensity of pain. In this stage, the person can experience pain on one or both the sides of the head. The pain has a pulsating, throbbing intensity, which worsens with physical activity. The pain may be accompanied by nausea, vomiting, light-headedness and sensitivity to light and smells.
  4. Postdrome: This is the final phase and occurs after the migraine subsides. The person feels confused, sluggish and drained out.

A person with a migraine problem should immediately seek medical help if he/she experiences an abrupt, severe headache like a thunderclap; has fever with a headache along with neck stiffness; experiences mental confusion or has an intolerable headache.

According to medical literature, migraines affect women more than men because of hormonal changes (read fluctuating oestrogen levels). Many factors can trigger a migraine, like environmental factors (heat, high intensity light, increased humidity and changes in weather conditions); lifestyle factors (skipping breakfast or fasting, consumption of certain types of cheese and chocolates, red wines, fizzy drinks, fermented foods, foods with MSG such as Chinese food,) and family history. Stress and sudden changes in sleeping pattern too, can trigger migraine attacks in some people.

Diagnosis and treatment

To diagnose migraine, a doctor first conducts a physical examination and jots down medical history and lifestyle of the person and advices tests like blood tests, CT scan, MRI scan among others.

For migraine treatment, one needs to identify trigger factors and take care to avoid them. “A doctor should be consulted in case the migraine is frequent and popping of pills on a regular basis should be avoided as they can have side effects,” said Dr K Ravishankar, Consultant-in-charge of the Headache and Migraine Clinic at Jaslok Hospital- Mumbai.

Lifestyle management can also help control migraine. “Healthy eating habits and avoidance of fermented foods and other foods that trigger migraine is recommended for migraine patients,” said Dr Nupur Krishnan, Nutrition Expert at Bio-Logics Nutrition Clinic-Mumbai.

For the prevention of chronic migraine, where the usual medicines don’t respond, a new treatment has become available now, in the form of injections of Botulinum Toxin.

Doctors may prescribe pain relieving medicines and preventive drugs. “Pain relievers like aspirin, ibuprofen and acetaminophen can provide relief from migraine headaches along with medicines for nausea and vomiting. Treatment varies from person-to-person and is designed according to the nature of the attacks. One needs a good physician to chalk out a treatment course for the successful management of migraine,” said Dr Ravishankar.

India as a destination for migraine treatment

Indian corporate hospitals especially in metro cities like Mumbai, Delhi, Chennai and Kolkata have dedicated migraine specialists, as a large number of the population suffers from migraine. Doctors confirmed that patients from countries like UAE, South Africa and Pakistan, often come to India for diagnosis and treatment. “Once the consultation is over, treatment and follow-up continues via social networking sites or online meetings via Skype. Proper diagnosis and course of treatment plays a crucial role in migraine management,” said Dr Ravishankar.

Ayurveda centres in India, especially in southern cities like Kerala, offer alternative therapy for migraine.

“Acupuncture, detox programme, panchakarma and massage therapies using herbal oils along with cognitive behavioural therapy, help in managing migraine. Many foreigners come to India for alternative therapy options for migraine, as most of them are tired of popping pills,” said Dr Rajeshwar Reddy of Poddar Ayurveda Hospital- Mumbai.

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