Year - 2024Volume - 2Issue - 1Pages - 01-08
The Effect of Ayurvedic Management of Ardhavabhedaka w.s.r. Migraine – A Conceptual Study.
06 Feb 2024
388
About Author
Shukla D1,Sharma D2,Lodhi D3,Sharma D4,
1 MD Scholar, PG scholar, 1st year, Pt KLS Govt. Ayurved college & Institute, Bhopal, M.P
2 Assistant professor , kayachikitsa department, Pt. KLS Govt. Ayurveda college, Bhopal, M.P
3 MD Scholar, PG scholar, 1st year, Pt KLS Govt. Ayurved college & Institute, Bhopal, M.P
4 Assistant professor , Assistant professor, kayachikitsa department, Pt. KLS Govt. Ayurveda college, Bhopal, M.P
Correspondence Address
Dr. Ratnesh Kumar Shukla
Post Graduate Scholar, Dept of Kayachikitsa,
Pandit Khushilal Sharma Govt Ayurveda College and Institute, Bhopal Madhya Pradesh
E-Mail: Drratneshs@gmail.com
Mo. No. - 9340525166
Contact No. : 9340525166, Email : Drratneshs@gmail.com
Date of Acceptance : 17 Feb 2024
Date of Publication : 27 Mar 2024
Article ID : SD-IJAY_001
How to cite this article : http://doi.org/10.55552/SDNJAY.2024.2101
Abstract
Migraine is a type of headache characterized by recurrent attack of moderate to severe throbbing and pulsating pain on one side of the head associated symptoms may be include nausea, vomiting, photophobia and phonophobia. Migraine affects more than one billion individuals each year across the world, global prevalence of migraine was 11.6%. In India more than 213 million people to be suffering from migraine while 60% of these cases were reported by women’s. Migraine word originated from Latin word ‘Megrim” means hemi cranial. In most cases pain is limited to one half of the cranium may be corelated to the Ardhavabhedaka presented in ayurveda. As per modern aspect for acute migraine treatment are NSAIDs, 5-HT antagonist, Ergotamine alkaloids, Non-selective B-blockers and calcium channel blocker, have their own complication. Hence an attempt is made to understand Migraine as Ardhavabhedaka in ayurveda and its management is discussed, which can be helpful in improving quality of life of patient of migraine.
Introduction
The concept of Shiroroga, including Shirahshool as a common symptom, has been extensively documented in Ayurvedic literature. Ardhavabhedaka represents a subtype where unilateral head pain occurs. According to Acharya Charak, this condition manifests as severe pain affecting half of the head, particularly impacting areas such as Manya, Bhru, Shankha, Karna, Akshi, and Lalaat. The nature of the pain is described as similar to that of Shastra bhedanavata.
Migraine represents a genetically influenced complex disorder marked by episodes of moderate-to-severe headaches, typically unilateral and often accompanied by nausea, as well as sensitivity to light and sound. Its name originates from the Greek "hemikrania," subsequently translated into Latin as "hemigranea," and finally into French as "migraine." This condition frequently leads to disability and work impairment. Migraine attacks are intricate brain events unfolding over hours to days in a recurrent manner. The most prevalent type, without aura, constitutes approximately 75% of cases. This review examines the etiology and pathophysiology of migraine while emphasizing the importance of an interprofessional approach in assessing and managing patients with this condition.
Discussion
In the classical text ayurveda treatment modalities are dependent on three major treatment ailments-
i. Nidana parivarjana
ii. Sansodhana (Panchakarma)
iii. shamana
1. Nidana parivarjana – In ardhavabhedaka must exclude ahar vihar which are Ruksha, adhyashana, poorvavata, avashyaya, maithuna, vega-sandharana, vyayam etc.
2. Sansodhana
According to ayurveda the role of virechana, basti, nasya and raktamokshana are the most prefarable samsodhana karma for ardhavabhedaka.
Role of Virechana
Virechana, expelling all three doshas through the lower body, particularly addresses vata dosha residing in the lower part of the body. By excluding pitta and kapha, which obstruct vata transmission and contribute to migraine pain, it provides relief. Virechana is a complete samsodhana karm for all three doshas. Vata dosha situated mostly in the Adhogabhaga of Sharir. Acharya Vagbhata described Mrudu samsodhana specially virechana in Vata Upkarma. Due to action and Prabhava of Virechana Dravya, Pitta and Kapha excrete out which obstruct transmission Vata and throbbing pain in Migraine.
Role of Basti
Basti therapy, primarily aimed at pacifying vata dosha, acts on the Pakwashaya, the main site of vata dosha. It is beneficial for treating neurological disorders by affecting neurotransmitters and reducing migraine pain intensity.
Role of Nasya
Administering medicine through the nasal route effectively treats migraine, a type of Shirogata Roga. Nasya therapy stimulates nerve endings, promotes the extraction of morbid doshas, and normalizes Tridoshas, thereby alleviating migraine pain.
Role of Raktamokshana
Raktamokshana, through bloodletting, reduces local pressure and alleviates migraine pain.
2. Other Therapies
- Shirobasti with chatur-Sneha, Seka with ghee or milk, Kavalgraha, Upnaha, Dahan
3.Shamana Chikitsa: - Shamana Chikitsa (Pacificatory Therapy) is a form of curative treatment aimed at addressing Ardhavabhedaka (migraine). The therapeutic approach involves various remedies such as:
Rasa Aushadhi: shiroshuladi vajra rasa, laxmivilasa rasa, and Mahalaxmi vilasa Rasa.
Kashayam (Decoction): Pathyadi shadangadi kashayam, guduchyadi kashayam, and Dhatryadi Kashayam.
Ghritapana: saraswata ghritha, brahmi Ghrita and Mayuradya Ghrita.
- Shirolepa (Head mask): Examples include Kumkuma Ghrita lepa and Sarivadi lepa. Additional remedies for shirolepa include processing Krishna marich powder with bhringraja swarasa and using it with bhringraja swarasa during an attack, as well as a mixture of Krishna tila, jatamansi powder, saindhava, and honey. Applying lepa to affected areas reduces pain and pressure. Medicinal lepas penetrate the skin, stimulate nerve endings, and transmit impulses to the central nervous system, reducing pain
- Shiro-Abhyanga (Head massage): Using dashamoola-dhatri Taila, saraswata ghritha, and Prapondrikadi Taila.
- Specific drug:
• Gorakhmundi kwath with prakshep of krishna marich
• Shudh Somal in very small quantities is effective but should only be used when the attack is suppressed, not during a migraine attack.
Conclusion
Neurological disorders are increasingly prevalent today, often attributed to lifestyle and dietary factors. Among these disorders, migraine stands out as a common condition that significantly disrupts daily activities. Many neurological disorders, particularly those related to vata imbalances, are diagnosed within this spectrum. Ayurveda identifies various nidanas, encompassing dietary, lifestyle, and psychological factors, which closely align with migraine triggers.
The frequent use of medications in migraine treatment can lead to drug dependency and withdrawal syndromes. Ayurveda offers a holistic approach to migraine treatment, addressing symptoms while also preventing potential side effects. Opting for Ayurvedic treatment for migraine can be beneficial in managing the condition effectively and mitigating further complications. The following case study highlights the efficacy of Ayurvedic therapies in managing Ardhavabhedaka (migraine). The human body operates as an interconnected system, with various subsystems performing distinct functions. By embracing a holistic approach that addresses the underlying Dosha imbalance and treats the entire system rather than isolated parts, patients can experience significant symptom relief within a relatively short timeframe, provided treatments are administered promptly and earnestly.
Although this review study has its limitations, it underscores the effectiveness of Panchakarma therapies such as Sarvang Abhyanga and Swedana, Nasya Karma etc and Ayurvedic oral medications in managing Ardhavabhedaka. These modalities offer a simple, holistic approach with minimal adverse effects on patients. To validate the findings further, it is imperative to administer similar treatments to a larger cohort of individuals for comprehensive assessment. By doing so, the valuable benefits of Panchakarma therapies can be substantiated and advocated as a dependable approach in managing Ardhavabhedaka.
References
1. Nisha, Journal of innovation in pharmaceuticals and biological sciences; 2015; 2(1): 68-71.
2. Prof. Ajay Kumar Sharma, Kaya chikitsa (Tritiya Bhaga), Chaukhambha Orientalia delhi
3. http://en.m.wikipedia.org.
4. Golwalla Medicine for students, 22nd edition, chapter no., 10: 501.
5. Golwalla Medicine for students, 22nd edition, chapter no., 10: 502- 503.
6. Sharangdhar Samhita, Bramhanand Tripathi, Choukhamba surbharati prakashan, Varanasi, Edition 2011, Chapter 5th, Purvakhand, kaladikakhyanam, 60: 43.
7. Acharya Vidyadhar Shukla, Professor Ravidatta Tripathy, Charak Samhita, vol.2. Choukhamba Sanskrit Prakashan, Delhi. Edition, Chapter 9th, Siddhisthana, Trimarmiyaadhyaya, 2009; 956: 74.
8. Acharya Vidyadhar Shukla, Professor Ravidatta Tripathy, Charak Samhita, vol.2. Choukhamba Sanskrit Prakashan, Delhi. Edition, Chapter 9th, Siddhisthana, Trimarmiyaadhyaya, 2009; 956: 75.
9. Acharya Vidyadhar Shukla, Professor Ravidatta Tripathy, Charak Samhita, vol.2. Choukhamba Sanskrit Prakashan, Delhi. Edition, Chapter 9th, Siddhisthana, Trimarmiyaadhyaya, 2009; 956: 76.
10. Sushrut samhita , Sushrutvimarshini, Anantram Sharma, Uttartantra, Choukhamba Surbharati Prakashan, Varanasi, Edition, Chapter 25, Shiroroga vidyaniya, 2015; 188: 15.
11. Acharya Vidyadhar Shukla, Professor Ravidatta Tripathy, Charak Samhita, vol.2. Choukhamba
Sanskrit Prakashan, Delhi. Edition, Chapter 9th, Siddhistana, Trimarmiyaadhyaya, 2009; 956: 78.
12.Martin VT, Behbehani MM. Toward a rational understanding of migraine trigger factors. Med Clin North Am. 2001 Jul;85(4):911-41.
13.Kelman L. The triggers or precipitants of the acute migraine attack. Cephalalgia. 2007 May;27(5):394-402.
14.Evans RW. Diagnostic Testing for Migraine and Other Primary Headaches. Neurol Clin. 2019 Nov;37(4):707-725.
15.Hawasli AH, Chicoine MR, Dacey RG. Choosing Wisely: a neurosurgical perspective on neuroimaging for headaches. Neurosurgery. 2015 Jan;76(1):1-5; quiz 6.
16.Rose FC. The history of migraine from Mesopotamian to Medieval times. Cephalalgia. 1995 Oct;15 Suppl 15:1-3.
17.Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211.
18.Merikangas KR, Risch NJ, Merikangas JR, Weissman MM, Kidd KK. Migraine and depression: association and familial transmission. J Psychiatr Res. 1988;22(2):119-29.