Sai Ram Acuu Centre

What is Migraine?

Migraine is a chronic neurological disorder characterized by moderate to severe headaches, and nausea. It is about three times more common in women than in men.

A typical migraine headache is experienced as a pulsatile pain on one side of the head and lasts from two to 72 hours with various symptoms that include nausea, vomiting, photophobia (increased sensitivity to light) and phonophobia (increased sensitivity to sound). These symptoms are generally aggravated by any routine activity. About onethird of people who suffer from migraine headaches perceive an aura, a transient visual, sensory, language, or motor disturbances that signals the oncoming bout of migraine.

Prodromal symptoms occur in 40–60% of those with migraines. This phase may consist of altered mood, irritability, depression or euphoria, fatigue, yawning, excessive sleepiness, craving for certain food (e.g. chocolate), stiff muscles (especially in the neck), dizziness, hot ears, constipation or diarrhea, increased or decreased urination, and other visceral symptoms. These symptoms usually precede the headache phase of the migraine attack by several hours or days, and experience teaches the patient or observant family how to detect a migraine attack is near.

About 20–30% of migraine sufferers who experience an aura that comprises focal neurological phenomena that precede or accompany the attack. They appear gradually over five to 20 minutes and generally last fewer than 60 minutes. Symptoms of migraine aura can be sensory or motor in nature. Visual aura is the most common of the neurological events, and can occur without any headache. There is a disturbance of vision consisting often of unformed flashes of white and/or black or rarely of multicolored lights or formations of dazzling zigzag lines. Some patients complain of blurred or shimmering or cloudy vision, as though they were looking at an area above a heated surface, looking through thick or smoked glass, or, in some cases, tunnel vision or partial temporary loss of vision.

Pain of Migraine

The pain of migraine is invariably accompanied by other features. Nausea occurs in almost 90 percent of patients, and vomiting occurs in about one third of patients. Blurred vision, delirium, nasal stuffiness, diarrhea, tinnitus, polyuria, pallor, or sweating may be noted during the headache phase. There may be localized edema of the scalp or face, scalp tenderness, prominence of a vein or artery in the temple, or stiffness and tenderness of the neck. Impairment of concentration and mood are common.

Treatment of Migraine

Initial treatment of migraine is with analgesics for the headache, an antiemetic for the nausea, and the avoidance of triggers. Common triggers quoted for migraine are stress, hunger, and fatigue (these equally contribute to tension headaches). Monosodium glutamate (MSG) is frequently reported as a dietary trigger. Migraines are more likely to occur around menstruation. Other hormonal influences, such as menarche, oral contraceptive use, pregnancy, perimenopause, and menopause, also play a role.

Cause of Migraine

Although the cause of migraine headache is unknown; the most supported theory is that it is related to hyperexcitability of the cerebral cortex and abnormal control of pain neurons in the brainstem. Fluctuating hormone levels also have a relation to migraine as is known that 75 percent of adult patients are women. Migraines were once thought to be initiated exclusively by problems with blood vessels, but the vascular changes of migraines are now considered by some researchers to be secondary to brain dysfunction

Migraines are underdiagnosed, and often are misdiagnosed. Migraine should be differentiated from other causes of headaches, such as cluster headaches. These are extremely painful, unilateral headaches of a piercing quality. The duration of the common attack is 15 minutes to three hours. Onset of an attack is rapid, and most often without the preliminary signs characteristic of a migraine. Medical imaging of the head and neck may be used to rule out secondary causes of headaches.

Prevention of Migraine

Preventive migraine drugs are considered effective if they reduce the frequency or severity of migraine attacks by at least 50%. The major problem with migraine preventive drugs, apart from their relative inefficacy, is that unpleasant side effects are common. So, preventive medication is limited to patients with frequent or severe headaches. Many medicines are available to prevent or reduce frequency, duration and severity of migraine attacks. They may also prevent complications of migraine. However, there are no drugs available to permanently cure migraine.

Medications are more effective if used earlier in an attack. The frequent use of medications may, however, result in medication overuse headache, in which the headaches become more severe and more frequent. These may occur with triptans, ergotamines, and analgesics, especially narcotic analgesics. Also, long-term side effects are known with all these drugs.

Complications of Migraine

The risk of stroke may be increased two- to three-fold in migraine sufferers. Young adult sufferers and women using hormonal contraception appear to be at particular risk. Migraine sufferers seem to be at risk for both thrombotic and hemorrhagic stroke as well as transient ischemic attacks.

Incidence of Migraine

Worldwide, migraines affect more than 10% of people. In the United States, about 6% of men and 18% of women get a migraine in a given year. Based on the results of a number of studies, one-year prevalence of migraine ranges from 6–15% in adult men and from 14–35% in adult women. In India, it has been reported that the prevalence of migraine is 9% among boys and 14% in girls. A rapid growth in incidence amongst girls occurs after puberty, which continues throughout early adult life.

Acupuncture in Migraine

Acupuncture has been studied as a treatment for migraine headache for more than 20 years. Researchers do agree that acupuncture appears safe and that it may be effective for many people. Results from a study published in 2003 suggest that receiving an acupuncture treatment when migraine symptoms first begin is as effective as taking any standard medication.

Many people who visit an acupuncturist's office come with a history of chronic headache. While a headache may sometimes be a warning sign of a more serious medical condition, most types of headache seen by an acupuncturist are either a tension headache, migraine, or a combination of both. For migraines, acupuncture treatment depends on whether the patient comes experiencing acute pain or is seeking preventative treatment in between migraine attacks. Prevention should be the long-term goal.

Acupuncture has been quite effective for managing the acute pain of mild to moderate migraine attacks. A typical acupuncture treatment involves the insertion of fine needles into acupuncture points on the body followed by gentle manipulation of the needles. Minimization of activity of the blood vessels in the head and neck during a migraine attack is beneficial and is done by limiting the acupuncture points selected to those on the arms and legs. In certain situations, a high frequency (100 Hz) electrical current may be used with the acupuncture needles to help constrict the blood vessels.

Acupuncture has been quite useful for migraine prevention also. Researchers have found that people living in fast-paced business centers tend to have an imbalance in the autonomic nervous system. This type of imbalance is associated with other health conditions such as heart disease, insomnia, high blood pressure, and premenstrual syndrome. In order to harmonize the autonomic nervous system, a special acupuncture technique called SES is used.

Acupuncture can help in the treatment of migraine by:

• Providing pain relief
• Reducing inflammation in neural vesels
• Reducing the degree of cortical spreading depression, an electrical wave in the brain associated with migraine
• Reduce plasma levels of calcitonin gene-related peptide and substance P.
• Modulating extracranial and intracranial blood flow.
• Affecting serotonin (5-hydroxytriptamine) levels in the brain thereby influencing overall function.
• Promoting homoeostasis and restoring normalcy.

Acupuncture is a tried and tested system of traditional medicine, which has been used in China and other eastern cultures for thousands of years to restore, promote and maintain good health. Its benefits are now widely acknowledged all over the world and in the past decade traditional acupuncture has begun to feature more prominently in mainstreamhealthcare in the UK. In conjunction with needling, techniques such as moxibustion, cupping, massage or electro-acupuncture are also used. Traditional acupuncture takes a holistic approach to health and regards illness as a sign that the body is out of balance. The exact pattern and degree of imbalance is unique to each individual. The precise nature of the underlying disharmony and selection of the most effective treatment leads to a permanent cure. The choice of acupuncture points will be specific to each patient’s needs. Traditional acupuncture can also be used as a preventive measure to strengthen the constitution and promote general well-being.

From a biomedical viewpoint, acupuncture is known to stimulate the nervous system, influencing the production of the body’s communication substances - hormones and neurotransmitters. The resulting biochemical changes activate the body's self-regulating homeostatic systems, stimulating its natural healing abilities and promoting physical and emotional well-being.