MANAGEMENT OF MIGRAINE THROUGH PANCHKARMA - A CASE STUDY

Ardhavabhedaka is a type of Shiroroga. It is unilateral headache with Compli- cations of blindness and hearing loss. It can be clinically correlated with migraine based on clinical manifestation. Affecting at least 1 adult in every 7 in the world (WHO). It is 3 time more common in women than men. it causes moderate to severe pain that is throbbing or pulsating, requiring long-term management. It causes personal suffer- ing, impaired quality of life and high financial cost. Nasya Karma and Shirodhara are the prime treatment modalities for Shirogata disease. A 19 year old girl patient came to OPD with complaining of severe headache. Shirodhara done with milk + Dashmool - Kwath and Mahanarayan tail. After done this Panchkarma treatment patient got highlysignificant relief in the cardinal symptoms of Ardhavabhedaka. Keywords: Migraine, Ardhavbhaedaka, Shirodhara

Migraine in Obesity: Is It Prevalent?

Background: Several studies have demonstrated an association between obesity and migraine. It’s still unclear whether migraine is the cause or it's the result of obesity. Objective: We investigated the prevalence of migraine among obese and non-obese individuals and analyzed the relationship between migraine prevalence and obesity. Patients and Methods: This is cross-sectional observational study was carried out at the neurology outpatients’ department of the Rizgary Teaching Hospital in Erbil, Iraq, from July 1st , 2018 to September 30, 2019. We interviewed and examined 300 persons, both obese (n=154) and non-obese (n=146), and of both gender. All of them were adults (>18 years old). Each person's weight, height, body mass index (BMI), and waist circumference were measured.The diagnosis of migraine was made according to the International Headache Society’s criteria. Obesity was present if the individual’s BMI is ≥30 and/or waist-to-hip ratio is >0.9 in females and >1.0 in males. Results: Out of the 300 persons, 14 males (8.5%) got migraines while migraine was found in 37 females (27.4%), irrespective of their weight. Out of the 300 persons, the prevalence of migraine among obese individuals was 21.4% (n=33) and while in non-obese individuals was 12.3% (n=18). There was a statistically significant difference between the groups (p-value=0.045). The overall prevalence of migraine was 16.9% of the persons interviewed. Conclusion: The results showed that migraine is more prevalent among obese persons than non-obese persons and the difference was statistically significant. Keywords: Migraine, obesity, BMI, headache

Biomarkers in migraine: a sea of something

Migraine is the most common headache disorder with high prevalence. Clinical features which forms basis for diagnosis are heterogenous, varying from person to person and in an individual patient from one headache to the next. In most of the migraineurs treatment is delayed, until the disease severity is high leading to significant disability and socioeconomic burden. Many patients receive various combination of prolonged therapy with no significant benefits. Identifying a biomarker for migraine might help in assessing the susceptibility, diagnosing the disease early, choosing appropriate therapeutic target and monitoring the disease course. Here in this review authors discuss most studied, promising biomarkers emerging in field of migraine. The keywords migraine, and biomarkers were used in the search engines of PubMed and Google scholar and articles identified were extensively reviewed. Genetic biomarkers ascertain susceptibility or predisposition to migraine and are valuable in diagnosis, developing novel therapeutic agents, assessing treatment response. This review briefs about most studied genetic and circulatory biomarkers of migraine. Further research into existing biomarkers with higher sample size, excluding confounding factors is necessary. Search for newer biomarkers which can be of great value in diagnosis and therapy is needed. Identifying a biomarker which is reliable, replicable, easily available and cost-effective is need of the hour in management of migraine.

Migraine And Pregnancy: What Should We Know

Migraine is a common headache characterized by unilateral throbbing-like headache and pulsating in nature and sometimes associated with aura. Migraine is a disabling disorder that among adults is more prevalent among women than men. It is primary headache that is often found in pregnancy. Migraine is a common disorder in women of childbearing age, and usually requires pharmacological treatment. Migraine can be considered an important risk factor for hypertensive and vascular diseases during pregnancy. Migraine therapy in pregnancy is very challenging, it must taken into a consideration about the health of the mother and fetus. Several effective antimigraine medications are reasonably safe for use by pregnant and breastfeeding women. Prophylactic theraphy should be given to patient with recurrent migraine attacks in pregnancy. Nonpharmacological strategies are always first-line treatment options for mild migraine, and should also be used complementarily whenever pharmacological treatment is required. Women with migraine should be offered periconceptional counselling to promote a safe and healthy pregnancy. Keywords: migraine; pregnancy; therapy

Migraine And Pregnancy: What Should We Know

Migraine is a common headache characterized by unilateral throbbing-like headache and pulsating in nature and sometimes associated with aura. Migraine is a disabling disorder that among adults is more prevalent among women than men. It is primary headache that is often found in pregnancy. Migraine is a common disorder in women of childbearing age, and usually requires pharmacological treatment. Migraine can be considered an important risk factor for hypertensive and vascular diseases during pregnancy. Migraine therapy in pregnancy is very challenging, it must taken into a consideration about the health of the mother and fetus. Several effective antimigraine medications are reasonably safe for use by pregnant and breastfeeding women. Prophylactic theraphy should be given to patient with recurrent migraine attacks in pregnancy. Nonpharmacological strategies are always first-line treatment options for mild migraine, and should also be used complementarily whenever pharmacological treatment is required. Women with migraine should be offered periconceptional counselling to promote a safe and healthy pregnancy. Keywords: migraine; pregnancy; therapy

Treatment of migraines during pregnancy

One in four women of reproductive age suffers from migraines with varying incidence of episodes. Treatment of migraines during pregnancy is a complex problem for doctors and patients. Nowadays, more than 70% of pregnant women receive prescription and overthe- counter medications during pregnancy. At the same time, information about the safety of taking such drugs by pregnant women is commonly not available. That is why doctors and patients use certain medications without a premeditated and coordinated tactics for controlling migraines, commonly making a decision at the beginning of the next episode. The article provides detailed information about the course patterns, as well as the rules for managing migraines during pregnancy. The article also describes the recommendations for developing an optimal tactics for relieving seizures and preventive therapy. Following these recommendations will allow patients to adequately prepare for pregnancy, avoid taking unsafe medications, while maintaining optimal control over the incidence and duration of migraine episodes during this critical perio d. KEYWORDS: migraine, pregnancy, seizure prevention, preventive treatment, sumatriptan, neurostimulation. FOR CITATION: Latysheva N.V., Filatova E.G., Naprienko N.V. Treatment of migraines during pregnancy. Russian Medical Inquiry. 2020;4(9):601–605. DOI: 10.32364/2587-6821-2020-4-9-601-605.

Putative role of 5-HT2B receptors in migraine pathophysiology

Objective In this review we attempt to characterize the acute and chronic role of 5-HT2B receptors with regard to meningeal nociception in animal experiments and clinical data targeting migraine therapy. Background Migraine is a common disabling neurovascular primary headache disease, the pathomechanism of which is still unclear. Serotonin (5-HT) and its receptors might play an important role in some aspects of migraine pathogenesis. The ability of the unselective 5-HT2B receptor agonist m-chlorophenylpiperazine to induce migraine attacks in migraine sufferers, the high affinity of prophylactic antimigraine drugs to this receptor and its expression in migraine-relevant structures like the dura mater argue for a role of 5-HT2B receptors in the pathogenesis of migraine attacks. Methods For this review, the relevant databases such as PubMed, MEDLINE®, Cochrane Library and EMBASE, respectively, were searched to December 2015 using the keywords “migraine, 5-HT2, trigeminal, neurogenic inflammation, nitric oxide, nitroxyl, vasodilatation, plasma protein extravasation” and combinations thereof. Conclusion Our literature review suggests an important role of 5-HT2B receptor activation in meningeal nociception and the generation of migraine pain.

Vascular biomarkers in migraine

Aim Migraine has been associated with stroke as well as with several non-atherosclerotic vascular conditions leading to discussions about the potential role of endothelium in the etiopathogenesis of migraine and migraine-associated stroke. We present a systematic review of the literature on vascular biomarkers in migraine, including those suggesting endothelial activation and damage. Methods We conducted a systematic literature search from 1990 to 2013 using multiple research databases with the keywords “migraine,” “headache,” “vascular,” and “biomarkers.” We used selected inclusion and exclusion criteria to create a final pool of studies for this review. Results The literature search identified a total of 639 citations of which 129 were included in our review. The final pool of clinical- and population-based studies assessed the level of various biomarkers (e.g. inflammatory, prothrombotic, endothelial activation, endothelial repair) in migraineurs of varying ages, gender, and demographic characteristics. Although for each biomarker there is at least one study suggesting an association with migraine, in many cases the quality of evidence is poor and there are conflicting studies showing no relationship. The results were, therefore, in each case inconclusive. Conclusion This systematic review indicated that in migraine populations there are a number of positive vascular biomarker studies, including some involving novel biomarkers such as endothelial microparticles and endothelial precursor cells. These lend insight into possible pathophysiological mechanisms by which migraine may be associated with stroke. More high-quality studies are needed to establish whether a true association between promising vascular biomarkers and migraine exists.

No Evidence for an Association of Vitamin D Deficiency and Migraine: A Systematic Review of the Literature

Vitamin D deficiency is associated with a number of human disorders, including cardiovascular disease, cancer, diabetes, frailty, and infections. Since an association between vitamin D and migraine has also been recently speculated, we performed an electronic search on Medline, Scopus, and Web of Science using the keywords “migraine” and “vitamin D,” “25OH-D” “cholecalciferol,” “ergocalciferol,” with no language or date restriction. The electronic search allowed identifying seven studies (3 observational, 2 cross-sectional, and 2 case reports). The two case reports, including four women, showed favourable effects of vitamin D supplementation on migraine severity, but these studies were small and not placebo controlled. As regards the three observational studies, vitamin D deficiency was observed in 13.2 to 14.8% of migraine patients, and these rates do not differ from those reported in the general population (i.e., vitamin D deficiency between 22 and 42%). The results of the two cross-sectional studies are even more controversial, since no association was found between vitamin D status and migraine in both trials. In conclusion, the current evidence suggests that the association between migraine and vitamin D lacks reliable scientific support.