Friends,in this video today i will discuss
about Migraine a common cause for Primary headache.Migraine occurs in 18% women,14%
men,and 10% children world over.How common is Migraine can be understood by the fact
that Migraine is more common than the total number of patients of Diabetes and Asthma
combined.The point prevalence of Migraine is 2.7%.This means that in India whose population
is 125 crores ,roughly 3 crore people or 30 million people are having Migraine attack
right now.It is also important to know about Migraine because it brings with it a barrage
of associated ailments.Thus Migraine patients are more likely to have Depression,Bipolar
Depression,Generalized Anxiety disorder,OCD,PTSD,Sleep disorder,Micturition Syncope,Motion sickness,and
Panic attacks.Again Migraine patients are likely to have Irritable Bowel Syndrome more
commonly.Epilepsy is 10 times more common in Migraine patients and so is hypertension.Strokes
are more common in patients of Complex Migraine.Asthma,Allergies,Eczema,Psoriasis,Allergic Rhinitis is more common in patients with Migraine.Patent
foramen ovale is also seen with increased frequency in patients of Migraine.Most Patients
with Migraine have one or the other associated ailment and together make a case for a typical
‘Migrainous Personality’in which the subject is reserved,petulant,laconic,and forgetful.Children
present with behavioural problems,often irritable,and throwing temper tantrums.Migraine is thus,
not just one bad day,but a whole host of problem which needs to be addressed. Let us now understand what constitutes a Migraine
attack.Many patients with impending attack may complain of prodromal symptoms 24-48hrs
before attack in which they may feel depressed,exhausted,thirsty,may yawn and feel like drained and lying,and may
want to eat sour or sweet food.Some patients paradoxically become cheerful and more talkative
in the prodromal period.During the attack patient has severe pain in one half of head
or all over.The pain is of throbbing nature,and localised mostly in the temporal or frontal
region,and associated with nausea,vomiting,photophobia(dislike for light),osmophobia(dislike for smell),and
phonophobia(dislike for sound).The pain increases with movement,bending,and the patient likes
to lie down still in a cool dark place and sleep over his pain.The pain may last 4-72
hrs,and after the attack patient feels drained,listless,for 1-2 days before regaining his/her full strength
and composure.During sleep patient may not complain,but notices the headache first thing
in the morning.In some patients pain may also be felt in the cheeks,inside ear,tip of nose,and
in the throat.These are called “lower headaches”.Some patients may have auditory hallucinations(sound
in ear)or visual hallucinations(seeing things when there is none).Eye symptoms of Migraine
consists of pain in eyes,usually assymmetrical,more in one than in other.Eyes may become red,water,may
burn.Many patients have pain abdomen,may have diarrhoea,and mild fever usually less than
99 degree F.Many patients complain of chakkar or vertigo.The Migraine vertigo is not that
of spinning type.But the patient complains of imbalance,being pushed from behind,or sudden
movement of environment.Some patients with Migraine may loose consciousness.This is actually
a state of unresposiveness where the patient may be able to hear but not speak and lie
still with eye lids shimmering.The patient may not use the word ‘throbbing’or ‘pulsatile’to
describe his/her pain but words based on educational status and cultural experiences which the
doctor needs to decipher. 20% Patients of Migraine may have a different
type of attack because of having ‘Complex Migraine’.In Complex Migraine patients have
‘Auras’.These are symptoms which the patient has during or just before the Migraine attack.Auras
may be visual,,sensory,motor,or in the domain of speech.In visual aura patient may complain
of scintilating,lighted figures in front of eyes,or darkness.Objects may appear near or
far,may change shapes,and appear high or low than they are.There is never complete blindness.Some
patients become afraid of these eye symptoms fearing impending doom.In sensory aura,patient
has tingling or numbness of limbs,which is short lasting (30-60 minutes),and assymmetrical,being
more in one than in other limb.In the speech aura patient may for sometime have difficulty
in reading,writing,speaking,comprehending spoken words,using right words in speaking.In
the motor auras patient may complain of weakness in limbs or face causing confusion with stroke. In children the presentation of Migraine may
be different.In small children the child may have imbalance,may lie down,complain of weakness,nausea,may
actually vomit,and then become normal in an hour or two.In teens Migraine headache is
holocranial and not unilateral,is not pulsatile and may last from 30mts to 3 hours.Some children
may have mild fever less than 100 degree farhenight,may have pain abdomen,diarrhoea,and vertigo.Children
may react abnormally to Migraine pain and may present with episodic behavioural abnormality.They
may throw temper tantrums,become irritable,and occasionally delinquent. Some patients with Migraine complain of their
attacks being triggered by certain stimuli.These triggers have been characterised as external
and internal.The external triggers are sunlight,Glare from a light source,hot weather,Noise.Internal
Triggers are sleep deprivation,prolonged fasting,disturbed routine,excessive coffee or tea intake,stress,hurry
and worry. Migraine may be avoided by some very simple
choices like avoiding heat by living on ground floor,indoors and in air condition,avoiding
prolonged fasting,using shaded lamps and not bare bulbs to avoid glare,regular exercise,adequate
hydration,rationing tea coffee,avoiding junk foods containing sodium glutamate,adequate
sleep,lowering volume of mobile ringtone and TV may go a long way in decreasing Migraine
attacks.Some foods containing tyramine like cheese,vinegar,wine,ripened bananas,and sometimes
chocolate,chinese foods are incriminated.Oral contraceptive pills may exacerbate Migraine
and may actually increase the risk of stroke in patients with complex Migraine.Similarly
Nitrates in heart patients may cause pulsatile headache. All Migraine patients are advised to maintain
a Migraine diary.This should mention the date,duration and severity of headache,and what patient
thinks may have triggered or abate the attack.In due course of time patients can zero in on
their triggers,can make corrective steps,and help doctor ascertain if the patient is a
candidate for prophylactic Migraine therapy. Migraine affects patient’s personal and professional
life and relationships.Hence all patients of Migraine should avoid choosing jobs with
night duty,long distance travelling,extreme stress,public dealing,deadlines.Day time jobs,sitting
jobs,indoor jobs are best suited for Migraineurs. Migraine has a genetic basis and 90% patients
will have a close relative having similar ailment.Migraine thus should be considered
during marraige like all other genetic ailments should be instead of considering Kundli. Migraine is not curable but eminently controllable
ailment.Two types of therapies are given to patients-1.abortive treatment to stop the
attack and 2.prophylactic treatment to decrease the frequency severity and duration of attacks,hoping
to suppress the ailment for prolonged length of time.In the abortive treatment paracetamol,ibuprofen,Naproxen,etc
along with metoclopramide,or proclorpromazine to take care of nausea is used.If the patient
is vomiting or unconscious,Injection metoclopramide and Diclofenec is used.Migraine specific pain
killers like Vasograin,and Triptans like Rizatriptan,Sumatriptan,Naratriptans are frequently used nowadays.Triptans should
not be used in children,heart patients and in complex Migraine.Nasal spray of Triptans
are also available and is increasingly being used. Ideal candidates for Migraine Prophylactic
treatment are those patients who have more than 5 attacks in a month,warranting rest
and loss of school,office or house work and necessitating more than 10 analgesics in a
month and progressing to have analgesic headache.Once prophylactic
treatment is given it is continued for atleast 6 months.The effect of the prophylactic treatment
may take several weeks and should not be given up quickly.After 6 months when the prophylactic
treatment is stopped many patients may remain headache free for years. Many patients with Migraine go to eye doctor
falsely believing that their headache may require glasses.Unfortunatele many are sold
costly spectacles also.But Migraine is a disease of Brain and not eye,though there may be eye
symptoms,and no amount of eyedrops or glasses are going to give any relief to patients.Again
many patients are told by some old doctors that their headaches are ‘Sinus Headaches’which
is far from truth.Sinus headaches or sinusitis are infections of sinuses which are vacant spaces inbetween our face- head
bones and need antibiotics.Sinusitis patients have high grade fever,and sinusitis can
be seen in MRI or sometimes plain X rays. To summarize,Migraine is
a common ailment and commonest cause for Primary headaches.The
unsuspected tyrannies of Migraine are because of accompanying ailments.Migraine
cannot be diagnosed by a test or CT Scan.Migraine is not
curable but con trollable.Thank you for watching this video.

14 thoughts on “Migraine”

  1. Very innovative step taken by you for the benefit of common people. specialy the use of rregional language is very useful as most of the contents on these topics are not available in layman's language. Kudos

  2. sir can i get your email.I am your patient bt i m in bombay so i m unable to consult you. can you please provide me your mail or no. i need to talk to you.

  3. sir i see the video as you provide the link on youtube. my mother has been suffering from migraine. this video is helpful for me to cure and diagnosis her correctly and empathy with her emotions and feelings better. thanks a lot dear sir.

  4. Hello sir good morning
    Sir u know me very well because my father two brother's are treatmented by u and recently i have visited with my nice who is only 5 years old.
    Sir as u have said that migran is Common but a 5 years child is suffering from this deseas how is it possible?

  5. Sir Meri bhatij abi 6 month ki h aur uska mind abi growth ni hua h aur usko jhatke ate h humne bhut jagh dikhaya is samye Dr jaiwardhan Rai ji ko dikha rhe h but koi effect ni AA RHA h aur unhone bol Diya h ki mi kuch ni Kr skta Kya sir ye possible h ki wo thik ho jayegi plz sir help me

  6. Sir ek complaint hai,

    Aap ka appointment lele ke liye jo number hai wo kaam ni krta

    The number doesn't work plz sir

    Agar urgrnt me koi problem ho jaaye to kya krege

  7. i have complex migrane but i think i have VISUAL SNOW TOO. i see this ??
    Can anyother neurological issue cause this type of wave pattern to see from eye. i met the doctors but they say my eyes are fine

  8. Hlo Sir I m ur patient I had a question sir I want 2 be an army officer. Can I do this job bcoz I only want to do this job only

Leave a Reply

Your email address will not be published. Required fields are marked *