ROLE OF PANCHKARMA IN MIGRANE

Headache is one among the most common reasons patients seek medical attention, on a global basis 

being  responsible  for  more  disability  than  any  other  neurological  problem.  Migraine is the 2nd most  common primary headache, also known as ‘Hemi crania’ , means ‘half of the head’ It affects 15% of women and 6% of men over a period of 1 year. A migraine is usually a moderate or severe headache, with a heaviness in the half of the head.

Apart from this, most people see headache as well as other symptoms like vomiting, dizziness, difficulty in seeing, etc.

It is an episodic headache that is associated with certain features such as sensitivity to light, sound or movement. Nausea and vomiting often accompany the headache. Due to this, the helpless pain in the head lasted from a few hours to a few days. This problem may start in childhood or it may not be known until adulthood.

It is benign and recurring syndrome of headache associated with other symptoms of neurologic dysfunction in varying admixtures. Migraine can often be recognized by its activators, referred to as triggers. In Ayurveda it can be correlated to Ardhavabhedaka. Allopathic treatment shows very limited role in treatment of this disease. However Ayurvedic treatments, especially Panchakarma offers significant relief treatment of this disease.

Migraine sufferers can benefit from Ayurvedic treatments. Ayurveda treats the disease at its root cause from within. Panchakarma, in Ayurveda plays a unique role in the management of the disease. All the Panchakarma procedures are indicated for migraine however Nasya Karma plays a vital role in disintegrating the pathology of the disease.

The vitiated doshas alleviated by Upvasadi langhana and digestive drugs do at a time get aggravated but those eliminated by Panchakarma do not recure. So Panchakarma leads to complete cure according to type of prognosis i.e. Sadhya, Krichasadhya, Yapya, Anupkrama etc.

The doshas can be well compared with trees. Unless the tree is uprooted from its root, it will grow (in spite of branches. Such is the case with vitiated doshas. They go on causing diseases unless they are eliminated from their root.

What are the Causes of Migraine?

There are several migraine triggers, including:

• Weather changes
• Sleep changes
• Stress
• Carbonated Drinks
• Hormonal changes in women
• High intake of alcohol, coffee, etc
• Certain medications
• Family history
• Depression

What type of migraine is there?

Migraines are of many types, some of which are as follows-

Visual Migraine – This type of migraine is also known as Classical Migraine. This migraine is found in about 25 percent of people. In the case of classic migraine, people have eye problems such as black spot in the light, glare in the light, etc.

Visible loss Migraine – It is estimated that about 11 percent of people worldwide suffer from this and if they suffer a severe headache, then some people suffer from vomiting, mood swings etc.

Menstrual Migraine – As the name suggests, this migraine occurs only to women.This migraine occurs in about 60 percent of women, mainly on the date of the onset of menstruation.

Chronic Migraine – Another name for this migraine is also mixed headaches as it involves the tissues of migraine and stressful headaches.

Panchakarma in Migraine Headache

Snehana Karma

• Use of Uttam Matra of Chatuh Sneha
• Jeerna ghrita paana
• Shiro Abhayanga with Dashmoola Taila, Kanaka Taila, Rudra Taila etc. 

Snehapana

Sneha acts as a solvent to remove the obstruction by dissolving Doshasin  it,  resulting  in  the  removal  of Srotorodha. After proper Snehanaall cells of the body becomes completely saturated with fats. the fat material comes out to extra-cellular fluid by osmosis process. Due to the aqueous properties of Sneha and liquefied Mala brought from the tissues, the levels of fatty acids etc. increases in the blood resulting in the high  plasma  volume.  To  keep  up  the  equilibrium  of the  normal  plasma  level,  the  extra  amount  of  liquidreaches  to  the Koshta for  excretion.  Later  on,  this increased  amount  of  the  body  fluids  are  evacuated through other therapies, like Vamana, Virechana.

Svedana Karma

• Nadi Sveda
• Upnaha Sveda (Specially Jangala Mamsa Upanaha)
• Pariseka ( Specially Aushadha siddha ksheeradhara)
Under Murdhani Taila Shirobasti is specially treatment of choice in all shiroroga, Acharya Charaka & Sushruta indicated Shirobasti in Ardhavabhedaka

Shiroabhyanga

During Shiroabhayanga different  type  of  mechanical sensation  is  given  to  the  skin  like  pressure, rubbing, touches.  These  impulses  are  received  by  respective receptors  present  on  the  skin  surface  and  carried  to the  hypothalamus  and  provides  soothing  effect  and also  stimulates  para  sympathetic  nervous  system, thus  decreases  stress  hormones  like  cortisol  and adrenalin  and  dilates  blood  vessels.  All these  factors provide relaxation to the mind and relieves pain.

Shirolepa

• Acharya Sushruta indicated Shiro lepa Some of the indicated Shirolepa are:
• Sarivadi Shirolepa
• Vayavidangadi Lepa
• Tiladi Lepam

Shirobasti

It  is  a Snigdha  Swedayukta procedure.  It  has  dual benefits   of   both Snehana  and Svedana. The temperature  of  the Taila  in Shirobasti leads  to peripheral  vasodilation.  This  increases  the  peripheral circulation  which  nourishes  the  tissues,  hastens phagocytosis and brings about regenerative changes.Thus Shirobasti is  a  very  complex  process  certainly influencing the Shareerika and Manasika Dosha.

Nasya Karma

In Nasya  Karma  the  medicine  is  put  into  nostril, moves  in  the  channels  upto  the Shringataka  and spreads  to  whole  of  the  interior  of  the  head  and  tothe  junction  place  where  all  the  channels  related  to eyes,  ears  and   throat  situated  together, thus  shows influence on Shiras by removing out the accumulated Doshas  localized  in Shiras  i.e.  from  all  sinuses  in  the skull,  the  action  known  as Shirovirechana.  The olfactory  nerves  entering  olfactory  mucosa  of  nose carry the sheaths dura, arachnoids and pia with them. They directly enter into the brain. Olfactory straie are extensively   connected   to   the   limbic system stimulation can nourishment of nerve ending throughNasya alters the pathology of migraine.

Nasya Karma plays a significant role in the management of Migraine
• Acharya Charaka mentioned Shirovirechana Nasya
• Acharya Sushruta mentioned Nasya 

Basti Karma

In Ardhavabhedaka,  Niruha  Basti  prepared  with Vatanashaka drugs should be given first, followed by Anuvasana Basti prepared of Ghrita, Taila etc. Basti is being considered as the one of the best therapeutic procedures  for  the  management  of  migraine.  The rectum  with  its  vascularity  and  venous  plexuses provides a good absorbing surface and many soluble substances  produce  their  effect  more  quickly  by entering  into  systemic  circulation.  Due  to Achintya Prabhavaof Basti,  it might  have  reduced  swelling of temporal  artery  and  there  by  the  patient  gets  relief from symptoms.

Vamana Karma

The active principle of VamanaDravya taken orally is absorbed  from  the  stomach  into  circulatory  system, where  from  it  is  circulated  to  all  over  body.  On reaching at the site of Dosha Sanghata, which is at the cellular level, it breaks the nexus of Dosha and brings back  the  toxic  substances  thus  released  into  the stomach,  where  from  they  are  expelled  out  of  the body by the action of vomiting.
Acharya Charaka indicated Vamana Karma , even Sadyo Vamana can be planned if doshas are in Utkleshavastha. Practically it shows significant affect in the reducing the frequency of Migraine attacks 

Virechana Karma

Virechana Dravya produced mild irritation in stomach and   intestinal   mucosa   respectively,   to   cause inflammation,  which  facilitates  quick  absorption of the active principal of the drug in initial stage. Later  on  it  facilitate  the  excretion  of  the  morbid matters,  which  generally  are  not  supposed  to  be excreted out through the mucosa of gut. It is possible only   because   of   inflammation   increases   the permeability of the capillaries, which in turn allow the absorption, as well as excretion of such substances.

• Acharya Charaka9 and Yogratanakara10 indicated Virechana Karma
• Depending upon the condition, Lakshanas and Doshas, Vamana Karma followed by Virechana Karma can be planned 

Agni-Karma

Provides significant  relief  in  the  symptoms  of migraine. Acharya Charaka indicated Dahana Karma. It is indicated on Lalata and Shankha Pradesha at two Angula area.  As  per  Ayurveda,  ‘pain  cannot  occur without involvement of Vata Dosha’. Agni has Ushna Guna,  this Ushna  Guna  gets  transferred  to Twak(skin),  and  normalises Vata  and Kapha,  helped  to reduce Shirashoola in Ardhavabhedaka.

Raktamokshana

The   vitiated   blood   can   be   detoxified   by Raktamokshana (bloodletting).  Removal  of  toxins balances the Doshas. It can remove Avarana of Kaphaor PittaDoshagiving  way  for Anulomana  indirectly cures  the Vatika  symptoms  along  with Pitta  and KaphaDosha  and  patient  gets  immediate  relief  in pain.  In  acute  migraine  attack, Raktamokshanafrom the jugular vein is beneficial.

Shirodhara

Involves gently pouring liquids over the forehead. The liquids  used  in Shirodhara  can  include  oil,  milk, buttermilk,  coconut  water  or  even  plain  water.  Its work by relaxing the hypothalamus in the brain, also normalize  the  functions  of  hormones  that  regulate sleep and emotions. The soothing of Marma`s and in turn  soothing  of  Nervous  system  and  endocrine glands as an effect of Shirodhara treatment procedure will  definitely  relax Prana Vayu, Sadhaka Pitta and Tarpaka Kapha in the brain

Dhoopana

It  dilates  blood  vessels  and  helps  in  oxidation  of blood.  It leads  to  adequate  tissue  perfusion  and oxygenation.   Thus,   reduces   inflammation,   pain, itching and eliminates infection

Agnikarma

• Acharaya Charaka indicated Dahana Karma
• The Agnikarma is indicated on Lalata and Shankha Pradesha at two angula area
• Agnikarma is indicated for mainly shleshma pradhanata, however if rakta and pitta are aggravated more then agnikarma should not be done.