Headache, Migraine and Homoeopathy

It is a rarity never to have suffered a headache. Indeed, so common is it that a headache at sometime can be viewed as a normal phenomenon. A lifetime prevalence study revealed that a many as 93 per cent of men experienced a headache at some time; the most common cause being tension-type headache (69 percent). For women, the lifetime prevalence was 99 percent, again tension-type headache being  the most common (88 percent) Rasmussen at al. 1991). Although such a high prevalence suggests a commonplace, almost trivial, symptom it can nevertheless be a symptom of grave significance. It is thus a major cause for attendance in neurological outpatient clinics, representing approximately 15 percent of routine neurological attendance (Murray 1977; Perkin 1989) and reflecting the anxiety amongst both patients and doctors that headache may be due to sinister cause. Thus every patient with headache requires careful consideration and sometimes thorough investigation (reviewed by Silbersrtein et al 1998).
Although most patients with headache will not contact their doctor, those with frequent headache, and those with migraine constitute a significant public health and economic problem. A pharmoco-economic study of migraine in the USA calculated that the annual loss of productivity due to migraine cost more than $1 billion per year (stang et al. 1996) and some studies have suggested that the cost might be as much as $47 billion per year (Osterhaus at al 1992).

Classification
In 1985, the international Headache society (IHS) established a classification committee which published the first international headache classification in 1988, including operational diagnostic criterial (Headache classification committee of the international headache society 1988) This has been adopted by the world federation of Neurology and the world Health Organization, which has incorporated the main features in the international classification of disease (ICD-10). The classification provides 13 broad categories which are then subdivided cation provides 13 broad categories which are then subdivided to allow for coding up to a four-digit level. The extent to the subclassification thus depends upon the degree of sophistication required. The classification has been an important advance, primarily for research but increasingly for clinical management. It is gradually replacing the previous variable terminology which included classic migraine, classical migraine, combined headache, psychogenic headache, and essential headache.
Revisions of the IHS classification have been proposed. For example, refocusing on the old problem of patient with very frequent headache, often referred to as chronic daily headache (silberstein et al. 1994, 1995), or addition of new entries, such as the short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) syndrome (Goadsby and Lipton 1997).

Classification of headache (data from headache classification committee of the international Headache society 1988)
Migraine

• Tension-type headache
• Cluster headache and chronic paroxysmal hemicrania
• Headache associated with head trauma
• headache associated with vascular disorders
• Headache associated with non-vascular intracranial disorders
• Headache associated with substances and their withdrawal
• Headache associated with non-cephalic infection
• Headache associated with metabolic abnormality
• Headache or facial pain associated with disorders of cranium, neck, eyes, ears, nose sinuses, sinuses, teeth, mouth, or other facial or cranial structures
• Cranial neuralgias, nerve truck pain, and differentiation pain
• Other types of headache of facial pain
• Headache not classifiable

Anatomy and physiology of headache
All the tissues covering the cranium are sensitive to pain, especially the arteries but also the muscles and pericardium. The skull bone itself is insensitive. Within the cranium, the venous sinuses and their tributaries, the dura mater and the cerebral arteries, and the fifth, ninth, and tenth cranial nerves are the chief pain-sensitive structures. The main factors causing headache (Lance 1981) have been considered to be:

1. Inflamation involving pain-sesitive structures of the head;
2. Referred pain;
3. Meningeal irritation;
4. Traction on or dilatation of blood vessels;
5. Pressure upon or distortion of pain-sesitive structures caused by tumours or other lesions; and
6. psychological causes, when the pain is considered in some instances to be due to tension in the muscles of the scalp and neck.

Migraine has been known to medical science for nearly 2000 years. In the first century of the Christian era, Aretaeus of Cappadocia referred to it as heterocrania, and the term hemicrania (from which the world migraine was derived) was introduced by Galen. A key feature of migraine headache is that it is periodic, with attacks lasting usually between 4 and 72 hours. Typical features, although not exclusive, are that it is unilateral and pulsatile. Operational diagnostic criteria (International Headache Classification) require that the headache is accompained by nausea or vomiting and/ or photophobia or phonophobia. The headache itself may or may not be associated with an aura of preceding neurological symptom. During the latter, characteristic changes in cerebral blood flow may be demonstrated.

Classification of migraine ((data from headache classification committee of the international Headache society 1988)
Migraine without aura
Migraine with aura

•   Migraine with typical aura
•   Migraine with prolonged aura
•   Familial hemiplegic migraine
•   Basilar migraine
•   Migraine aura without headache
•   Migraine with acute-onset aura

Ophthalmoplegic migraine
Retinal migraine
Childhood periodic syndromes that may be precursors to or be

•   Associated with migraine
•   Benign paroxysmal vertigo of childhood
•   Alternating hemiplegia of childhood

Complication of migraine

•    Status migrainosus
•    Migrainous infarction

Unclassifiable migraine-like disorder

The International Headache Classification (Headache Classification Committee of the International Headache Society 1988) distinguishes between migraine with aura and migraine without aura. The former subsumes a number of migraine subtypes or variants. This classification replaces the earlier terms of classic/ classical migraine, referring to those with aura, and common or simple migraine, referring to those without. The new classification is quite explicit and avoids confusion. Migraine with and without aura can, of course, both occur in an individual patient.
Migraine is extremely common. Recent epidemiological studies, using the IHS criteria, suggest a prevalence in women of between 15 and 20% and in men between 5 and 10% (Stewart et al 1992) and in some studies even higher in women (Rasmussen et al 1991). There is  a strong family history reported in migraine sufferers, particularly in those suffering from migraine with aura (Russell and Olesen 1995).
As per Homoeopathic physician of Indore (M.P.) India Dr. A.K. Dwivedi Homoeopathic Medicine are best option of treatment for Headache & Migraine.