Ayurvedic management of chronic migraine (~Ardhavabhedaka): A clinical insight

Abstract: Migraine is a common neurological disorder and a leading cause of disability, especially among women. Many patients continue to struggle with chronic headaches even after standard treatment and therapies. In Ayurveda, migraine can be correlated with Ardhavabhedaka (~hemicranial headache/chronic migraine), a condition predominantly involving vitiated Vata (~ dosha responsible for movement and cognition) and Pitta dosha (~ dosha responsible for regulating body temperature and metabolic activities). A 38-year-old female visited the Ayurveda hospital with a 7–8-year history of chronic migraine presented as recurrent unilateral throbbing headache, associated with photophobia, phonophobia, nausea, vomiting, disturbed sleep, and occasional facial swelling. Despite regular use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), relief was inadequate. The patient underwent Ayurvedic treatment consisting of internal medications, Nasya (~medication through the nose), Shirotalam (~medicated paste on the crown or forehead), and Shirodhara (~therapeutic oil-streaming over the head) for a duration of four months. Progressive clinical improvement was observed throughout the treatment period, with a reduction in the Visual Analog Scale score from 8 to 2. The Migraine Disability Assessment score decreased from 28 (severe disability) to 6 (mild disability), while the Headache Impact Test (HIT-6) score reduced from 68 to 46, indicating a marked reduction in headache-related disability and impact on quality of life. Dependence on NSAIDs reduced from daily use to occasional requirement during the treatment period. This case demonstrates that a holistic Ayurvedic treatment approach may effectively reduce the severity, frequency, and disability associated with chronic migraine.