Clinical Evaluation of an Herbal Unani Formulation (Itrifal-e-Ustukhuddus) in the Management of Migraine (Shaqeeqa): A Series of Case Reports.

Background: Migraine is a disabling neurovascular disorder with few targeted, tolerable, and effective treatments. It is characterized by acute headaches that substantially impair patients' quality of life and work performance. Migraine patients frequently require long-term treatment due to frequent attacks or a chronic course of the condition. Many people still suffer from side effects or insufficient alleviation despite advances in mainstream treatment, which has led to interest in alternative remedies. This case series evaluates the efficacy of Itrifal-e-Ustukhuddus (an herbal Unani formulation) in chronic migraine. Methods: Four cases of diagnosed migraine patients were treated with the Unani formulation, Itrifal-e-Ustukhuddus, for 8 weeks. The primary outcome measures included improvements in pain intensity (VAS), migraine disability assessment (MIDAS), and migraine-specific quality of life (MSQOL). Results: All the patients showed notable improvement in symptoms and quality of life. VAS scores reduced from 9/10 to 3/10, 8/10 to 2/10, 8/10 to 3/10, and 9/10 to 2/10, indicating pain relief. Additionally, more than 50% improvement was observed in MIDAS and MSQOL scores, reflecting a reduction in migraine-associated disability and improved quality of life, respectively. Conclusion: With no side effects noted, the Unani formulation showed encouraging effectiveness in treating chronic migraine. However, thorough prospective clinical studies are recommended to confirm its scientific validity and possible incorporation into standard medical practice. keywords: chronic migraine, Itrifal-e-Ustukhuddus, Unani medicine, alternative therapy, case series, quality of life.