Management of Ardhavabhedaka (~Migraine) with folklore and Ayurveda medicines: A single case report

The International Classification of Headache Disorders-3 classifies Migraine as a common and disabling primary headache disorder. The Global Burden of Disease 2019 study estimates that about 1.1 billion people worldwide experience migraine, with a prevalence of around 14%. This high prevalence poses challenges for the healthcare systems. Migraine ranks second in Years Lived with Disability among all diseases and are particularly common in women of childbearing age (15–49 years), affecting 21% to 28% annually. Here, we present the case report of a 34-year-old female patient who visited the outpatient department with a throbbing left-sided headache associated with nausea, photophobia, phonophobia, ocular pain, and cutaneous allodynia while combing and washing her face since last one day. The patient also had episodes of throbbing headaches for the past 17 years. The management was done on inpatient and outpatient basis with Ayurveda internal medications including Pathyaksha dhatryadi kashaya along with the external application of Sahadevi–Navaneeta lepa (~anointment) on forehead, temple area, cheek, and lateral neck region followed by Pathya (~wholesome) diet and lifestyle regimen for four months. The distinctiveness of the case is the external application of Sahadevi–Navaneeta lepa, which is one of the Folk medicines used in Kerala by few traditional practitioners. The patient showed remarkable improvement in the severity, duration, and frequency of headaches within three months. On assessment, the Visual Analog Scale score and Migraine Disability Assessment score reduced considerably to 0 from 10 and 7 from 27, respectively. Further, improvement in the quality of life of the patient without any adverse reactions during the treatment and follow-up period was seen, inferring the significant role of the interventions in the management of Migraine.