Migraine

You don’t need to suffer!!! This severe form of headache can be efficiently managed either by advanced medical treatment or in some cases by a surgical procedure.

We are the Best Migraine Headache Clinic in Mumbai

If you are someone who suffers from migraines, you know just how debilitating they can be. The throbbing pain, the intense sensitivity to light and sound, and the nausea that accompanies migraines can feel insurmountable. Look no further! Welcome to Jaslok Hospital, the best hospital for headache near me, offering comprehensive care as the premier Best migraine treatment clinic in Mumbai. Our specialists are here to provide advanced and effective solutions tailored to relieve your suffering.

Overview of Migraine

Migraine is characterized by constant and frequent, mild to disabling throbbing or pulsating headache associated with a wide variety of other symptoms. If you’re wondering, “Which headache doctor near me or head specialist near me can truly understand my condition?”—our expert team is the answer.

In neurosciences, the Ad Hoc Committee defines migraine as “recurrent attacks of headache widely varied in intensity, frequency, and duration. The attacks are commonly unilateral at onset; are usually associated with anorexia, and sometimes, with nausea and vomiting; in some, are preceded or associated with conspicuous sensory, motor, and mood disturbances (aura), and are often familial.”

In general population, migraine is notorious to affect a fair number of people. Mostly women are affected more than men. Its incidence is 15 – 18 % in females, about 6% in males and 4 – 6 % in children. Incidence varies with age, gender and presence of aura. Migraine with aura has an earlier onset of age. During and after puberty, migraine is more common in women than men. Overall, migraine is a chronic debilitating disease making day to day activities difficult for the patient.

Medical management is the mainstay of treatment of migraine, but a large number of patients are refractory to medical management. There is worsening of migraine in spite of treatment. Occipital nerve stimulation is an invasive procedure is highly effective procedure when other conservative treatment fails to relieve the intractable pain of chronic posterior headache.

What is Migraine?

In colloquial language, migraine is considered synonymous with headache due to its wide distribution among the population. But neurologically it is more than just a headache because it involves neural pathways, neurotransmitters, and hormones.

Migraine is characterized by recurring, severe headaches that can last for hours to days. These headaches typically occur on one side of the head and may be accompanied by visual disturbances, known as auras. The exact cause of migraines is not entirely understood, but various triggers can set off an attack.

Types of Migraine

There are several types of migraines, and understanding the specific type you experience is essential for effective treatment. The two most common types are:

  • Migraine with Aura:
    This type is characterized by neurological symptoms known as auras that precede or accompany the headache. Auras may include visual disturbances, such as flashes of light or blind spots, and tingling sensations in the face or hands.
  • Migraine without Aura:

              In this type, there are no preceding auras, and the headache is the primary symptom.

  • Chronic Migraine:
    This refers to migraines that occur on 15 or more days per month for at least three months.

Symptoms of Migraine

The symptoms of migraines can vary from person to person, but common signs include:

  • Intense, pulsating headaches
  • Sensitivity to light and sound
  • Nausea and vomiting
  • Blurred vision or visual disturbances
  • Tingling or numbness in the extremities

Causes of Migraine

While the precise cause of migraines remains elusive, research suggests that both genetic and environmental factors play a role. Some common triggers include:
  • Hormonal changes
    Fluctuations in estrogen levels can trigger migraines, often experienced by women during menstruation, pregnancy, or menopause.
  • FoodCertain foods like aged cheese, processed meats, and caffeine can act as migraine triggers for susceptible individuals.
  • StressEmotional stress and anxiety can lead to migraines in some people.
  • Environmental factorsBright lights, loud noises, and strong odors can initiate migraine attacks.Weather changes: Rapid weather changes, particularly shifts in barometric pressure, may trigger migraines.
  • Diagnosis of Migraine

Diagnosing migraines involves a thorough assessment of medical history, symptoms, and potential triggers. Our migraine specialist in Mumbai uses advanced diagnostic tools to rule out other underlying conditions and confirm the diagnosis. Understanding your unique migraine profile helps us devise personalized treatment plans for the most effective outcomes

Incidence and Challenges

In the general population, migraines affect a significant number of individuals. Women are notably more affected than men. The incidence stands at 15–18% in females, about 6% in males, and 4–6% in children. The condition often begins earlier in life in cases of migraine with aura. During and after puberty, migraines become more prevalent in women. Overall, this chronic, debilitating disease hinders daily activities and leaves patients searching for a reliable headache doctor or dr for head pain.

For those wondering, “Headache which doctor to see?” or “Headache near me—how do I find help?,” Jaslok Hospital’s specialists are here to provide answers and tailored care.

Migraine Headache Treatment in Mumbai

At Jaslok Hospital, we offer a comprehensive range of treatment options tailored to each patient’s needs. Our experienced team of neurologists and headache specialists works diligently to provide relief and improve the quality of life for migraine sufferers. Treatment options may include:
  • Anticonvulsants

    These are initially intended to manage epilepsy, have displayed potential in preventing migraine attacks. By stabilizing abnormal brain electrical activity, these medications can reduce the frequency and severity of migraines.
  • Abortive therapy

Abortive medications aim to halt a migraine attack in its tracks. Their effectiveness is highest when taken at the first signs of an impending migraine, providing relief from pain and associated symptoms.

  • Simple Analgesics

    Over-the-counter pain relievers, like acetaminophen or ibuprofen, can offer relief for mild to moderate migraines. However, they may be less effective for severe headaches.
  • Sumatriptan and other triptan

    Triptans, a specific medication class, constrict blood vessels and block pain pathways in the brain. Sumatriptan is a frequently prescribed triptan for acute migraine treatment.
  • Beta blockers

Commonly used to manage hypertension, beta blockers have also proven effective in reducing migraine frequency and severity. They work by relaxing blood vessels and lessening the impact of stress hormones.

  • Serotonin antagonist

    Also known as antiemetics, serotonin antagonists help alleviate nausea and vomiting linked to migraines.
  • Nsaids

Nonsteroidal anti-inflammatory drugs (NSAIDs) can be beneficial for some migraine sufferers in relieving pain, especially when used in combination with other medications.

Innovative Treatments

While medical management is the cornerstone of migraine treatment, some patients remain refractory to medications. In such cases, our headache doctors offer advanced therapies like occipital nerve stimulation, an invasive yet highly effective procedure that alleviates intractable pain caused by chronic posterior headaches. If you’re looking for migraine online treatment or migraine medicine online, we also provide guidance on these options.

Our expert care isn’t just limited to migraines; if you’re looking for help with migration head pain or head migration, we provide holistic treatment plans. Our team, which includes renowned headache doctor name and specialists, is equipped to handle even the most severe conditions.

Patient Support and Follow-up Care

At our headache clinic in Mumbai, we believe in providing comprehensive support to our patients throughout their migraine treatment journey and after the treatment. Our team is dedicated to answering any questions and addressing concerns to ensure a positive and comfortable experience.

Why Jaslok Hospital for Migraine Headache Treatment in Mumbai?

Jaslok Hospital is the ideal headache hospital near me for those seeking advanced care for headaches and migraines. We understand the challenges of migraine prevention and management. If you’re searching for Indian medicine for headache, we also explore complementary options for effective results.

There are several reasons why Jaslok Hospital stands out as the best migraine headache clinic in Mumbai:

  • Our hospital has a team of highly experienced neurologists and headache specialists who are experts in managing migraines.
  • We are equipped with advanced medical technology to ensure accurate diagnosis and effective treatment.
  • We prioritize patient comfort and strive to provide a caring and compassionate environment.
  • Our approach to treatment considers both medical and lifestyle factors to address migraines comprehensively.
  • We have a history of successful migraine management, and our patient testimonials speak to our commitment to excellence.

We have the Best Migraine Treatment Doctors in Mumbai

At Jaslok Hospital, we take pride in having some of the best doctors for migraine treatment in Mumbai. Our team led by the best Neurosurgeon in India, Dr Paresh K Doshi is dedicated to staying at the forefront of migraine research and treatment advancements, ensuring that you receive the highest standard of care by medical or surgical means.

Symptoms

Best Trigeminal Neuralgia Treatment Doctors in Mumbai

There are four phases of a migraine attack. It is not necessary that all these phases might be experienced by one person. Each phase comes with its own symptoms which are as follow-

Prodrome-

It occurs one or two days before migraine and can be considered as a warming period. Most common symptoms that one may experience are-

  • Mood changes ranging from depression to extreme happiness or elation. One may feel euphoric even.
  • Constipation
  • Increased thirst and urination
  • Immense hunger
  • Frequent yawning
  • Neck stiffness
Symptoms of migraine

Aura-

It is the most characteristic feature of a migraine attack but does not always precede or accompany a migraine attack. Auras are manifestations of the nervous system. They are usually visual disturbances, such as flashes of light or wavy, zigzag vision. There might be temporary loss of vision as well. Auras initiate about 60 minutes before the headache starts. This phase is called the “skip phase”. It may last for 5 minutes to an hour.

Yet an aura is not only visual disturbances. It can also be:

  • Sensory disturbance which can feel like pins and needle sensation in the arms or legs, extreme sensitivity to sound.
  • Movement or motor disturbance exhibiting as weakness or numbness of the face or one side of the body. There may also be uncontrollable jerking or other movements.
  • Speech disturbance can lead to difficulty in speaking.
other symptoms of migraine

The Attack-

The frequency and nature of a migraine attack depends person to person. Its usual duration is anywhere between 4 to 72 hours. The recurrence of the attack may vary from once a month to many times a month. During the attack a throbbing or pulsating pain is present on one or both sides of the head. During this phase the presence of an external irritant such as noise, light or smell can worsen the pain. This is the reason why during the attack one may find comfort in a dark room with as little noise as possible. Nausea and vomiting are commonly associated with the headache. The visual disturbance might be pronounced and lead to blurring of vision. Sometimes the attacks are very severe and unbearable.

Other symptoms include:-

  • Loss of appetite
  • Scalp tenderness
  • Seizures
  • Syncope
  • Alteration of consciousness
  • diarrhea

Post-Drome:-

This marks the end of the migraine attack. It can last for 24 hours where the one may either be drained and washed out or feel exhilarated. There might be some confusion, residual weakness, dizziness.

Diagnostic Test:

  • Blood test- to rule out infection in brain or spinal cord, toxins or blood vessel problems.
  • Magnetic Resonance Imagining- to rule out stoke, infections, tumor, brain bleeds or any other neurological conditions.
  • Computerized tomography scan- it diagnoses the same conditions the MRI does but with the help of X-rays.
  • Lumbar puncture-mainly done to rule out infections and bleeding in the brain.

Causes

There are many theories behind the cause of migraine. One of the theories says that the level of serotonin in the body dictates the migraine headache. Serotonin is a neurochemical present in the brain that influences the blood vessels in the brain. Usually when the serotonin level falls the blood vessels dilate and cause compression in the brain which leads to the development of a headache.

The trigeminal nerve carries sensation of pain to and from the brain. During a migraine attack there is alteration in the interaction between the brain and trigeminal nerve making the pain as unbearable as it is.

If either the mother or father or both suffer from migraine there is a 60% probability that one may also develop it later in their life span.

Gender: During childhood, migraines affect boys more than girls. After puberty women are more affected than men due to the hormonal change.

Age: It can start any time right from childhood, through adolescence or early twenties. It’s very rare for migraines to start after the after of 40 years. If that does happen one should visit the doctor as earliest as possible.

The following maybe considered as migraine triggers:-

  • Hormonal changes in women: Women experience a migraine episode during their period, throughout pregnancy and also during menopause. This is caused due to the fall in estrogen levels. The use of oral contraceptive pills and hormone replacement therapy is seen to cause migraines in some but not all women.
  • Food and drinks: Missing meals or keeping a long gap between each meals is known to exacerbate the migraine attack. Certain food additives such as artificial sweaters or monosodium glutamate also trigger an attack.
  • Stress: It is one of the most common cause seen in most migraine sufferers.
  • Sensory stimuli: Any sensory stimulus such asbrightlight, loud noice or strong smell can aggravate a migraine attack.
  • Changes in sleep-wake pattern: Lack of sleep or getting too much sleep may trigger migraines in some patients.
  • Physical factors: Intense physical exertion, including sexual activity, may provoke migraines.
  • Changes in the environment: A change of weather or barometric pressure can prompt a migraine.
  • Medications: Oral contraceptives and vasodilators (e.g nitroglycerin) may aggravate migraine.

Migraine Risk Factors

There are several factors which contribute in development and progression of migraine:-

  • Family history-it is commonly seen that a person who has migraine will have at least one member with the same condition.
  • Medicine overuse- increased use of NSAIDS (Aspirin, Diclofenac), opiates (morphine) and barbiturates may lead to development of migraine.
  • Obesity-regular exercise in the form of sports or regular gym is very helpful in preventing migraine attacks and is very rarely seen in people with a healthy lifestyle.
  • Depression-OR excess stress.
  • Sleep apnea/ snoring- Lack of or excessive sleep.
  • Neurological illness-like epilepsy, MS hormonal fluctuations during menses. Alcohol or other chemical stimulation.
  • Allodynia- this is central pain sensitization to a previously non painful stimulus.
  • Caffeine overuse-
  • Asthma-
    Studies show that persons affected by migraine with aura are at increased risk of having ischemic stroke and myocardial infarction.

Migraine Headache Prevention

  • Identification and avoidance of specific headache triggers: this can be done by keeping a trigger log, which documents the triggers that are specific to oneself.
  • Stress management: this can be done by eliminating the stressful stimulus, transcendental meditation, yoga or any other form of relaxation therapy. Hypnosis may also be tired.
  • Regularized lifestyle: A healthy diet, regular excersice, regular sleep patterns, avoidance of acute changes in stress levels, being particularly wary of the letdown effect.
  • Transcutaneous supraorbital nerve stimulation (t-SNS): This device (Cefaly), similar to a headband with attached electrodes, was recently approved by the Food and Drug Administration as a preventive therapy for migraines. In research, those that used the device experienced fewer migraines.
  • Learn to cope: By exposing oneself to headache triggers one can learn to desensitize to them.
  • Reduce the effects of estrogen: reducing the intact of medicines that have estrogen in them maybe one way of preventing the migraine attacks.

Treatment and Drugs for Migraine

Abortive therapy: This is used to block the acute attack or to control the acute attack.

Simple Analgesics: These include NSAIDS like

  • Paracetamol
  • Ibuprofen
  • Diclofenac
  • Combination analgesics- The combination of acetaminophen, aspirin and caffeine is useful in mild to moderate migraine attacks.
  • Ergotamine tartrate- This is a sublingual preparation which means it’s placed under the tongue. Care should be taken to not eat or drink anything till the effects of this medicine kick in.
  • Dihydroeargotamine

Sumatriptan and other triptan: They bring about the constriction of blood vessels in the brain which reduces the headache. Available as nasal spray, pills and injection.

  • Sumatriptan (Imitrex)
  • Rizatriptan (Maxalt)
  • Almotriptan (Axert)
  • Naratriptan (Amerge)
  • Zolmitriptan (Zomig)
  • Frovatriptan (Frova)
  • Eletriptan (Relpax)
  • Prednisone
  • Dexamethasone
  • Prophylactic therapy- Patients suffering from frequent and repeated attacks are put on prophylactic therapy. This will reduce the frequency and severity of the attacks. In most patients, a combination of drugs is used. One needs to be aware about the benefits and side effects of these drugs. You are requested to consult your physician before using any of these drugs.

Beta blockers:

  • Propranolol
  • Metoprolol tartrate (Lopressor)
  • Timolol (Betimol)
  • Calcium channel agonist- Verapamil
  • Anti-depressants- Amitriptyline and selective serotonin reuptake inhibitors

Serotonin antagonist:

  • Carbinoxamine
  • Cyproheptadine
  • Methdilazine
  • Promethazine

Nsaids:

  • Naproxen
  • Lithium

Anticonvulsants:

  • divalproex sodium
  • topiramate

If medical management fails or patient remains refractory to this treatment then Occipital Nerve Stimulation is the treatment of choice.

Occipital Nerve Stimulation for Migraine

The Occipital Nerve arises at the back of the head and supplies sensation to the back of the head. There are two Greater Occipital Nerves, Right and Left. These nerves have connections in the brain with an area called trigeminovascular (TVS) complex, which is involved in pain generation felt in Migraine. It was noted by Dr. Dodick and Dr. Godsby that stimulation of GON can alter the chemical balance in this TVS complex and help to control the migraine.

A number of painful conditions can be treated using Occipital Nerve Stimulation. It may be extremely effective when other treatments fail to relieve the intractable pain of chronic posterior headache. There are no assurances for any medical treatment and every individual case is different, but the surgical treatment we do aims to minimize the number and severity of your migraines.

There are a many factors to consider in deciding if migraine surgery is your best option. The patients are asked to maintain a precise diary of their migraine headaches and to complete a monthly questionnaire documenting relevant information related to their headaches. At our institute, patients are selected by the specialist as per the International Headache Society guidelines and criteria to undergo this treatment.

If you have any questions or anxieties, please be sure to discuss them with Doctor.

Mumbai, October 17, 2008, Jaslok Hospital & Research Centre conducted a novel surgery for the treatment of Migraine by Stimulation of the Greater Occipital Nerve (GON). This is the first case in India that such a surgery has been conducted. This was conducted by Dr Paresh Doshi, Functional Neurosurgeon, Dr. Preeti Doshi, Pain Physician and Dr. K Ravishankar, Headache specialist at Jaslok Hospital.

Procedure

The patients for occipital nerve stimulation are selected after careful evaluation the first step in selecting the patient used to evaluate the response of the patient to the greater occipital nerve block this no block is administered using local anaesthetic and a combination of steroid once administered the patient will feel relief office migraine headache for a short duration this can last for few hours to few days a good response to know block will ensure that the patient will is likely to respond to occipital nerve stimulation.

Once this is confirmed we bring the patient back into the hospital for the main procedure of Greater occipital nerve stimulation the greater occipital nerve stimulator involves implantation of an electrode which is connected to a pacemaker is very thin wire electrode Travis is across the greater occipital now and stimulates the greater occipital now this is a very safe procedure as the wire is implanted just under the skin the patient is taken to the operation theatre wearing under x-ray guidance.

Indian awake condition the wire is put across the greater occipital now and connected to a trial stimulator this trial stimulator delivers the current and the patient would feel paraesthesia in the area of pain or migraine headache once this is confirmed the patient is given general anaesthetic and the pacemaker is implanted after the surgery the pacemaker is programmed to deliver desired amount of stimulation to achieve pain relief over next few months the medicines are then titrated and slowly reduced our experience tells that it takes up to 6 months to take off the patient completely from medications the greater occipital nerve stimulation is a fairly successful procedure is performed in selected cases and we have now and experience of more than 6 patients who have undergone this surgery.

Landmarks for the insertion of Occipital nerve stimulation leads. Patient lying in a prone position (on his stomach).

In carefully selected patients the results are very good. We have operated five patients so far. All of them have got excellent relief. The first patient is completely relieved of his migraine and also not needing the stimulation anymore. Another lady also had an instantaneous improvement as seen below.

Migraine Treatment

Alternative Treatment:

  • Acupuncture: Very popular for pain management. The technique requires a set of needles to be inserted into the skin at particular locations to relieve the pain.
  • Biofeedback: This includes deep breathing exercises, progressive muscle relaxation, guided imagery, mindfulness meditation.
  • Message therapy: This is known to reduce the frequency of migraine attacks.
  • Cognitive behavioral therapy: It is a form of psychotherapy where reflection of ones behavior can help in the perception of pain.

Lifestyle and Home Remedies for Migraine Headache

Though there is no known cure for migraine but some home remedies can help get relief from migraine and reduce its frequency.

  • As cold reduce inflammation contribute to headache, applying an ice pack to the back of your neck can give relief from a migraine.
  • Ginger tea- few times a day can give some relief.
  • Eat Nuts, it can work as both a pain reliever and a preventative method to stave off future onsets.
  • Drink Grape juice. Grapes are excellent pain reliever.
  • Gently massage your head with your first two fingers in a circular motion. It may help to reduce the pain frequency.

Some lifestyle alterations might help to reduce migraine frequency such as:

  • Getting enough sleep
  • Drinking plenty of water
  • Regular physical Exercise
  • Avoiding certain foods
  • Reducing stress level

If the above lifestyle changes do not alleviate the frequency of migraine then, we need to focus on avoiding triggers to control symptoms and take proper treatment/ medicines.

Coping and Support

Lets see how to deal with Migraine Headache:- Your body always tells you that something need to be changed, so begin to notice those signals yes, a little changes in lifestyle can help to overcome headaches in a natural and healthy way.

Physical activity seems to help prevent migraines. Regular, mild exercise helps to reduce tension and region off stress, a well-known trigger for many migraine sufferers. Exercise also triggers the release of endorphins, which act as a mild relaxing.

Testimonials

Mr. TL, 42 yrs old male had been suffering from Migraine for last 11 years. For past 4-5 years it had become intractable. He experienced attacks for 15-20 days in a month, sometimes on the left and sometimes on the right. There could be multiple attacks during the day leaving him significantly disabled for 8-10 hours. Apart from medical treatment, he had also tried Botulinum Toxin treatment without much benefit.

As his work was significantly affected by his disease condition, he agreed to undergo Occipital Nerve (ON) stimulation procedure. As this patient qualified for ON stimulation, we went ahead and implanted two eight contact point electrodes in this patient overlying the GON. They have been connected to a pacemaker implanted on the chest wall. The pacemaker delivers current to stimulate the GON through the electrodes. Whenever the patient gets a Migraine attack he can switch on the pacemaker and control his migraine.

It has been now two years and the patient has been off drugs for the past week and has not suffered any lasting Migraine attacks. For one year he has not been on any medications or has not even required to use the pacemaker.