Abstract

Introduction: Headache is one of the common symptoms in clinical practice with a life time prevalence of 30% in the general population. Migraine is the second most common causes of headache amongst the primary headache syndrome. The clinical presentation of migraine varies from patient to patient and even the same patient from time to time and causing sufficient morbidity. Keeping in view of its variable clinical practice and management the present study was undertaken for the clinical picture, diagnosis and treatment.

Material And Methods: All the patients, who came mainly for headache in OPD clinic were analysed for their types and subtypes according to aetiology. The primary headache syndrome patients were again analysed and only patients with migraine were included in this study. They were diagnosed by other criteria laid down by the headache classification subcommittee of the International Headache Society^1,2. All of them were interrogated for headache, its time of onset, duration, character, site and associated features. They were subjected to detailed physical examination and relevant investigations.

Observations And Results: During the period of April 2014 to March 2015, 2300 patients attended the OPD clinic and of whom there were 924 cases (40.1%) complained mainly for headache. Out of 924 cases there were 224 cases (24.2%) belonged to primary headache syndrome of total OPD attendance. Amongst these primary headache syndrome, there were 38 (16.9% or 0.8% of total OPD attendance) were of migraine who constituted the clinical material for the study. 10 of them (26.3%) presented as classical migraine ie., migraine with aura. The 4 phases of migraine ie., prodrome, aura, headache and post drome blended imperceptibly with one another during the course of attack. It is common in 4^th decade of life (34.8 +/- 11.8yrs). Typical pattern of headache ie., recurrent paroxysmal headache associated with nausea, vomiting, photophobia and phonophobia was seen in 89.4% of cases. Neurological manifestation was seen by 31.3% of cases in the formed paresthesia, vertigo, altered consciousness and syncope. Clinical examination and investigation could not reveal any positive finding. They all responded to non pharmacological and pharmacological methods. Propanolol and amitryptiline had good response.

Conclusion: Migraine is a common condition amongst the primary headache syndrome. If diagnosed early and treated with change in life style and use of prophylaxis with Propanolol and Amitryptiline will prevent the morbidity.

Keywords: Migraine, Primary Headache,  Aura