Ayurvedic Intervention in Ardhavabhedaka (Migraine) with Pathyadi Kwatha and Guda Shunthi Avapeeda Nasya: A Case Report

Background: Ardhavabhedaka, a type of Shiroroga described in Ayurveda, is characterized by episodic hemicranial pain and can be correlated with migraine.As headache disorders are a leading cause of disability worldwide, Ayurveda offers minimally invasive management options. Patient profile and diagnostic assessment:A 25-year-old male postgraduate student presented with a 7 years history of recurrent alternating unilateral headache (2-3 episodes/week) associated with photophobia, phonophobia, nausea, and prodromal symptoms of heaviness and mental blankness.Identified triggers included stress, sleep deprivation, hunger, sunlight exposure, strong smells, travel, and stormy weather.Based on clinical features, trigger history, Ayurvedic assessment, and International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria, the condition was diagnosed as Ardhavabhedaka correlated with migraine without aura.Baseline Migraine Disability Assessment (MIDAS) indicated Grade III disability.Intervention: The patient received oral Pathyadi Kwatha for 30 days and Avapeeda Nasya with Guda and Shunthi for 7 days, along with individualized lifestyle modifications based on identified triggers.Outcomes: The patient showed a marked reduction in headache frequency from 2 to 3 episodes/week to no episodes for the first 3 months after treatment.Lifestyle modifications were continued for 3 months after treatment.During the 9 months follow-up, only mild headache episodes occurred approximately once per month after trigger exposure, with headache duration reduced from 5-6 to ≤2 hours and pain intensity improving from visual analog scale (VAS) 7/10 to 2/10.Analgesic medication was no longer required, and MIDAS grade improved from III to II, indicating reduced migraine-related disability and improved quality of life.Key learning points: This case highlights the potential of a trigger-oriented, minimally invasive Ayurvedic approach using Pathyadi Kwatha, Avapeeda Nasya, and lifestyle modification in reducing migraine burden and improving functional outcomes in Ardhavabhedaka.