Migraine
1. PRELIMINARY DATA
- No.: 203/2026
- Patient's Name: JKL
- Address: Row House 14, Sunshine Meadows, Pune.
- Occupation: Teacher (high work stress, long hours grading papers)
- Religion: Hindu
- Date: 10/03/2026
- Age: 38 Years
- Sex: Female
- Education: M.A. B.Ed
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Head (mostly right side, occiput to forehead) | Throbbing, bursting headache with nausea; aura (zigzag lights) in 30% attacks | < Light/noise, < Hormonal changes (pre-menstrual), < Stress/overwork, < 4-6 PM, > Dark quiet room, > Pressure/binding head, since 10 years (frequency 2-3/month, worse last 4 years) | Vomiting (bilious), photophobia, phonophobia, irritability before/during attack |
| Eyes | Blurred vision during aura | < Reading/small print | Fatigue after attack, depression post-attack |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Childhood motion sickness; recurrent acidity treated with antacids; suppressed skin eruptions in teens with ointments; hormonal imbalance post-marriage; frequent headaches after head injury at age 25 (minor).
- Family History: Mother has chronic migraine. Maternal aunt has epilepsy. Father has hypertension.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Diminished before attack, normal otherwise
- Desires: Chocolate (+++), Salty food (++), Cold drinks (+)
- Aversions: Fatty food, coffee smell
- Thirst: Increased during attack, for cold water
- Elimination:
- Urine: Normal
- Stool: Constipated before attack
- Perspiration: Scanty, but profuse on forehead during pain
- Sleep: Disturbed by attacks; wakes with headache; dreams of falling/failure
- Thermal State: Hot patient (prefers cool room, uncovers head)
B. Reactions - Physical Factors
- Weather: Aggravation in cloudy/rainy weather
- Position: Better sitting with head supported; worse lying flat
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Perfectionist, suppressed anger, weepy during attacks
- Anxiety: About children's future, work performance
- Fear: Fear of stroke/brain tumor during severe attacks
- Dreams: Falling, being pursued, unsuccessful efforts
- Other: Broods over trifles, feels neglected
6. PHYSICAL GENERAL EXAMINATION
- Wt: 68 kg | Ht: 160 cm | Temp: 98.6°F
- RR: 18/min | Pulse: 80 bpm | B.P.: 128/82 mmHg
- Face: Pale during attack, anxious expression
- Tongue: Clean
- Nails: Normal
- Skin: Dry, occasional acne scars
7. SYSTEMIC EXAMINATION
- Nervous: No focal deficits; tender scalp during attack
- CVS: S1, S2 Normal
- Respiratory: Clear
- GIT: Mild epigastric tenderness
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Perfectionism, anxiety about future, fear of serious illness, weepiness (Grade 3)
- Physical General: Hot patient, desire chocolate/salt, thirst cold during attack, scanty sweat (Grade 3)
- Particular: Right-sided throbbing migraine with aura, < light/noise/pre-menstrual, > dark/pressure (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic recurrent migraine with strong Mental Generals (perfectionism, fears, weepiness) and Physical Generals (thermal, desires) dominating; Kent excels in detailed head rubrics for modalities and concomitants.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Perfectionist nature
- Anxiety about future
- Fear of stroke/brain disease
- Desire chocolate and salt
- Hot patient
- Headache right side throbbing
- Aura with zigzag lights
- Nausea/vomiting bilious
- < Light, noise, pre-menstrual, 4-6 PM
-
Dark room, pressure
- Constipation before attack
- Family history of migraine
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Perfectionist | Mind; FASTIDIOUS | 48 |
| 2 | Anxiety future | Mind; ANXIETY; future, about | 7 |
| 3 | Desire chocolate | Stomach; DESIRES; chocolate | 483 |
| 4 | Headache right throbbing | Head; PAIN; right; throbbing | 144 |
| 5 | Nausea headache | Stomach; NAUSEA; headache, during | 508 |
| 6 | < Light | Head; PAIN; light, from | 142 |
| 7 | > Pressure | Head; PAIN; pressure amel | 145 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Iris Versicolor | 7/7 | 20 |
| 2 | Natrum Muriaticum | 6/7 | 17 |
| 3 | Sanguinaria | 5/7 | 14 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Throbbing pain, irritability, anxiety | Periodic attacks, aura | Family neurological issues | Bursting sensation, destructive fear |
Dominant Miasm: Psora-Tubercular
14. FINAL STEPS
- Provisional Diagnosis: Migraine
- Differentiation of Remedies: Compared Iris Versicolor with Natrum mur. Nat mur has more grief/suppressed emotion, thirstlessness, salt desire; Iris matches classic migraine with aura, visual disturbances, bilious vomiting, right-sided, < afternoon, gastric concomitants, desire chocolate/sweets. Sanguinaria more right occiput to eye without aura.
- Selection of Remedy (Materia Medica): Iris Versicolor matches chronic migraine with visual aura, right-sided throbbing, nausea/vomiting, < light/motion, gastric symptoms, desire sweets/chocolate (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic recurrent neurological case, sensitive constitution)
- Actual Prescription:
- Iris Versicolor 200 — single dose (one dose only, wait & watch)
- Placebo — 4 pills twice a day for 6 weeks
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|
| 10/04/2026 | Frequency reduced to 1/month, intensity 60% less, no aura in last attack | Placebo | Avoid triggers (stress, chocolate excess), regular meals, relaxation exercises |
| 10/07/2026 | Only 2 mild attacks in 3 months, no vomiting, aura rare, overall energy better | Placebo | Continue stress management, report pre-menstrual worsening if any |