Article

1. September/October 2026 Vol 40.5Management of Chronic Migraine Without Aura with Classical Unani Formulations: A Case Report
   Authors: Usama Akram MD, Abdul Aleem MD, Fatima Anjum MD, Nazim Husain MD, Younis Iftikhar Munshi MD
   Abstract:

   Background: Although tension-type headache is the most prevalent primary headache disorder, affecting nearly 26-30% of the population, migraine affects approximately 14-15% globally and is associated with a considerably higher burden of disability. Migraine typically presents as recurrent, pulsatile pain accompanied by nausea, photophobia, and phonophobia. Despite long-term use of conventional treatment, chronic cases often remain refractory. In Unani medicine, this condition corresponds to the melancholic type of migraine (Shaq?"«qa Sawd?"wiyya), caused by derangement of black bile (Sawda'). This case report presents the therapeutic role of classical Unani formulations in alleviating symptoms of chronic migraine without aura.

   Case Presentation: A 23-year-old female presented with a 14-year history of recurrent, unilateral throbbing and pulsating headaches associated with nausea, photophobia, and phonophobia. The episodes occurred 2-3 times per week, with each attack typically lasting approximately 48 hours and occasionally persisting for up to 72 hours. The patient had a positive family history of migraine, and previous conventional as well as homeopathic treatments failed to provide sustained relief. Based on the clinical presentation and Unani diagnostic principles, the patient was diagnosed with Shaq?"«qa Sawd?"wiyya, corresponding to chronic migraine without aura. The patient was managed with oral and local Unani formulations along with dietary regulation and was followed up from August 2025 to October 2025, with an additional 2-week post-treatment follow-up.

   Results: At the final follow-up, the patient showed substantial clinical improvement, with the Migraine Disability Assessment (MIDAS) score decreasing from 121 to 4, accompanied by a marked reduction in symptom severity.

   Conclusion: The classical Unani regimen demonstrated beneficial effects in the management of the patient with chronic migraine without aura. This case highlights the potential of Unani medicine in managing migraine, which can be evaluated in larger clinical trials with robust methodologies

   Keywords: Headaches, refractory migraine, neurological disorder, Migraine Disability Assessment, Unani medicine, case report, Shaqiqa
   Open Access: Yes
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