Terminology of migraine in Arabic

The word migraine has undergone significant linguistic evolution. It originates from the Greek noun ἡμικρανία “hemikrania,” to denote a pain on one side of the head, and this entered late Latin as “hemicrania.”^1,2 The English term “megrim” was borrowed from the French word migraine. ² However, in modern English, the term “migraine” is commonly used. Interestingly, migraine is known by native Portuguese and Spanish speakers as “enxaqueca” and “jaqueca,” respectively, both terms of Arabic origin, derived from the Arabic word al-shaqiqah “الشقیقة‎.” ² Our aim is to raise awareness in clinical practice about the potential for misinterpretation of Arabic terminology of migraine by both physicians and patients, which may lead to inappropriate management, inaccurate epidemiological estimates, and reduced comparability of study findings.

The Arabic translation of “migraine” is complex, as two primary terms are used: “صداع نصفي” ṣudā‘ niṣfī and “الشقيقة” al-shaqiqah. The word al-shaqiqah is derived from the verb shaqa, meaning to split or to cleave, reflecting the intensity of migraine pain. Patients often describe a migraine attack as an overwhelming sensation of their head being split apart, or as if their skull is being forcibly cleaved or fractured. Historically, the earliest documented usage of the word al-shaqiqah in the context of headache dates back to the 9th century. Notably, a Hadith narrated by Abdullah ibn Abbas reported that the Prophet Muhammad underwent cupping on his head, due to suffering from al-shaqiqah. ³

Navigating the Islamic Golden Age in the early medieval period, we find that the prominent Persian scholar and physician Avicenna (Ibn Sina, 980–1037 AD) used the term al-shaqiqah in his renowned medical encyclopedia, The Canon of Medicine, to describe and treat migraine. ⁴ Similarly, Abu al-Qasim al-Zahrawi (Abulcasis, 936–1013 AD), a pioneering Andalusian physician and surgeon, addressed migraine treatment in his medical compendium, Kitab al-Tasrif, also using the term al-shaqiqah. ⁵

The alternative term ṣudā‘ niṣfī literally translates to “half-headache” and is composed of two words: ṣudā‘, meaning headache, and niṣfī, meaning half. Indeed, this term is arguably more anatomically descriptive than al-shaqiqah, as it directly refers to the unilateral nature of migraine pain. However, its usage can sometimes lead to confusion or disagreement among patients and even physicians, particularly in cases where the migraine pain is bilateral. Furthermore, the emphasis on the “half-headache” aspect may contribute to diagnostic inaccuracies, as other hemicranial headache disorders, such as cluster headache, might be misclassified as migraine solely based on the one-sided presentation. In the Arabic version of the International Classification of Diseases (ICD), migraine is listed under the term ṣudāʿ niṣfī. ⁶

Although migraine is a common neurological disorder across Arab countries, its reported prevalence shows considerable variation, even among nations with similar cultural, economic, climatic, and ethnic characteristics.^7,8 One possible explanation for this discrepancy is methodological bias, particularly the terminology used to describe migraine. The choice between using the term ṣudāʿ niṣfī or al-shaqiqa may affect participants’ understanding and influence prevalence estimates. Given the considerable variation in Arabic dialects across Arabic-speaking countries, we propose that the term al-shaqiqah “الشقيقة” is a more precise and universally comprehensible designation for migraine. In contrast to ṣudā‘ niṣfī “صداع نصفي” which literally denotes a unilateral headache, may be misleading as it emphasizes laterality, a feature not consistently present in all migraine presentations.