Migraines: Understanding Triggers, Symptoms, and Treatment in Singapore

Migraines are a debilitating neurological condition that affects millions of people worldwide, including in Singapore. Far more than just a severe headache, migraines can disrupt daily life with intense pain and accompanying symptoms such as nausea, sensitivity to light, and visual disturbances. Understanding migraine triggers and how to manage the condition can significantly improve quality of life for those who suffer from these painful episodes.

What Are Migraines?

Migraines are intense, recurring headaches that can last for hours or even days. They often come with additional symptoms, including nausea, vomiting, sensitivity to light (photophobia), and sound (phonophobia). Migraines typically occur in stages and can vary greatly from person to person, both in frequency and intensity.

The four stages of a migraine include:

1. Prodrome: This stage occurs hours or even days before the migraine. Symptoms may include mood changes, food cravings, neck stiffness, or fatigue.
2. Aura: Not everyone with migraines experiences this stage, but it can involve visual disturbances such as flashing lights, blind spots, or zigzag patterns. Other sensory changes, like tingling or numbness, can also occur.
3. Headache: This is the phase where the actual migraine headache occurs. The pain is usually severe, throbbing, and often localized to one side of the head, though it can affect both sides. This phase can last between 4 to 72 hours.
4. Postdrome: After the headache subsides, people may feel drained, fatigued, or confused. This recovery phase can last for up to a day.

Common Migraine Triggers

Migraines are often triggered by certain environmental, emotional, or lifestyle factors. Identifying and avoiding triggers can help reduce the frequency and severity of migraine attacks. Common triggers include:

• Stress: Emotional stress is one of the most common migraine triggers. Changes in stress levels, whether from work pressure or personal issues, can trigger an attack.
• Hormonal Changes: Fluctuations in estrogen levels, particularly during menstruation, pregnancy, or menopause, can trigger migraines in women.
• Dietary Triggers: Certain foods and drinks, such as aged cheese, processed meats, alcohol (especially red wine), caffeine, and food additives like monosodium glutamate (MSG), can provoke migraines.
• Sleep Disruptions: Both too much and too little sleep can trigger migraines. Maintaining a regular sleep schedule is crucial for those prone to migraines.
• Sensory Stimuli: Bright lights, loud sounds, and strong smells (perfumes, smoke) can set off migraines in sensitive individuals.
• Weather Changes: Sudden changes in weather, temperature, or barometric pressure can trigger migraines in some individuals.
• Dehydration or Skipping Meals: Not drinking enough water or skipping meals can also lead to migraine attacks.

Symptoms of Migraines

While the hallmark of migraines is severe headache pain, they are often accompanied by a variety of other symptoms, which may include:

1. Throbbing or Pulsing Headache: The pain is often intense and located on one side of the head but can also affect both sides.
2. Nausea and Vomiting: Many migraine sufferers experience gastrointestinal symptoms during an attack.
3. Sensitivity to Light and Sound: Bright lights or loud noises can worsen the pain.
4. Visual Disturbances (Aura): About one-third of people with migraines experience an aura, which can include visual changes like flashing lights, blind spots, or zigzag patterns.
5. Fatigue and Irritability: Both before and after a migraine, you may feel unusually tired or irritable.

When to Seek Medical Attention

While occasional migraines can often be managed at home, there are times when medical attention is necessary:

1. The migraine lasts longer than 72 hours or occurs more frequently than usual.
2. The pain is unusually severe or accompanied by confusion, fever, or sudden vision loss.
3. You experience new or different symptoms that may indicate a more serious underlying condition, such as a stroke.

Treating Migraines

Migraines can be treated using a combination of lifestyle adjustments, medications, and preventive strategies. Treatment approaches include:

• Over-the-Counter Pain Relievers: Mild migraines can often be treated with over-the-counter medications like ibuprofen or paracetamol. However, excessive use of these medications can lead to medication-overuse headaches, so they should be taken with care.
• Prescription Medications: For more severe migraines, your doctor may prescribe medications such as triptans, which help to relieve pain by blocking pain pathways in the brain. In some cases, anti-nausea medications are also prescribed.
• Preventive Medications: For those with frequent or debilitating migraines, preventive medications may be recommended. These can include beta-blockers, anticonvulsants, antidepressants, or CGRP inhibitors, which are newer migraine-specific medications.
• Lifestyle Modifications: Regular exercise, maintaining a consistent sleep schedule, and managing stress through relaxation techniques like yoga or meditation can reduce the frequency and severity of migraines.
• Botox Injections: For individuals with chronic migraines (15 or more days of migraines per month), Botox injections have been approved as a preventive treatment.

Preventing Migraines

While migraines can’t always be prevented, you can reduce the likelihood of attacks by managing your triggers and making certain lifestyle changes. Here are some preventive tips:

1. Identify and Avoid Triggers: Keeping a migraine diary can help you identify specific triggers, such as foods, stress, or sleep patterns, and take steps to avoid them.
2. Stay Hydrated: Drink plenty of water throughout the day to avoid dehydration, a common migraine trigger.
3. Eat Regularly: Don’t skip meals, and try to eat a balanced diet rich in nutrients that support overall health.
4. Manage Stress: Practice stress-reduction techniques such as deep breathing exercises, meditation, or progressive muscle relaxation to reduce the likelihood of stress-induced migraines.
5. Maintain a Sleep Routine: Establish a regular sleep schedule by going to bed and waking up at the same time each day. Aim for 7-9 hours of sleep per night.

Living with Migraines

Living with migraines can be challenging, but with proper management, it is possible to reduce the frequency and intensity of attacks. If you suffer from frequent or severe migraines, consult a healthcare provider to discuss a personalized treatment plan that works for you.

At Igaku, we offer expert consultations for managing migraines. Whether you prefer an in-person visit at one of our clinics or a convenient teleconsultation via WhatsApp, our specialists are here to help you find relief and get back to living life without the disruption of migraines.

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