Migraine attacks are accompanied by a throbbing pain either on one or both sides of the head. Unlike a regular headache, the consequences of a migraine is likely to seep into and impact all areas of our lives. Sunway Medical Centre (SMC) Consultant Neurologist Dr. Raymond Tan, based in Kuala Lumpur, Malaysia, has said that migraines are as incapacitating neurological disorder, and comes with a wide range of symptoms including blurred vision, nausea, and vomiting.
People who suffer from migraines may be sensitive to lights, noises, and scents, and — for some, experience aura or focal neurologic symptoms; episodes as such can last between 4 to 72 hours in duration.
According to the Office on Women’s Health, migraine is three times more common in women than in men, and is the fourth leading cause of disability in women.
Dr. Sharmina Kamal, SMC Consultant Obstetrician and Gynaecologist, revealed that this is largely due to specific changes in the hormone oestrogen: “Oestrogen helps regulate the female reproductive system and controls chemicals in the brain that impact the sensation of pain. Therefore, a drop in oestrogen levels can contribute to the development of chronic headaches or migraines.”
Still, migraines can affect both men and women, from all walks of life.
In childhood, migraines are more prevalent in males but cedes once the influence of oestrogen begins – that is when the prevalence starts to rise in females, contributing to more common, longer-lasting migraines in women between the ages of 20 and 45. Besides hormonal changes, factors such as stress, lack of or too much sleep, skipped meals, weather changes, alcohol, and caffeine can also trigger migraines.
Fortunately, migraines are a modifiable disorder and there is hope for relief through very simple methods.
“The best thing to do at the start of a migraine is to stop your activity and get some rest, preferably in a quiet and dim lit room or area. Taking a simple analgesic like paracetamol at the start of the migraine often helps to limit the severity. Application of topical menthol may also lessen the intensity of acute migraines, although this is best avoided in women who are pregnant or breastfeeding,” suggested Dr. Raymond.
Combining therapy or medication with behavioural measures and a lifestyle that promotes overall good health is also a proven way to handle migraine attacks. For example, maintaining a healthy lifestyle includes consuming nutritious foods, as well as ensuring adequate hydration, frequent exercise, and proper sleep.
You can also speak to your physician about daily vitamins or supplements, such as vitamin B or magnesium.
Migraines are a real source of pain, but most of the time, they are not signs that one has a serious medical problem. However, it is worth speaking to your doctor when you have symptoms that are more severe than normal, including:
- Uncontrollable vomiting
- Loss of consciousness
- Seizures or convulsions
- Blurred vision or other vision changes
- Loss of balance or coordination
“Occasionally, the migraine attacks persist for more than 72 hours and become debilitating and resistant to conventional treatment. And in cases associated with persistent vomiting, this could lead to potential dehydration and its associated problems, which could require hospitalisation with intravenous fluids and medications,” Dr Raymond said.
Young women, in particular, who experience migraines with aura, especially those who smoke or use oral contraceptives, have an increased incidence of strokes and seizures. It is advisable for women at risk to avoid smoking and choose other forms of contraception, if possible.
As a close, you should know and avoid your triggers, treat symptoms early, and find medications or therapies that work best to relieve your migraine pain. When it comes to treating migraines, timing is everything – waiting too long to address your migraine symptoms or take preventive steps can increase how often and severely a migraine strikes.
Headaches or the more debilitating migraines can disrupt daily activities – while they may stem from various causes that are treatable, medical experts at Sunway Medical Centre Velocity (SMCV) in Kuala Lumpur, Malaysia, say that worsening headaches or migraines may point to an underlying condition.
Tension headaches, the most prevalent type of headache in Malaysia (26.5%), and migraines (9.0%) have the potential to turn into chronic headaches, according to Dr. Kok Chin Yong, Consultant Neurologist and Internal Medicine Physician from SMCV.
“Chronic headaches are defined as headaches that last 15 days or more in a month, for more than three months,” Dr. Kok said. “Chronic headaches should not be taken lightly – while it may not always be a marker of something serious, one should seek medical attention if the headache is accompanied by other symptoms such as numbness, weakness, difficulty speaking and walking, visual disturbance, fever and loss of weight.”
Dr Kok went on to explain how most patients experience episodic headaches that come and go, with some needing little to no painkillers to manage the pain. Half of patients with chronic headaches may also suffer from what is called a medication overuse headache (MOH), which is often underdiagnosed but can be treated by managing the usage of painkillers to reduce its severity.
“Migraines can affect one’s life and work. It can worsen with physical activity, affecting focus and concentration that in return reduces one’s efficiency at their workplace. Episodic migraines can be prevented from turning into chronic migraines by taking good preventative medications and making lifestyle changes,” added Dr. Kok.
These lifestyle changes include regular exercise, managing stress levels, and getting proper hours of sleep.
“Non-drug strategies are crucial as they can worsen and trigger migraines. One needs at least seven hours of good quality sleep – do not consume alcohol in order to sleep or take caffeine later than 3pm as it affects your sleep quality. High screen time can also trigger migraines especially in young adults, and these patients are sensitive to lights and flickering sound, which can also worsen the migraines.
“The key to prevent migraines is regularity. Patients with migraines need to have a regular eating and sleeping time, as a lack of it can trigger migraine attacks. If someone has high frequency of migraine attacks, one must be aware that there are good and effective preventative medications to reduce the burden. Some come in the form of pills and some in the form of injections [which are] very easily administered and can reduce the frequency and severity of migraine attacks.”
As for constant headaches and migraines as indicators of more serious health issues, SMCV Consultant Neurosurgeon Dr. Gerard Arvind Martin revealed that some headaches can be signs of tumours or other such anomalies, which are fatal if left untreated.
“We have seen this to be especially true for those whose headaches are caused by tumours or vascular conditions such as aneurysms. A tumour may announce itself by affecting that specific area it is pressing against or developing in, therefore causing symptoms related to that part of the brain. A growing tumour may grow, either quickly or slowly over time, and push aside the brain, causing the brain to react to tumour tissue and brain swelling occurs, and headache ensues,” said Dr. Martin.
Aside from these headaches, patients should also look out for effects in other neurological functions such as impairment of decision-making, thinking, and memory. The presence of a seizure, either before, during, or after the onset of headaches can also be an accompanying feature to brain tumours.
“While it is alarming to think that [headaches] are always caused by something sinister occurring within ones’ head, the truth is that headaches can also be caused by other parts of the head such as the eyes, ears, neck, the sinuses, or even teeth. Therefore, it is a good practise to rule out anything occurring in these areas as well during an initial consultation.
“Those who act upon their symptoms in a timely manner and get themselves treated are able to mitigate their conditions and, depending on the diagnosis, able to continue to lead fuller lives,” Dr. Martin concluded.