Migraine Headache

What is a migraine?

A migraine is a severe headache characterised by throbbing pain, usually on one side of the head. A migraine attack typically lasts from four hours to several days.

The pain may worsen with triggers such as physical activity, movement, bright lights, loud noises, strong smells, coughing, or sneezing. Migraine is a relatively common condition, affecting approximately 12–15% of the world’s population.

What is the difference between cluster headache and migraine?

Cluster headaches and migraines are classified as primary headache disorders, meaning their symptoms arise directly from the condition itself rather than from another underlying problem. There are several similarities in symptoms between cluster headaches and migraines, which can cause confusion.

Cluster headaches are less common than migraines, affecting about 1 in 1,000 individuals, whereas migraines are much more prevalent, affecting approximately 1 in 7 people.

Cluster headaches usually begin in individuals in their 30s and 40s, although they can occur at any age. Migraines, on the other hand, can occur at any age, with most people experiencing their first attack during adolescence. Cluster headaches are more common in men, while migraines are more common in women.

Migraine headaches are typically described as throbbing or pulsating pain, usually localised to one side of the head. In contrast, cluster headaches tend to start suddenly and are characterised by sharp, stabbing, or burning pain, often centred around or behind one eye.

Migraines are not usually dangerous, but they can significantly affect a person’s quality of life.

What are the characteristics and types of migraine?

There are two main types of migraine:

• Migraine with aura (classic migraine): Involves visual disturbances and other neurological symptoms that begin 10–60 minutes before the headache and usually resolve within an hour. Other symptoms may include difficulty speaking, abnormal sensations, numbness or muscle weakness on one side of the body, tingling in the hands or face, and confusion.
• Migraine without aura (common migraine): The most common type. Symptoms include sudden headache, one-sided head pain, nausea, confusion, blurred vision, mood changes, fatigue, and increased sensitivity to light or sound.

Other types of migraine include:

• Abdominal migraine
• Basilar-type migraine
• Hemiplegic migraine
• Menstrual migraine
• Migraine without headache
• Ophthalmoplegic migraine
• Retinal migraine
• Status migrainosus

What are the signs, symptoms, and stages of migraine?

There are four stages of migraine, and symptoms vary by stage.

1. Prodrome (24–48 hours before headache):
   • Depression
   • Irritability
   • Euphoria
   • Food cravings
   • Constipation
   • Neck stiffness
   • Difficulty concentrating
   • Fatigue
2. Aura (5–60 minutes):
   • Visual disturbances
     1. Flashing lights or bright spots
     2. Zigzag lines
   • Numbness or tingling in fingers, lips, tongue, or lower face
3. Headache (4–72 hours):
   • Severe headache on one or both sides of the head
   • Nausea and vomiting
   • Sensitivity to light, sound, and smell
   • Sensitivity to touch
4. Postdrome (hours to 48 hours):
   • Fatigue
   • Neck stiffness
   • Low mood or euphoria
   • Difficulty concentrating
   • Nausea

What causes migraines?

The exact cause of migraine is unknown, but people with a family history are more likely to experience it.

Common triggers include stress, hormonal changes, certain medications, sleep disturbances, anxiety, depression, weather changes, excessive or insufficient physical activity, caffeine or tobacco use, missed meals, and exposure to bright lights, loud sounds, or strong smells.

How is migraine diagnosed?

Migraine is diagnosed based on medical history, physical examination, and neurological assessment. Tests may include blood tests, CT or MRI scans, and electroencephalogram (EEG).

How can migraines be treated?

Although there is no cure for migraine, symptoms can be managed.

Medications:

• Acute treatments: aspirin, acetaminophen, NSAIDs, triptans, ergot derivatives, antiemetics
• Preventive treatments: anti-seizure medications, beta blockers, antidepressants, calcium channel blockers

Lifestyle tips:

• Avoid migraine triggers
• Eat meals regularly
• Reduce caffeine intake
• Practise relaxation techniques such as yoga
• Exercise regularly
• Maintain good sleep hygiene

When should I see a doctor?

You should consult a doctor if your migraines are severe, disrupt daily activities, occur frequently, worsen over time, or do not respond to over-the-counter medication.

Make an appointment at Pantai Hospitals

Migraine is not the same as a regular headache. Treatment options are available to help manage migraines and improve your quality of life. Consult a neurologist to explore personalised treatment options.

The dedicated neurology team at Pantai Hospitals is ready to provide expert care and support. Contact us today to book an appointment or visit the nearest Pantai Hospital Health Screening Centre.

Pantai Hospitals are accredited by the Malaysian Society for Quality in Health (MSQH).