Migraine is a common neurological condition that causes repeated attacks of headache, usually with other symptoms. Attacks are described as migraine with aura or without aura.1
It can affect children and adults, but it is more common in women, often starts in the teenage years or early adulthood, and tends to run in families (read about migraines and genetics).
A migraine attack typically includes:
Without treatment, an attack usually lasts between 4 and 72 hours.1 Some people also have an aura before or during the headache, such as flashing lights, blind spots, or tingling or numbness in the face or hand. An aura usually builds up over several minutes and fades within an hour.1
Triggers differ from person to person, and not everyone can identify one. Commonly reported triggers include:
Keeping a headache diary can help you and your doctor spot patterns.
Go to the nearest emergency department.
A new headache, or a change in the pattern of your usual headaches, should be checked by a doctor first.
It is a good idea to see a pain specialist if your attacks are frequent, if painkillers are not working or you need them often (frequent use can itself bring on headaches), or if migraines are affecting your work, family life or sleep.
Diagnosis is based on your story and an examination. Dr Liu will ask about the pattern and length of your headaches, any aura, how often they occur, what helps or worsens them and your family history, and will check your nervous system.
A scan is not usually needed for typical migraine (read when an MRI or CT scan is useful). It may be advised if your headaches are unusual or have changed, if you have symptoms such as numbness or weakness, or if there are other warning signs, to rule out other causes.
Treatment has two parts: stopping an attack when it starts, and reducing how often attacks happen.
If painkillers are no longer enough, see also Beyond Panadol: chronic migraine treatment. Dr Liu will explain which options may suit you, including the benefits and risks of each.
There is no permanent cure for migraine, but many people are able to reduce how often attacks happen and how severe they are with the right plan. At your consultation we will go through your attack pattern, triggers and any treatments you have tried, and plan the next steps with you. We aim to help you get back to work, family and the things you enjoy.
MOH accredited Pain Specialist and Medical Director of Alleviate Pain Clinic at Farrer Park Hospital. He completed an interventional pain fellowship at the University Health Network in Toronto and was previously a Senior Consultant in Pain Medicine at Singapore General Hospital.
Read more about Dr LiuThis page gives general information and is not a substitute for medical advice. Please see a doctor about your own symptoms and treatment options.
Yes, although they can overlap. Migraine is usually a throbbing headache, often on one side, with nausea or sensitivity to light and sound, and it gets worse with activity. A tension-type headache is more often a dull, tight pressure on both sides without nausea. An assessment helps tell them apart, because the treatments differ.
There is no permanent cure, but treatment can help. Many people are able to reduce how often attacks happen and how severe they are with a plan that combines attack treatment, preventive treatment where needed, and trigger and lifestyle management.
A migraine that lasts more than 72 hours is called status migrainosus, and you should seek medical help promptly. Treatment may include fluids, anti-nausea medicines, other medicines to ease the headache and, in some cases, nerve blocks.
Many women find their migraines improve during pregnancy, especially in the second and third trimesters, but they can return after delivery. Some migraine medicines are not suitable during pregnancy or breastfeeding, so please talk to your doctor before taking or stopping any medicine.
Botulinum toxin is used to prevent chronic migraine, which means headaches on 15 or more days a month. Small injections are given around the head and neck and are usually repeated about every 12 weeks. It is not used to treat an attack that has already started. Dr Liu will explain whether it may suit you and the possible side effects.
Interventional pain procedures are covered by the Ministry of Health's Table of Surgical Procedures (TOSP). They are therefore reimbursable by all Integrated Shield Plans and most corporate insurance plans. However, it is advisable to obtain preauthorisation from your insurer before the procedure. Our clinic staff will guide you through this process.
Effective pain solutions for a better living. Specialist pain management at Farrer Park Hospital, Singapore.
1 Farrer Park Station Road #08-14
Farrer Park Hospital (Connexion)
Singapore 217562
Mon–Fri 9am–5pm
Sat 9am–1pm · By appointment
