It starts innocently enough. You cannot shake off a sudden urge to indulge in a bar of chocolate despite having just eaten lunch; or perhaps it is the frequent yawning even after a good night’s sleep.
The day after, it strikes – one of those crippling headaches that can last up to three days and leave you feeling drained, nauseated and needing to recuperate in a quiet, dark room.
These sudden food cravings or frequent yawning could be more than isolated incidents. According to the Mayo Clinic, these and other warning signs such as a stiff neck1, unusual tiredness or even unexpected sadness could mean that a migraine episode is just one or two days away1.
It may be common practice to pop a pill and push through the pain, but this may not prevent future migraines – and over time, it could even make things worse1.
What’s the difference between headache and migraine?
According to Adjunct Associate Professor Jonathan Ong, senior consultant, Division of Neurology, Department of Medicine, National University Hospital (NUH), the above could be signs of something more than a common headache. Prof Ong is also the current president of the Headache Society of Singapore.
He explains: “A headache is a symptom, not a diagnosis2. Because migraine is a neurological condition affecting multiple brain pathways3, it can sometimes occur without significant head pain, but with other symptoms.”
“Just as an engine warning light on a car dashboard signals that something is wrong but doesn’t identify the cause, a symptom signals that there is a problem, while a diagnosis identifies the underlying cause – such as a faulty spark plug.”
Migraine commonly causes recurrent attacks² characterised by pulsating pain, sensitivity to movement, light and sound, as well as nausea and vomiting1,2,4.
Other key signs of migraine2 may include intense, often one-sided throbbing pain, visual or neurological disturbances, such as flashing lights, jagged zigzag lines, blurry patches or blind spots1, collectively known as auras2.
How common is migraine in Singapore?
In Singapore, roughly 1 in 10 adults – or around 330,000 people – are affected by migraine5, with the condition up to three times more common in women after puberty due to hormonal factors such as menstrual cycle changes, contraception or hormonal therapy6.
A local study, Economic Burden of Migraine in Singapore, estimated that migraine resulted in $1.04 billion in economic losses in 20185,7. This was mostly due to lost productivity, and the remaining 20 per cent was attributed to healthcare costs, such as medical tests and consultations. Prof Ong was one of the researchers involved in the study.
Migraine episodes can disrupt work and daily activities, but recognising the early signs may help people seek medical advice sooner (see footnote 4 and 8).
PHOTO: GETTY IMAGES
Yet migraine is often underdiagnosed, under-recognised and undertreated in Singapore, with only a proportion of patients seeking medical care, and many not receiving long-term optimal care8.
It all boils down to awareness, adds Prof Ong, citing global awareness initiatives, including Migraine Awareness Month in June9, and the work that organisations such as the Headache Society of Singapore does, which all aim to raise awareness about migraine as a potentially disabling neurological condition rather than “just a headache”.
He adds: “People need to recognise the symptoms so they know when to seek medical advice8. There is a need to raise awareness among both healthcare professionals and the general public, and significant opportunities remain for further improvement.”
Episodic vs chronic migraine: when to seek treatment
Even among people with migraine, there is a distinction between those who suffer from episodic and chronic migraines10.
Prof Ong explains that the latter, which he says affects about 2.5 per cent10 of the entire migraine cohort, means a person experiences migraine headaches on 15 or more days each month10, for more than three months.
“Chronic migraine often develops from episodic migraine when symptoms such as headache and nausea aren’t managed well11,” says Prof Ong.
That is where preventive care is key, he adds. “Early recognition and appropriate management may help reduce the risk of episodic migraine progressing to chronic migraine11.”
For people whose episodic migraine is starting to disrupt their daily life, a combination of preventive treatment4 and lifestyle adjustments4 may be recommended. For chronic migraine, preventive treatment is usually necessary to reduce both frequency and severity12, 13.
Yet in reality, however, it is not so simple, notes Prof Ong. “Migraine can be highly disabling14. A single attack may keep someone off work for days, and visual symptoms15 can be especially dangerous for people who drive or work in high-risk jobs14.”
Read Full Article At Source
