When does a normal headache cross the line to become a migraine?

First, it is important to understand what a migraine is. A migraine is a common neurological condition caused by a wide range of symptoms. It is more common in women than it is in men. In Singapore, migraines affect a significant portion of the population. An estimated 10% of Singaporeans suffer from migraines. [1] It is in essence a moderate to severe throbbing headache that takes place on one side of the head. Migraine headaches are accompanied with other symptoms that do not come along with normal headaches. If you are experiencing additional symptoms that accompany an intense, throbbing headache like flashes of light and nausea, your headache is most likely a migraine. 

Migraines take place in four stages, however, not all who experience migraines go through all four stages:

    1. Prodrome
      This stage takes place one to two days before a migraine attack. Here, subtle symptoms such as mood swings, frequent food cravings, increased need for urination, hyperactivity, neck stiffness, occur and warn of an upcoming migraine.
    2. Aura
      After the prodrome stage is the aura stage. Here you may have problems with your five senses and difficulty with movement. The symptoms of the migraine become increasingly noticeable. They include seeing flashes of light or brightness, temporarily losing vision, feeling prickling sensations over your body, difficulty speaking properly, weakness or numbness in parts of the body, uncontrollable jerking, and hearing noises.
    3. Attack
      The attack stage is where the migraine is most severe and pain is most acute. This can occasionally overlap with the aura stage of the mgiraine. The symptoms in the attack stage usually last from 4 to 72 hours when left untreated. However, the symptoms experienced and the length of the migraine varies from person to person. The symptoms experienced in this phase include an intense, throbbing, and debilitating pain in one side of the head, sensitivity to light, sound, and touch, nausea, and vomiting.
    4. Postdrome
      The postdrome phase takes place after the attack phase. In this phase, mood changes and swings are experienced. While you may feel exhausted, others may feel elated and euphoric. It is different from person to person and depends on your own body.

    There are various types of migraines:

    Migraine with aura (complicated migraine) 

    In this type of migraine, the aura stage is present. There are warning signs of the migraine including flashing lights, nausea, and sensory and visual changes. 

    Migraine aura without headache (silent/acephalgic migraine)

    In this type of migraine, there is no head pain. Instead there is nausea, sensitivity to light, and all the other symptoms that accompany the aura stage. It is essentially the aura phase without the attack stage. 

    Migraine without aura (common migraine) 

    In this type of migraine, the migraine lacks warning symptoms that are present in migraines with aura (complicated migraine). It involves intense, pulsating headaches. 

    Chronic migraine 

    If you are experiencing migraines for more than 15 days a month you may have chronic migraines. They may vary in intensity and some migraines may be mistaken to be headaches. People with chronic migraines tend to take pain relief medication for more than 15 days a month which results in more headaches. 

    Retinal migraine 

    Retinal migraines cause you to lose vision in one eye during the migraine. The blindness as a result of retinal migraines are usually reversible. If you are experiencing this, it is important to see a specialist immediately as it could be a sign of a more serious condition.  

    Hemiplegic migraine

    This migraine feels like a stroke. There are aura symptoms which include tingling and prickling sensations as well as numbness on one side of the body. It does not necessarily always include intense headaches.

    WHAT CAN TRIGGER A MIGRAINE?

    The causes of migraines are not fully understood but there are some of the various common triggers which can start a migraine. 

    1. Stress
      There is a correlation between your daily stress level and your daily migraine activity.
    2. Drinks (alcohol/caffeine)
    3. Irregular sleep patterns
      A woman’s menstrual period can sometimes trigger a migraine due to the change in hormones. Some hormonal treatments which change the balance of hormones in your body can also worsen or even help migraines. 
    4. Food/dietCertain salty, processed food, or food additives can trigger migraines. 
    5. Sensory stimuli
      Exposure to bright lights, loud sounds, strong smells, etc. can all trigger migraines. 
    6. Weather changes
      A change in weather and environmental pressure can trigger migraines.

    You can try to prevent or reduce the number of migraines you have by identifying the triggers for your migraines. This way you can actively avoid your triggers.

    HOW ARE MIGRAINES DIAGNOSED?

    When visiting your physician, they would have a look at your clinical/family history, consider your reported symptoms, and rule out any other causes of your symptoms with the help of neuroimaging if needed before diagnosing you with a migraine. Obtaining an accurate diagnosis to migraines can take some time as there is no one way to diagnose migraines. 

    TREATMENTS FOR MIGRAINE

    Unfortunately, there is no current cure for migraines. However, there are some treatments available to help you manage and treat your migraine symptoms. Common treatments include painkillers, anti-sickness medications, combination medications for migraines (which include both painkillers and anti-sickness medicines, migraine prophylaxis treatment, migraine therapy for immediate relief from pain

    RELATED CONDITIONS

    While migraines are not the cause of other medical conditions, they are linked to a few other ailments. Having migraines may increase your chances of certain conditions including sudden hearing loss, anxiety, depression, seizures, high blood pressure/hypertension, heart disease, and in some cases even stroke. 

    If you are experiencing symptoms that affect your ability to function in everyday life, it is important to consult a doctor. It is important to never self-medicate and to always check through everything with your neurophysician. Book a consultation today with one of our doctors to help you identify your symptoms, conditions, and suitable treatments. 

    1. https://www.duke-nus.edu.sg/allnews/migraine-is-a-billion-dollar-headache-for-singapore-nationwide-study-finds#:~:text=In%20Singapore%2C%20migraine%20affects%20up,National%20University%20Hospital%20(NUH).&text=%E2%80%9CA%20significant%20portion%20of%20Singapore’s%20population%20has%20migraine