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SINGAPORE - A patient is diagnosed by a doctor as having a migraine if he meets certain criteria issued by the International Headache Society. Some of these symptoms include one-sided throbbing and moderate to severe headaches with nausea.
Most headaches are tension-type headaches. They tend to be felt as tightness around the head. The cause for these remains unclear.
Migraines have a genetic basis and 80 per cent of sufferers have a family member with migraines.
Preventive medication for migraine is taken daily. Abortive medication is taken only during a migraine attack.
When we put patients on migraine medication, we put them on it for at most a year at a time, after which, we will attempt to taper it off.
When we do so, the headaches may return. If this is the case, then we go back to the full dose. Otherwise, we stop the medication altogether.
Many patients are able to come off it after a while, so most do not take it for life.
But some people need to take preventive medication for prolonged periods or even years. This should be done only under a doctor's supervision.
Most people do not become immune to medication, although some people may find that the medication loses effect after a while.
In that case, there are now many types of medication that we have at our disposal to control migraines, so you should not be concerned that there will be no alternatives.
Usually, medication that is taken for migraine prevention is safe to use in the long term.
However, certain types of such medication may affect the liver, and the patient will need to have regular blood tests to check on the function of the liver. The effect on the liver is usually reversible once the medication is stopped.
Apart from oral medication, we can now use other forms of prevention, such as injections of Botulinum toxin. Botox prevents migraines by reducing inflammation in the peripheral nerves, which in turn dampens the sensitivity of the brain and reduces the chance that it will cause migraines.
One can decrease the chance of migraines by increasing physical exercise, such as running, swimming and cycling.
Avoiding migraine triggers, keeping regular meal times and sleep patterns, and getting at least seven hours of sleep daily can also help.
DR CHARLES SIOW
Consultant neurologist at Siow Neurology, Headache and Pain Centre at Mount Alvernia Hospital, Mount Elizabeth Medical Centre and Mount Elizabeth Novena Specialist Centre
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