March 28, 2017, 10 p.m.


Migraine is a very common illness. People who suffer from migraine usually develop a one-sided

headache that is pulsating in nature. The pain can be moderate to severe in intensity. It is most

commonly present with nausea and/or vomiting. Usually the headache worsens gradually and cal last

between four and 72 hours. People with migraine tend to avoid bright light or loud noises, and find

solace in a quiet and dark room.


Those with classic migraine experience the aforementioned symptoms with the addition of an aura,

which can be visual (e.g. flashes of light), a sensation (e.g. a feeling of “pins and needles” down the

limb) or affect speech (e.g. inability to speak). An aura can last up to 60 minutes and the headache

follows within an hour. However, some patients may experience an aura without a headache.


A GP will be ale to diagnose migraine based on your medical history. He usually advice remedies such

as proper rest in a dark and quiet room. Use of painkillers can sometimes help to further alleviate the

headache. If vomiting or nausea is the main issue, the GP usually recommends anti-nausea medication,

which can be given orally or through injection (if needed). He may also prescribe medication to prevent

migraine if it is deemed regular enough to be disruptive to the patient's lifestyle and well-being.


Most of the time, migraine is triggered by:

  • Foods such as chocolate, oranges, tomatoes or cheese
  • Bright light or excessive noise, strong odour or extreme weather
  • Emotional or physical stress, exercise/physical exhaustion or oversleeping
  • Contraceptive pills, monosodium glutamate (MSG)
  • Menstruation, hunger, or physiological effects of shift work


Migraine-sufferers are usually able to identify what their triggers are and avoiding them tends to

prevent an attack. It is recommended to keep a headache diary to help identify the trigger factor if you

are unsure.


Visit us if you are unwell and experiencing symptoms listed below so that we can assess your condition

and determine whether a referral to the A&E is required for further investigation:

  • Sudden and severe headache
  • Disturbed consciousness
  • Neurological signs such as unilateral weakness of limb or slurring of speech
  • Headache triggered by cough or exertion or while engaged in sexual activity
  • Neck stiffness
  • Fever
  • If you are experiencing headaches and you are above 50 years old, immunocompromised, or suffering from cancer


This article first appear on Changi General Hospital Caring Magazine (Jan-Feb 2017)

(By Dr Tan Shi Ching)