Migraine

Gambaran keseluruhan

A migraine is much more than a bad headache. It is a neurological condition — meaning it involves the nervous system and the brain — that causes intense, often throbbing head pain, usually on one side of the head. Along with the pain, many people experience nausea (feeling sick to the stomach), vomiting, and extreme sensitivity to light, sound, or smell. A migraine attack can last anywhere from a few hours to several days, and the pain can be severe enough to interfere with everyday life. Some people also experience an 'aura' before or during the headache — this is a short period of visual disturbances (such as seeing flashing lights or blind spots), tingling sensations, or other neurological symptoms. Migraine is a genuine medical condition, not just a 'strong headache,' and it is well understood and treatable.

Migraine is extremely common. It affects approximately one billion people worldwide, making it one of the leading causes of disability globally. In the UK, the NHS estimates that around 10 million people experience migraines. It is the third most common disease in the world according to the Global Burden of Disease study.

Migraine can affect people of all ages, including children. However, it most commonly begins in early adulthood, typically between the ages of 15 and 55. Women are about three times more likely than men to experience migraine, likely due to hormonal influences. There is also a strong genetic (inherited) component — if a parent has migraines, their child has a significantly higher chance of developing them too.

Gejala

Gejala biasa

• A moderate to severe throbbing or pulsating headache, often on one side of the head
• Nausea — feeling sick to the stomach — and sometimes vomiting
• High sensitivity to light (photophobia), so that even normal indoor lighting feels painful
• High sensitivity to sound (phonophobia), making ordinary noises feel unbearable
• Sensitivity to smells (osmophobia) — certain odours can worsen or even trigger the headache
• Visual aura — seeing zigzag lines, flashing lights, or temporary blind spots, usually before the headache begins
• Tingling or numbness in the face, hands, or arms, sometimes as part of an aura
• Difficulty speaking clearly, which can occur during an aura
• Neck stiffness or pain in the days leading up to an attack
• Fatigue and difficulty concentrating — often called 'brain fog'
• Yawning, mood changes, food cravings, or increased thirst in the hours before a headache begins (the warning or prodrome phase)
• Exhaustion, confusion, and feeling 'washed out' after the headache fades (the postdrome or recovery phase)

Gejala pada kanak-kanak

• Headaches that may be shorter in duration than in adults, sometimes lasting just one to two hours
• Pain that is more often felt on both sides of the head rather than just one side
• Stomach pain, nausea, and vomiting that may seem more prominent than the headache itself
• Pallor — the child may look unusually pale during an attack
• Dizziness or a feeling that the room is spinning (vertigo)
• Motion sickness, which may be a related symptom in children prone to migraine
• Episodes of unexplained vomiting without a clear headache — sometimes called 'abdominal migraine' or 'cyclical vomiting syndrome'

Gejala pada orang dewasa yang lebih tua

• New-onset migraines are less common in older adults, so any new severe headache should be evaluated by a doctor promptly
• Aura symptoms — such as visual disturbances — may occur without a headache, which is called 'migraine with aura' or 'silent migraine,' and is more common as people age
• The headache pain may be less intense than in younger years, but aura symptoms may persist or become more noticeable
• Migraine frequency often decreases after menopause in women
• Some medications commonly used in older adults can interact with migraine treatments, so specialist advice is especially important

Punca

Punca utama

• Migraine is caused by complex changes in brain chemistry and activity. During an attack, nerve pathways and chemicals in the brain are activated in an abnormal way, leading to inflammation (swelling) and pain signals being sent along the trigeminal nerve — the main nerve associated with head and face sensation.
• Changes in levels of serotonin — a chemical messenger in the brain — are thought to play a role in triggering migraine attacks.
• A spreading wave of electrical activity across the brain, called 'cortical spreading depression,' is believed to be responsible for aura symptoms.
• Genetic factors play a significant role — migraine tends to run in families, suggesting that some people are simply born with a nervous system that is more sensitive to triggers.

Faktor risiko

• Family history: having a parent or sibling with migraine significantly increases your risk
• Sex: women are more commonly affected, likely due to the influence of hormones such as oestrogen
• Hormonal changes: fluctuations around menstruation, pregnancy, or menopause can trigger or worsen migraines in women
• Age: migraines most often begin in the teens or twenties, though they can start at any age
• Stress: high levels of emotional or physical stress are one of the most commonly reported triggers
• Sleep disruption: too much or too little sleep, or irregular sleep patterns, can provoke attacks
• Skipping meals or fasting: going without food for long periods can trigger an attack in some people
• Dehydration: not drinking enough water is a well-recognised trigger
• Bright or flickering lights, loud noises, or strong smells
• Certain foods and drinks in some individuals — commonly cited ones include alcohol (especially red wine), caffeine (or caffeine withdrawal), and aged cheeses
• Weather changes, such as shifts in temperature or barometric pressure
• Overuse of pain-relieving medication, which can paradoxically lead to more frequent headaches — known as 'medication overuse headache'

Bila perlu berjumpa doktor

Jumpa doktor dengan segera jika:

• You experience your first-ever severe headache or one that feels dramatically different from any headache you have had before
• Your headache comes on suddenly and reaches its worst point within seconds or a couple of minutes
• You have a headache alongside fever, stiff neck, confusion, vision changes, weakness, or difficulty speaking
• Your migraine lasts more than 72 hours continuously
• You are having migraines much more frequently — for example, more than 15 days a month
• Your usual treatments are no longer helping at all

Buat temujanji rutin jika:

• You are having migraines regularly and they are affecting your daily life, work, or relationships
• You have never seen a doctor about your headaches and would like a proper diagnosis
• You are pregnant or planning to become pregnant and want advice on safe management
• You think your migraine triggers might be related to your menstrual cycle and want help managing hormonal migraines
• You feel your current treatment plan is not working well enough and you want to explore other options
• You are taking pain-relieving medication more than 10–15 days a month to manage headaches

Diagnosis

There is no single blood test or scan that can diagnose migraine on its own. Doctors diagnose migraine primarily by listening carefully to your symptoms and medical history. They will ask detailed questions about your headaches — how often they happen, what they feel like, how long they last, what seems to trigger them, and what helps. They will also carry out a physical and neurological examination (checking your reflexes, coordination, and vision) to rule out other causes. Because of this, keeping a headache diary before your appointment can be incredibly helpful. Note down the date, time, duration, severity, and any associated symptoms of each attack, as well as any possible triggers.

Ujian yang mungkin dilakukan

• Blood tests — not used to diagnose migraine directly, but may be done to rule out other conditions such as anaemia (low iron in the blood) or thyroid problems that can cause headaches
• MRI scan (Magnetic Resonance Imaging) — uses magnetic fields to create detailed pictures of the brain. This is not routinely needed for migraine, but your doctor may recommend it if your headaches are unusual, very severe, or do not respond to treatment, to make sure there is no other underlying cause
• CT scan (Computed Tomography) — a type of X-ray that creates cross-sectional images of the brain, sometimes used in emergency settings to rule out serious causes of sudden severe headache
• Lumbar puncture (spinal tap) — a procedure in which a small sample of fluid surrounding the brain and spine is taken. This is done in specific circumstances, such as when meningitis or bleeding around the brain is suspected
• Headache diary review — while not a medical test, a detailed diary completed by the patient is one of the most useful diagnostic tools available to both the patient and their doctor

Apa yang diharapkan semasa temujanji anda

Your first appointment will likely involve a thorough conversation about your headaches and general health. Your doctor will not rush to conclusions — getting the history right is the most important part. If your symptoms are clear and fit the recognised pattern of migraine, tests may not be needed. If there is any uncertainty, you may be referred for a scan or to a neurologist (a specialist in conditions of the nervous system and brain) for a more detailed assessment. The process is thorough and aimed at making sure you get the right diagnosis and the most helpful treatment plan.

Rawatan

There is no permanent cure for migraine, but treatments can significantly reduce how often attacks happen and how painful they are. Treatment falls into two broad categories: treatments taken during an attack to relieve pain and other symptoms, and preventive treatments taken regularly to reduce the frequency and severity of attacks. The right approach for you will depend on how often you get migraines, how severe they are, and how they affect your daily life. Your doctor will work with you to find the most effective and suitable plan.

Penjagaan diri di rumah

• Rest in a quiet, dark room during an attack — reducing exposure to light and sound can make a real difference to how you feel
• Apply a cold or warm compress to your forehead or neck — some people find cold packs more soothing, others prefer warmth; try both to see what works for you
• Stay hydrated by sipping water regularly — dehydration can worsen a migraine attack
• Try to sleep if possible — sleep often helps a migraine to pass more quickly
• Avoid strong smells, screens, and loud environments during an attack
• Keep a headache diary to identify your personal triggers — once you know what tends to set off your migraines, you can take steps to avoid or manage those triggers
• Practise stress management techniques regularly, such as deep breathing, mindfulness (a type of focused relaxation), or gentle yoga
• Maintain a consistent daily routine, including regular sleep and meal times — irregular patterns can provoke attacks
• Limit caffeine intake and try to avoid sudden changes in caffeine consumption, as both high intake and withdrawal can trigger migraines

Rawatan perubatan

Medical treatments for migraine fall into two main groups. The first group is 'acute' or 'abortive' treatments — these are taken at the start of or during a migraine attack to stop or shorten it. Common approaches include over-the-counter pain-relieving tablets (your pharmacist can advise on suitable options), anti-nausea medicines to help with sickness, and a class of prescription medicines specifically designed for migraine that work by targeting the cause of the attack rather than just the pain. The second group is 'preventive' treatments — taken regularly (often daily) even when you feel well, with the aim of reducing how often migraines happen and how severe they are. These include several types of prescription medications from different drug families, as well as newer injectable treatments that target specific proteins involved in migraine. Preventive treatment is usually considered when attacks are frequent, long-lasting, or significantly disruptive to daily life. Non-drug preventive options include acupuncture (a complementary therapy involving fine needles placed at specific points) and cognitive behavioural therapy (CBT), a type of talking therapy that helps manage the emotional impact of chronic pain. Your doctor will guide you through the options most appropriate for your situation.

Bila pembedahan dipertimbangkan?

Surgery is not a standard or recommended treatment for migraine. Occasionally, specific procedures such as nerve blocks (injections near certain nerves to reduce pain signals) may be used in specialist settings for difficult-to-treat cases, but these are carried out by specialists and are not routine. There is ongoing research into various interventional techniques, but for most people, the main treatments are medications and lifestyle changes.

Hidup dengan keadaan ini

Living with migraine can be challenging, especially when attacks are frequent or unpredictable. It may affect your ability to work, socialise, and care for your family. It is important to acknowledge that migraine is a real, recognised medical condition — not a sign of weakness or something to simply push through. On days when you feel well, planning ahead can help. Let close friends, family, or your employer know about your condition so they can support you when needed. Carrying any prescribed treatments with you, staying hydrated throughout the day, and protecting your sleep routine are all practical daily habits that can reduce the impact of migraine on your life.

Tip gaya hidup

• Aim for a consistent sleep schedule — going to bed and waking at the same time every day, including weekends
• Eat regular meals and avoid skipping meals, as drops in blood sugar can trigger attacks
• Stay well hydrated by drinking plenty of water throughout the day
• Limit alcohol, particularly drinks that are known personal triggers such as red wine
• Manage caffeine carefully — keep intake consistent and avoid sudden changes
• Identify and where possible reduce your personal stress triggers — this might involve changes at work, relationship support, or relaxation techniques
• Exercise regularly but build up gradually — very intense sudden exercise can trigger a migraine in some people, while regular moderate exercise (such as walking, swimming, or cycling) is generally beneficial
• Use sunglasses in bright light and consider blue-light filtering glasses if screen time is a trigger
• Consider wearing ear protection in very noisy environments if noise is a known trigger for you

Diet dan senaman

There is no single 'migraine diet,' but eating regular, balanced meals is important. Some people find that certain foods or drinks trigger their attacks, though triggers vary enormously between individuals — what affects one person may have no effect on another. Common food-related triggers reported by some people include alcohol (especially red wine), caffeine or caffeine withdrawal, aged cheeses, processed meats, and foods containing a natural compound called tyramine. Keeping a food and headache diary can help you spot patterns. Regular moderate-intensity exercise — activities that raise your heart rate gently, such as brisk walking, swimming, or cycling — is generally beneficial for migraine management. It can reduce stress, improve sleep, and support overall wellbeing. Try to warm up gradually, stay hydrated during exercise, and eat a small snack beforehand to avoid low blood sugar.

Kesihatan mental dan kesejahteraan emosi

Living with a chronic (long-term) condition like migraine can take a significant toll on mental health. Anxiety about when the next attack will strike, frustration at having to cancel plans, and the sheer exhaustion of frequent attacks can lead to feelings of depression, isolation, or hopelessness. These feelings are completely understandable and very common among people with migraine. It is important not to face this alone. Talking to your doctor about how migraine is affecting your mental wellbeing is a crucial part of getting the right support. Therapies such as cognitive behavioural therapy (CBT) can be particularly helpful for managing chronic pain and the emotional strain it brings. If you are ever feeling overwhelmed, please know that help is available — speaking to a mental health professional, a support group, or a helpline can make a real difference.

Pencegahan

Migraine cannot always be prevented entirely, but the frequency and severity of attacks can often be significantly reduced. The two main strategies are avoiding known personal triggers and taking preventive medical treatment if your doctor recommends it. Identifying your triggers through a headache diary is one of the most empowering steps you can take. Common modifiable triggers include poor sleep, dehydration, skipping meals, high stress, and excess caffeine. Preventive medications — taken regularly and as advised by your doctor — can reduce attack frequency by half or more for many people. Lifestyle measures such as regular exercise, consistent sleep, and stress management also play an important preventive role.

Vaksin

There are no vaccines for migraine.

Program saringan

There are no routine screening programmes for migraine. However, if headaches run in your family, or if you notice frequent, recurring headaches affecting your daily life, speaking to your doctor early is the best course of action.

Komplikasi

Jika tidak dirawat

• Chronic migraine — defined as having headaches on 15 or more days per month for more than three months — can develop if migraine is not properly managed
• Medication overuse headache (sometimes called 'rebound headache') — this occurs when pain-relief medicines are taken too frequently, paradoxically causing more headaches rather than fewer
• Status migrainosus — a rare but serious complication in which a migraine attack lasts longer than 72 hours continuously, requiring medical treatment
• Migrainous infarction — a very rare complication in which an aura symptom lasting more than an hour is associated with a small area of reduced blood flow in the brain. This is much rarer than commonly feared but is one reason why unusual or prolonged aura symptoms should always be reported to a doctor
• Significant impact on quality of life — including effects on work performance, relationships, and mental health — if attacks are frequent and left without adequate support or treatment

Pandangan jangka panjang

The outlook for most people with migraine is genuinely positive. With the right diagnosis, treatment plan, and lifestyle support, the vast majority of people are able to significantly reduce the number and severity of their attacks and lead full, active lives. Migraine also often naturally decreases in frequency with age — many people notice improvements after their forties or fifties, and women may find attacks reduce or stop after menopause. Research into migraine is growing rapidly, and new and more targeted treatments continue to become available. You are not alone in this, and effective help is available.

Cari sokongan

Organisasi antarabangsa

• Migraine Trust (International Resources Hub) ↗
• International Headache Society — Patient Resources ↗
• World Health Organization — Headache Disorders ↗

Organisasi tempatan

• The Migraine Trust ↗ · United Kingdom
• NHS — Migraine Information and Support ↗ · United Kingdom
• American Migraine Foundation ↗ · United States
• Migraine Canada ↗ · Canada
• Headache Australia ↗ · Australia

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