13 Apr 2006
My head is exploding (ST, 9 April 06)


DIANNE Elizabeth Mathews needs someone to be with her each time she leaves her home. The Singaporean has fainted in public several times because of the unbearable pain from migraine, which has dogged her since her early teens.

There are various types of headaches - from tension-type ones, which are the most common, to the severest form, migraine.

The pain can be above the eyes or ears, behind the head, or in the back of the upper neck.

'Your head feels like a construction site - it keeps pounding and throbbing. You feel like pulling your hair out,' says Ms Mathews of a typical attack.

Dr Charles Siow, a consultant neurologist of the National Neuroscience Institute, says headaches are very prevalent here, with an estimated 360,000 sufferers, or one in 10 Singaporeans. About 50,000 to 60,000 people have chronic migraine every day.

Dr Siow, who set up a headache clinic in the Singapore General Hospital in 2003, says it sees about 180 to 200 patients each month.

While the number of patients has risen since the clinic was opened, he says this could be due to a greater awareness for headache and migraine treatments.

Dr Siow, who is president of the Singapore Headache Society, gave a talk on managing migraines to women in their 20s and 30s at a forum yesterday. Held annually, the SingHealth Women's Forum is in its third year.

Migraine tends to affect more women than men because of differences in genetic make-up. They experience hormonal changes each month and these are believed to trigger migraine attacks.

Dr Chan Yee Cheun, a consultant neurologist at National University Hospital, says people whose family members have migraine are more likely to be affected, too.

Sufferers might experience visual auras such as flashes of light, zig-zag lines, blind spots or blurred vision. In very rare instances, migraine is known to cause loss of vision.

But severe attacks can be very disabling since 'symptoms can interfere with work or even confine patients to bed', says Dr Chan.

Indeed, Ms Mathews, who is single and in her 40s, quit her job as a regional manager at a marketing company six years ago. While she used to love travelling, she has not stepped out of the country since 2000.

She says that before she consulted Dr Siow in 2003, she was always on pain medication, starting off with Panadol. She gradually progressed to stronger medicines like Cafergot. Her treatment now includes medication and injection.

Now, she has only seven to 10 bad days a month, instead of at least 20 in the past. 'The injection helps me tide over a longer period of time.'

The headache clinic has psychologists, psychiatrists, physiotherapists and occupational therapists to help migraine patients who experience depression, anxiety and seizures.

From the traditional Chinese medicine point of view, migraine tends to be sparked by strong emotions, says Dr Jennifer Seow, a physician at Sinchong Meheco.

While medications are short-term solutions to relieving the pain, she recommends counselling to find out what triggers the attack.

Dr Chan advises sufferers to avoid any known triggers which could include too much or too little sleep, hunger, alcohol, environmental changes, stress or physical exertion.

Though migraine may not be cured completely, sufferers can learn to manage the condition by seeking medical help like Ms Mathews.

While she used to be a very active person, sports is very much restricted now. But she can go out for a movie with friends. 'Now, I have a semblance of a normal life.'