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Headache vs Migraine

Pain in the head is one of the most common complaints among people especially in the developed world. While some people experience headaches, others encounter a more severe form of headache known as migraines. However, most people are not quite aware of the difference between them.

The key to getting the right diagnosis, and hence the right treatment, would depend on the amount of information you provide to your healthcare provider. As such, it is important not to miss out details that may seem trivial when you are seeing a doctor, such as medications or nutritional supplements that you are taking, or whether you are ‘seeing things’ (aura) prior to your headache.

Not all headaches are normal chemical reactions in the brain caused by triggering factors. Some headaches can be a sign of more serious diseases and should be checked by a doctor, sometimes immediately as they could be signs of a stroke, meningitis or encephalitis which are fatal.
Look out for these signs and seek medical advice when you or a loved one experience them when having a headache:

  • Sudden and drastic headache
  • Fainting
  • Confusion and difficulty understanding
  • Fever of 39° C to 40° C
  • Numbness or weakness on one side
  • Stiff neck
  • Loss of vision and balance
  • Slurred speech
  • Trouble walking or moving arms and legs
  • Nausea or vomiting
  • Memory loss
  • Redness in one eye
  • Recent head injury

Keeping a Headache Diary

If you are having headaches or migraines frequently, having a diary to record the symptoms can help you determine the triggers so that you can avoid future attacks. They also serve as a medical history for your doctor during consultancy.

Below is an example of a headache diary. Over time, you may notice a distinctive trend in your diary postings whether in the food, hours of sleep, stress factors or emotional distress, which will help you recognise triggers and seek long-term prevention methods.


8 April 2014



Duration of Headache

2 hours

What You Ate in Last 24 Hours

Roti canai, banana leaf rice, fried noodles

Hours of Sleep The Night Before


Stress Factors

Heavy rain, traffic jam

What Were You Doing or Thinking Before Headache

Started PND project presentation


Painkiller, sleep

Headache Diary Example



Pain or discomfort in the head, scalp and neck

Affects one side of the head, usually near the temples, forehead and eyes. Often accompanied by nausea, vomiting, and sensitivity to light

Most headaches are not serious and can be treated with pharmacy remedies and lifestyle changes, such as getting more rest and drinking more water

The symptoms may last from four hours to three days if untreated. Severe migraine affects the quality of life as sufferers are unable to function as normal

Can be categorised into two types:
1) Primary headaches, which are not linked to other underlying health problems
2) Secondary headaches, which are caused by a certain illness

When a migraine attack happens, patients become very sensitive to light, sound, or mild exertion, such as walking or climbing the stairs

Primary headaches are divided into tension headaches and cluster headaches. Each has different causes and effects

Migraines can be triggered by certain foods, stress, hormonal change, anxiety, lack of sleep and rest, even weather changes

The most common causes of primary headaches
Include emotional or work stress, excessive alcohol, lack of sleep, depression, skipping meals and dehydration.

Dietary habits such as fasting, dieting or skipping
meals, and certain foods such as fermented foods (cheese, processed meats), alcohol, food additives, can cause a migraine attack

Secondary headaches may result from excessive
alcohol consumption, a head injury or concussion, cold, flu, allergic reaction or sinusitis

Some people get aura migraines, where they
experience an aura about 20 minutes to an hour before the migraine begins. They may have blurry vision or blind spots, or see flashing lights, wavy lines, or dots

Rebound headaches (recurring headaches) may occur from overuse of painkillers (taking of pain medication more than 3 days a week on a regular basis). These may also be called medication overuse headaches

Migraines are more common among women and is believed to run in families


Hormonal changes in women caused by contraceptive use, menopause and menstrual period can also cause headaches

Migraines are linked to epilepsy, depression, asthma, anxiety, stroke, and other neurologic and hereditary disorders. Frequent migraines need to be checked to rule out these conditions

Some people may carry genes that make them more
likely to develop primary headaches caused by
chemical activity in the brain, the nerves or blood vessels of your head outside your skull, or muscles of your head and neck

The brain has a migraine “pain center” or generator. Migraines happens when hyperactive nerve cells
send out impulses to the blood vessels, causing them to constrict and dilate. This releases hormones called prostaglandins, serotonin, and other inflammatory substances that causes the throbbing pain in the head

Most headaches are not serious and are temporary in nature. However, do see a doctor if your headache:

  • Are becoming more frequent and severe
  • Becomes worse or does not change with medications
  • Affects your work, sleep or other day-to-day activities
  • Causes you distress and you would like to control it better

When having a migraine, try these tips:

  • Rest in a quiet, dark room
  • If you have vomited, drink some water to avoid getting dehydrated
  • Sipping some warm tea may help
  • Close your eyes and place a damp cloth on forehead
  • Practise breathing or any relaxation techniques that can help you relax and control the pain
  • Take any medications prescribed by your doctor
Article by:
Dr Fariz Sazadilla

Health Screening Doctor