Throb! Throb! Throb!It’s a Pain

By Annie Freeda Cruez

“OH no, not tonight, dear. I’ve got a headache.” And you had better believe it. ANNIE FREEDA CRUEZ looks at some figures and talks to an expert about an ailment that afflicts many Malaysians.

A study of the causes, distribution, and control of disease shows Malaysian women suffer more than men from a lifetime prevalence of headaches, especially migraine and tension-type headaches.

For women, the lifetime prevalence is 99 per cent for headaches of any kind, 25 per cent for migraine and 88 per cent for tension headaches.

For men, the lifetime prevalence is 93 per cent for headaches of any kind, eight per cent for migraine and 69 per cent for tension headaches.

The men and women who suffer from headaches and migraine make up more than 14 per cent of all patients encountered in a survey among neurology practice in Malaysia.

Malaysians take medical leave mostly because of severe headaches, especially migraine.

Narayanan Krishnan, 42, has been suffering from migraine for the past 15 years, and each time it hits him, the pain is unbearable.

“Sometimes, I felt like banging my head against the wall,” said the clerk.

“I just can’t take the excruciating pain in the back of my head. I take two 1,000mg painkiller tablets to deaden the pain. Sometimes, even these don’t help.”

Narayanan said he used to tie a bandana around his head when he got a migraine.

“When it strikes, I need to be in a quiet, dark place. I need to sleep or throw up. Only then will I feel better.”

Narayanan sometimes suffers from blurred vision when he gets a migraine, which occurs at least three or four times a month.

Every year, some 8,400 patients seek treatment for headaches at the Neurological Department of Kuala Lumpur Hospital.

They are 60 per cent of the 14,000 patients who visit the hospital each year.

Dr Julia Shahnaz Merican, president of the Headache Society of Malaysia, said the most frequent diagnoses are migraine and tension headaches, other migraine variants and cluster headaches.

“More common diagnoses include headaches caused by infections and those caused by nose, nasal, paranasal, sinus, otic, dental and ophthalmic disorders.”

Consultant neurologist Dr Shahnaz’s mother suffered from migraines for more than 40 years, and so Dr Shahnaz said she has “first-hand experience helping to deal and alleviate these headaches”.

She said migraine is a common primary headache disorder affecting two to 15 per cent of the world population and is placed in the top 20 diseases causing disability.

Lost time from school, work, social activity and productivity are among the consequences of disability.

She added that migraine affects 15 per cent of women and six per cent of men.

Prevalence can vary with age, and is at the highest between ages 25 to 55 years for both males and females.

Dr Shahnaz said the majority of headaches were benign, with studies showing only about one per cent were a symptom of underlying serious pathology.

With more and more Malaysians suffering from headaches, especially migraine and tension headaches, primary care physicians have been advised to determine whether the presenting symptoms are part of a primary headache disorder or signs of another illness (secondary headache).

“An accurate diagnosis, in which the individual headache episode is distinguished from a primary disorder or from a secondary headache, is essential to plan any necessary investigations and form a management plan,” she said.

A migraine is more than a headache. The throbbing pain of a migraine, which typically occurs on one side of the head, is often accompanied by nausea, vomiting and extreme sensitivity to light and sound.

Symptoms may include nasal stuffiness, blurry vision, diarrhoea, abdominal cramps, abnormal sensations of heat or cold, anxiety, depression, irritability and an inability to stay focused.

Migraine sufferers have long been cautioned to avoid certain foods believed to bring on attacks, especially chocolate, alcohol (red wine in particular) and aged cheese. But the evidence supporting this notion is meagre.

(c) 2007 New Straits Times. Provided by ProQuest Information and Learning. All rights Reserved.