What are the advanced preventive therapies for migraine?

1. GRP monoclonal antibodies: These are the first medications specifically designed to prevent migraines. Administered as a monthly self-injection, they block the CGRP receptor, effectively "shielding" the brain from pain signals. 2. Botulinum toxin (Botox) therapy: For chronic sufferers, precise injections around the head and neck can paralyse the nerve endings that lead to pain, providing relief for up to 12 weeks. 3. Neuromodulation devices: Wearable technology, such as Cefaly or gammaCore, uses mild electrical stimulation to "train" the trigeminal nerve, raising the brain’s threshold against future attacks. 4. Preventive nutraceuticals: High-dose magnesium, riboflavin (Vitamin B2), and coenzyme Q10 are often prescribed as a natural first-line preventive layer.

What are the environmental and lifestyle that trigger migraine?

1. The "weekend headache": Sudden changes in sleep patterns or caffeine withdrawal on Saturdays can trigger "let-down" migraines. 2. Thermal stress: Moving frequently between Singapore’s extreme outdoor humidity and highly air-conditioned offices. 3. Dietary "hidden" triggers: Nitrates in processed meats and MSG in certain hawker dishes can act as neuro-stimulants. 4.Digital fatigue: Prolonged exposure to blue light from screens, common in Singapore’s tech-heavy workforce.

How to manage and relief migraine?

Identifying and avoiding migraine triggers: Even though migraines may occur even without a trigger, recognising and avoiding known triggers may reduce the frequency of migraines occurring. Taking medication to treat attacks: Off-the-counter painkillers may be effective in reducing the intensity and duration of migraine attacks. You should take them when needed, or under the advice of your doctor, as these medications may have side effects. Resting: Finding a quiet and dark room to rest in at the start of a migraine attack may reduce its intensity. This can be combined with medication to improve your symptoms. Regularly exercising: Regular exercise reduces stress and tension, which contributes to reducing the frequency of migraines. Aerobic exercise, in particular, may be beneficial. Maintaining a regular routine: Eating at regular timings and sticking to regular sleeping hours may reduce the frequency of migraines.

Migraine Prevention: Desnsitising the brain and identifying triggers

Q: What are the symptoms for migraine?

The headache may start from only side of the head and may gradually spread to both sides. It could possibly affect both sides at the same time. Other symptoms, such as nausea, vomiting, sensitivity to certain lights, sounds, and sometimes smells and touch may also accompany the headache. Engaging in simple activities such as walking, may even worsen the pain. Some people may experience an aura before or during a migraine attack. It is a sensory disturbance that develops and disappears gradually, usually lasting up to an hour. The aura may include: 1. Seeing various shapes 2. Change / loss of vision 3. Tingling sensation in your limbs 4. Seeing flickering and flashing spots of light 5. Difficulty in speech

Stopping the pain before it starts

In today’s fast-paced environment, a migraine is often dismissed as “just a headache”. However, for the 10 per cent of Singaporeans living with this neurological condition, the reality involves debilitating pain, sensory sensitivity, and significant “down-time”. The modern medical consensus has shifted: we no longer wait for an attack to occur. Instead, the focus is now on Migraine Prevention, desensitising the brain and identifying triggers to reclaim your quality of life.

The science of the “migraine brain”

A migraine is not just a symptom. It is a state of neuronal hyperexcitability. In a “migraine brain”, the threshold for reacting to external stimuli is lowered. When triggered, the brain releases Calcitonin Gene-Related Peptide (CGRP), a protein that causes inflammation and dilation of the blood vessels around the brain.

Preventive care aims to keep this CGRP level stable. By adopting a “Preventive First” mindset, patients can move from chronic migraine (15+ days a month) to Episodic Migraine, and eventually to long-term remission.

Identifying environmental and lifestyle triggers

Prevention begins with awareness. In our tropical, urban context, certain local factors are high-risk triggers.

The “weekend headache”: Sudden changes in sleep patterns or caffeine withdrawal on Saturdays can trigger “let-down” migraines.
Thermal stress: Moving frequently between Singapore’s extreme outdoor humidity and highly air-conditioned offices.
Dietary “hidden” triggers: Nitrates in processed meats and MSG in certain hawker dishes can act as neuro-stimulants.
Digital fatigue: Prolonged exposure to blue light from screens, common in Singapore’s tech-heavy workforce.

Symptoms of migraines

The headache may start from only side of the head and may gradually spread to both sides. It could possibly affect both sides at the same time. Other symptoms, such as nausea, vomiting, sensitivity to certain lights, sounds, and sometimes smells and touch may also accompany the headache. Engaging in simple activities such as walking, may even worsen the pain.

Some people may experience an aura before or during a migraine attack. It is a sensory disturbance that develops and disappears gradually, usually lasting up to an hour. The aura may include:

Seeing various shapes
Change / loss of vision
Tingling sensation in your limbs
Seeing flickering and flashing spots of light
Difficulty in speech

Management and relief

Identifying and avoiding migraine triggers: Even though migraines may occur even without a trigger, recognising and avoiding known triggers may reduce the frequency of migraines occurring
Taking medication to treat attacks: Off-the-counter painkillers may be effective in reducing the intensity and duration of migraine attacks. You should take them when needed, or under the advice of your doctor, as these medications may have side effects
Resting: Finding a quiet and dark room to rest in at the start of a migraine attack may reduce its intensity. This can be combined with medication to improve your symptoms
Regularly exercising: Regular exercise reduces stress and tension, which contributes to reducing the frequency of migraines. Aerobic exercise, in particular, may be beneficial
Maintaining a regular routine: Eating at regular timings and sticking to regular sleeping hours may reduce the frequency of migraines

Advanced preventive therapies at Raffles Neuroscience Centre

For individuals whose lives are disrupted more than twice a month, or those who find standard painkillers ineffective, our specialists at Raffles Neuroscience Centre offer several preventive options.

CGRP monoclonal antibodies: These are the first medications specifically designed to prevent migraines. Administered as a monthly self-injection, they block the CGRP receptor, effectively “shielding” the brain from pain signals.
Botulinum toxin (Botox) therapy: For chronic sufferers, precise injections around the head and neck can paralyse the nerve endings that lead to pain, providing relief for up to 12 weeks.
Neuromodulation devices: Wearable technology, such as Cefaly or gammaCore, uses mild electrical stimulation to “train” the trigeminal nerve, raising the brain’s threshold against future attacks.
Preventive nutraceuticals: High-dose magnesium, riboflavin (Vitamin B2), and coenzyme Q10 are often prescribed as a natural first-line preventive layer.

Why early intervention matters

Ignoring frequent migraines can lead to “central sensitisation”, where the nervous system becomes permanently wound up, making the pain harder to treat over time.

Early consultation allows for a structured Headache Diary analysis and the creation of a bespoke migraine action plan. This proactive approach reduces the reliance on “rescue” painkillers, which, if overused, can lead to medication overuse headaches, a secondary condition that complicates recovery.

Your journey to relief: From primary care to specialist excellence

At Raffles Medical Group, we provide a seamless, integrated pathway for migraine management.

Step 1: Enrol in Healthier SG with Raffles Medical

Start your journey at any of our island-wide clinics. By enrolling in Healthier SG (HSG), your family doctor acts as your first line of defence. They will help you track triggers, manage lifestyle adjustments, and provide subsidised first-line preventive medications.

Step 2: Specialist care at Raffles Neuroscience Centre

If your migraines remain frequent or severe, your HSG doctor provides a direct and seamless referral to our neurologists at Raffles Neuroscience Centre. Here, you will have access to advanced diagnostics and the latest biologic and neuromodulation therapies tailored to complex cases.

Take charge of your health today. Enrol in Healthier SG via the HealthHub app and choose Raffles Medical, or schedule a specialist consultation at Raffles Neuroscience Centre to develop your long-term prevention plan.

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