Migraine Misdiagnosis: Why Doctors Get it Wrong

January 30, 2013 | By UM Staff
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Migraine Misdiagnosis

While statistics show that migraines go undiagnosed and untreated in at least half of all sufferers, there are no concrete statistics showing how often migraines are misdiagnosed. The results of many studies do indicate that misdiagnosis is very common. There are many reasons for the frequent misdiagnosis of migraines.

Symptoms Similar to Other Illnesses

Many symptoms of migraine can be symptoms of other headache disorders or even completely unrelated illnesses. For example, approximately 9 out of 10 migraineurs with sinus pain and congestion are misdiagnosed as having a sinus headache. This can also work in reverse, and people have been diagnosed as having migraines when in reality they suffer from an unrelated condition.

Migraine misdiagnosis in children is extremely typical. In many cases, headaches are attributed to other causes such as anxiety or lack of sleep. Children may not even get an actual headache but suffer from abdominal pain instead.

People who have overused pain relievers, particularly narcotics, may cause medication overuse headaches. This can lead to more frequent and more severe headaches that can be misdiagnosed as a migraine disorder.

Variety of Frequency, Severity and Duration

Frequency of migraines can vary from a few times per year to multiple times per month. The severity of pain can be moderate to excruciating and the duration of a migraine can be as little as four hours up to several days. These wide variations make an accurate migraine diagnosis difficult.

No Definitive Testing

Less than a third of migraineurs experience the 'aura' associated with classic migraines which makes diagnosis easier. Diagnostic tests are non-existent so testing that is done can only rule out other conditions.

Inaccurate Self-Reporting

Self-reporting of headache history and symptoms is the most important key to obtaining an accurate diagnosis for migraines. Family history of headaches is also a factor that should be mentioned.

Keeping a headache diary for one to three months can help a sufferer get the right diagnosis the first time. Things that should be noted include any triggers prior to the event, symptoms that occur before the onset of pain, what type of pain, how severe the pain is, how long the headache lasts and any other symptoms that co-occur, such as nausea or light sensitivity. Any treatments such as pain relievers should also be noted.

In most cases, the longer period of reporting is best as it can indicate patterns. This can not only help with reaching a diagnosis, but also in establishing the best course of treatment or preventative action.

Inexperience of Doctors

There are few true migraine specialists so most people end up going to their regular doctor about their headaches or in some cases, the emergency room. All too often, migraineurs are told they have a different type of headache, such as a tension or sinus headache. Sometimes, sufferers are told they should seek psychological help for anxiety or depression.

According to the Migraine Awareness Group, more than 60 percent of migraineurs report having a bad experience with a doctor. Many do not pursue further diagnosis or treatment for fear of reliving that negative experience.







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