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Why Is Migraine Diagnosis Delayed?


"I've had headaches for years, but I didn't know they were Migraines." That statement is made frequently, often by people who have recently been diagnosed with Migraine.

Sometimes, that statement is made by people who hadn't been diagnosed with Migraine disease because they'd never told their doctors about their symptoms. Unfortunately, it's also made by people who have told their doctors about their symptoms, and their doctors either didn't give them a diagnosis or misdiagnosed them.

The question of why so much time elapses between the time someone starts having Migraines to the time they're diagnosed is one that researchers have been studying. A recent study took a good look at this issue.

The study:

Study objective:

"To investigate the factors involved in the delayed diagnosis of migraine without aura among patients attending a tertiary center for headache diagnosis and management."1

Study methods:

  • Researchers started with 200 consecutive patients seen in the headache center of the Polytechnic University of Marche – Department of Neuroscience (in Ancona, Italy) over a six-month period who were diagnosed for the first time with Migraine with aura, following International Headache Society ICHD-II criteria.
  • Any patients with migraine with aura, other primary headache disorders, secondary headache disorders, or medication overuse headache were excluded from the study.
  • Patients with incomplete medical history were also excluded.
  • Participants were interviewed about their Migraine history with questions including when their symptoms began, any specialists consulted previously (this means any type of specialist, not just Migraine specialists), laboratory test and imaging studies done previously, and standard questions to establish demographic and social characteristics.

Study results:

  • Study participants were divided into three groups based on the time elapsed from the first Migraine symptoms and the diagnosis of Migraine at their center:
    • Group I: Patients who had had Migraine symptoms for less than one year, 33 patients.
    • Group II: Patients who had had Migraine symptoms for more than five years, 60 patients.
    • Group III: Patients who had had Migraine symptoms for one to five years, 107 patients.
  • Participants who had seen at least one specialist were three times more likely to have undergone at least one diagnostic examination compared to those who had not seen a specialist.
  • Participants who had seen more than one specialist had correspondingly higher chances of having undergone diagnostic examinations.

Study conclusions:

"Our findings suggest an insufficient awareness of the diagnostic criteria of migraine by non-specialist physicians, who often prescribe expensive and unnecessary diagnostic investigations that do not alleviate patients’ symptoms while wasting health care resources."1

Summary and comments:

The results and conclusions of this study are, unfortunately, not surprising. Medical students are taught very little about Migraine during their years in medical school, and some are still being taught that Migraines are "vascular headaches." When medical school students are still being taught information that is so out-of-date, it's no wonder that too many doctors can't accurately diagnose Migraine.

This is a problem that patients can do little to solve. What patients must do is talk to their doctor about unexplained headaches and accompanying symptoms and, when their doctors can't diagnose or the diagnosis and treatment from their doctors doesn't work, seek care from an actual Migraine and headache specialist.



1 Viticchi, Giovanna, MD; Silvestrini, Mauro, MD; Falsetti, Lorenzo. MD; Lanciotti, Chiara. MD; Cerqua, Raffaella. MD; Luzzi, Simona, MD; Provinciali, Leandro, MD; Bartolini, Marco, MD. "Time Delay From Onset to Diagnosis of Migraine." Headache. Early Online. Accepted for publication August 3, 2010. doi: 10.1111/j.1526-4610.2010.01778.x.


Medical review by John Claude Krusz, PhD, MD


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© Teri Robert, 2010. Last updated November 15, 2010.


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