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Tension-type headache - tension headache
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Tension-type headache - tension headache

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BRAIN & NERVOUS SYSTEM
Pain

Tension-type headache typically causes pain that radiates
in a band-like fashion bilaterally from the forehead to the occiput.

 

Most Doctor Visits for Headache Due to Migraine

The overwhelming majority of people who visit their primary care physician complaining of episodic headache have migraine, but an inaccurate patient self-diagnosis can lead physicians to misdiagnose.

Dr. Stewart J. Tepper of The New England Center for Headache in Stamford, Connecticut, reported an analysis of findings from the 14-country, multicenter Landmark Study, which enrolled 1,217 patients attending a primary care physician with a complaint of headache.

At the beginning of the study, each patient made a self-diagnosis, and was given a diagnosis by their doctor. They then kept diaries for each of their next six headache attacks.

The diaries of around 400 patients with newly diagnosed migraine or non-migraine headache were reviewed by the researchers. The panel assigned a diagnosis based on International Headache Society criteria. Ninety-four percent had either migraine or migrainous headaches.

If a patient comes in and complains of episodic migraine and exam's normal -- it's migraine until proven otherwise.

The expert panel then looked at the correlation between the primary care physician's diagnosis, the patient's self-diagnosis and the diagnosis based on the analysis of the six diary entries.

If the GP diagnosed the patient as having migraine then 98% of the time the GP was correct. If the patient diagnosed themselves as having migraine, there was a high chance they were right.

However, where things went awry was if primary care doctors diagnosed non-migraine. Then there was an 80% likelihood the patient had migraine. If the patients self-diagnosed non-migraine, there was an 85% likelihood the patient had migraine.

Several factors were linked to the misdiagnosis, but the biggest driver seemed to be an inaccurate self-diagnosis by the patient.

If the patient said to the GP, 'I don't think I've got migraine,' then the GP would say OK. It didn't seem to matter about the intensity of the headache or the frequency of the headache, it was what the patient said the headache was that drove the diagnosis.

Only migraine was commonly severe enough to make people visit their doctor. We know there are many, many hurdles for patients to get to the doctor and then to get the message across, so what we're saying here is that tension-type headache is not severe enough to make people go and see their doctor and jump those initial hurdles.

If someone comes in and says that they're having problems with their headaches, probably one of the first questions you should ask is, are these headaches ones that stop you doing things? Does it actually affect your quality of life? If the answer is yes, they're liable to be migraine.

Tension-type headache - tension headache > 1 > 2 > 3 > 4

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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Last Modified : 03/15/08 02:25 AM