Let’s Talk Migraine Misdiagnosis
By: Brooklyn A. Bradley, BS; Medically edited by Dr. Deena Kuruvilla, MD
Migraine is a common and debilitating condition that affects millions of people worldwide. However, accurate diagnosis of migraine is not simple, and there are many individuals who are misdiagnosed.. Understanding the causes, consequences, and potential solutions of migraine misdiagnosis is vital to ensure that patients experiencing migraine are receiving the appropriate care and treatment. . In today’s blog post, we will dive deeper into migraine misdiagnosis and the potential steps we can take to improve the process of migraine diagnosis.
Many individuals who experience migraine symptoms are often misdiagnosed. As a result, they may experience inadequate treatment and unnecessary suffering. It is important to understand that migraine is more than just a severe headache. Migraine is characterized by a wide variety of symptoms that can be unique to each patient, and even vary from one migraine episode to the next.
Migraine is often attributed to genetic factors, changes in blood flow within the brain, and abnormalities in the activity of the brain. Factors such as stress, hormonal changes, certain foods, and environmental factors can trigger migraine. In terms of pain quality, headache pain is usually described as a constant dull ache. It can range from mild to moderate in intensity and often affects both sides of the head [2]. For migraine, the pain is typically moderate to severe and is often described as pulsating or throbbing. It typically will affect one side of the head and may be accompanied by additional symptoms such as nausea, sensitivity to light and sound, and vomiting.
These symptoms are not unique to migraine, and can overlap with other medical conditions. Thus, it can be challenging for healthcare providers to distinguish migraine from other headache types or neurological disorders. For example, migraine may cause facial pain and pressure around the eyes and forehead in addition to severe head pain. These symptoms are often misdiagnosed as sinusitis, especially when there is sinus-related discomfort. According to a 2013 study involving a total of 130 migraine patients, 81.5% of these patients were misdiagnosed as sinusitis [3]. In addition, a multicentre study conducted across seven countries found that out of 1161 patients, 64% called their migraine a “headache,” and only 28% of patients were aware that they suffered from migraine [4].
The consequences of migraine misdiagnosis can be dangerous to a patient’s health and quality of life. These consequences include delayed treatment, decreased quality of life, ineffective medications, and financial burden. Patients may be spending a considerable amount of time and effort to find the correct diagnosis and treatment plan.
Improving the accuracy of migraine diagnosis is essential to ensure that patients receive appropriate treatment, care, and support for their condition. While it is not always possible to eradicate misdiagnosis entirely due to the complexity of migraine symptoms and presentation, there are some steps that can help reduce the likelihood of misdiagnosis. Patients should provide their healthcare team with a comprehensive medical history, including a detailed description of their symptoms, frequency, duration, and any triggers or patterns that they have observed. For example, patients can maintain a headache diary to track this information. Having an open line of communication with providers is helpful as patients should feel comfortable discussing their condition openly. In addition, consulting specialists or seeking a second opinion can be especially helpful when a migraine diagnosis is uncertain.
In conclusion, migraine misdiagnosis is a common challenge that can be a burden for patients. By working towards improved communication between patients and providers, in addition to further knowledge on migraine as a disease, we can reduce the likelihood of misdiagnosis and ensure that individuals experiencing migraine receive the appropriate care and support they need.
References:
- (2022) Migraine vs. Headache: How to Tell the Difference. https://www.pennmedicine.org/updates/blogs/health-and-wellness/2019/november/migraines-vs-headaches. Accessed 24 Oct 2023
- Is It a Migraine or Headache? In: Temple Health. https://www.templehealth.org/about/blog/is-it-migraine-or-headache. Accessed 24 Oct 2023
- Al-Hashel JY, Ahmed SF, Alroughani R, Goadsby PJ (2013) Migraine misdiagnosis as a sinusitis, a delay that can last for many years. J Headache Pain 14:97. https://doi.org/10.1186/1129-2377-14-97
- Viana M, Khaliq F, Zecca C, et al (2020) Poor patient awareness and frequent misdiagnosis of migraine: findings from a large transcontinental cohort. Eur J Neurol 27:536–541. https://doi.org/10.1111/ene.14098