Do We Overdiagnose Migraine? A Prospective Study at Emergency Departments of Two Tertiary Care Hospitals

Taimoor Ashraf Khan, Muhammad Abdullah Zahid, Sheharyar Zameer, Umair Asif Siddiqi, Sheharyar Raashid, Fakhar Humayun

Abstract

Objective: To assess pathologies in patients previously diagnosed with migraine for their recurrent headache complaints, with an aim to uncover the misdiagnosis of migraine.
Study Design: Prospective cohort study.
Place and Duration of Study: The study was carried out at Emergency departments of Military Hospital and Combined Military Hospital, Rawalpindi Pakistan from April 2018 to February 2019.
Materials and Methods: This study is a prospective cohort study. Raosoft was used for sample size calculation. Non-probability convenient sampling technique was used. All patients included in the study were diagnosed as a case of migraine by a Medical Specialist /Neurologist and were already on treatment protocols for migraine. All patients with additional CNS pathology were excluded from this study. The data analysis was done using IBM SPSS for Windows version 25.  Categorical Data was presented as percentages and frequencies.
Results: One hundred thorty one patients participated in the study. The subjects ranged from 19 to 51 years of age with 32% males and 68% females. Seventy seven of those patients reported more than 4 acute attacks of headache per 6 months which compelled them to visit their nearest ER. The participants were divided according to possible causes after reassessment. Other causes included Hypertrophied Nasal Turbinates, DNS, Frontal Sinusitis, Septal Spur, TMJ disorders, Maxillary Sinusitis, Pansinusitis and Post Herpetic Neuralgia. After managing their acute attack in the ER, the patients were referred to various departments for respective treatment protocols. After 6 months of follow-up, 54.7% of the patients reported a reduction in visits to the ER for acute episodes of headache.
Conclusion: There is an increased tendency to label and treat patients with any headache as migraine which results in the administration of unnecessary analgesia which may have serious effects on health.

Keywords:  Headaches, Migraine, Misdiagnose.

How to cite this: Khan TA, Zahid MA, Zameer S, Siddiqi UA, Raashid S, Humayun F .  Do We Overdiagnose Migraine? A Prospective Study at Emergency Departments of Two Tertiary Care Hospitals. Life and Science. 2023; 4(1): 9-13 .  doi: http://doi.org/10.37185/LnS.1.1.234

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