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.

14th Migraine Trust International Symposium London September 24, 2002

Dr. Mercola's Comments:

Migraine headache pain can be quite severe and is one of only a few pains that can be so severe that some patients will actually consider suicide as a reasonable alternative.

Of course, the traditional medical paradigm focuses on the use of drugs to resolve this problem, but there are far better solutions. Drugs will never address the cause of the problem.

Most people experience dramatic improvement after adopting the eating plan I promote. Most migraines seem to have a food based reaction relating to wheat, dairy, sugar, or artificial preservatives or chemicals. Eliminating these foods and incorporating the other eating plan measures, frequently improves migraines.

Generally there is a 70-80% reduction in the frequency and intensity of the pain after following the eating plan. Headaches are very common problems for many people who see me the first visit, but the vast majority of people who return in one month for their follow-up visit tell me that their headaches are gone.

If additional improvement is required, I recommend psychological acupressure tools like EFT. This technique focuses the attention on the cause of the stress, rather than just treating the pain. The new EFT videos are available and have been significantly updated and improved so you can learn to use this method on your own. We also have a free manual that is an additional guide to coincide with the videos or use on its own. I have also provided an EFT referral page to locate a clinician near you.

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