By Blake Miller
Medically Reviewed by Sanjai Sinha, MD
Migraine is the third most common illness in the world, affecting an estimated 39 million people in the United States alone, according to the Migraine Research Foundation. Despite its prevalence, more than half of all people who get migraines never receive a diagnosis for their condition — and among those who do, many of them never seek treatment for their symptoms.
“I’d have migraines a couple of times a week,” she says, “and sometimes they’d last several days. It was definitely a long process of trying to figure out how to treat them effectively.”
Durkin is not alone. Even though 25 percent of people who get migraines would benefit from a preventive treatment, according to the Migraine Research Foundation, a mere 12 percent actually get treated.
Here’s why so many people with chronic migraine are never diagnosed (or treated).
The process for diagnosing migraines can seem like an imperfect science. “There’s no test that we can administer that says a patient gets chronic migraines or doesn’t,” says Timothy Collins, MD, a neurologist and migraine specialist in the department of neurology at Duke University in Durham, North Carolina. Rather, doctors confirm a chronic migraine diagnosis by discussing your medical history and asking about your symptoms.
Not all migraines begin with a pounding headache. Migraine episodes are often accompanied by a variety of other symptoms, including nausea, vomiting, dizziness, and tingling in the extremities or face, all of which may easily be mistaken for other illnesses.
What’s more, it can be confusing to determine what qualifies as chronic migraine, says Dr. Collins, who says the condition is characterized by 15 or more headaches a month, with one or more being debilitating.
For example, some people may experience a few headaches per week, plus two to three major migraines a month, he says. But because not all their headaches are migraines, they don’t believe they have chronic migraine.
“Oftentimes, people don’t look at those less severe headaches as related to migraines,” he says. “They don’t realize they’re actually suffering from an illness and can seek medical treatment for it.”
For example, a study published in May 2016 in Headache: The Journal of Head and Face Pain found that only about 25 percent of people who sought medical care received a correct diagnosis of chronic migraine. Another study, published in 2013 in the Journal of Headache and Pain, found that more than 80 percent of people were misdiagnosed with sinusitis instead of migraine.
Because chronic migraine and sinus headache symptoms are similar, it can be difficult to determine the underlying cause, says Collins.
The key to making a correct diagnosis, he says, is a close examination of each symptom. Sinus headaches, for example, are generally located in your sinus area, while migraines can affect your whole head, one side of your head, or the back of your head, he says. Plus, migraines are often accompanied by a host of other symptoms, such as nausea and vomiting; and unlike sinus headaches, migraines are made worse with movement, light, and sound. “We have to really look hard at the details,” says Collins.
Migraine Specialists Can Be Hard to Find
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