Instrumental investigations and migraine diagnosis

Migraine diagnosis is based on clinical parameters. Before reaching a correct diagnosis, patients usually consult a large number of specialists and perform unhelpful exams. This represents a significant problem for an optimization of healthy resources. Our aim in this study was to evaluate the relationship between time interval from symptoms' onset to a correct diagnosis and number and type of clinical and instrumental investigations. We considered 180 consecutive patients referred to our Headache Center who obtained the first diagnosis of migraine without aura. Most patients were referred to our center by general practitioners (80%). Previously, about half of patients consulted a specialist not involved in migraine management. In 68% of cases, patients performed radiological and/or laboratory exams. Time from symptom onset to a correct diagnosis of migraine was less than 1 year in only 16.7% of the cases. In 83.3% of patients, the time delay overcame 1 year. In 53.3%, it reached 5 or more years. The time interval to obtain a correct diagnosis significantly influenced the number of specialists consulted and the number of radiological and laboratory investigations performed. Our findings confirm the presence of problems in migraine management. In particular, expensive and unnecessary visits and exams are very often prescribed. This inappropriate procedure could be easily counteracted by a correct application of diagnostic criteria for migraine.