Abstract Details

Title Diagnostic Delay in Patients Prior to Being Seen in Headache Clinic

Topic Headache

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-024

Objective

The objective of this study was to analyze time to diagnosis in patients presenting to a headache clinic.

Background Studies have identified barriers to treatment of headache patients including limited access to headache specialists. A high number of patients referred to the university headache clinic have chronic migraine (CM) and medication overuse headache (MOH). Our concern is that diagnoses of migraine, especially CM and MOH, are missed and specific treatments are not offered. We therefore decided to evaluate new referrals to headache clinic to identify those with no previous specific diagnosis, estimate the duration of delay, and who had seen them previously.

Design/Methods All new patients referred to our university headache clinic complete a detailed patient intake questionnaire prior to their first visit. Since August 2017 the database we have added a “New Diagnosis” category into our headache database. Clinicians. All patients are seen face-to-face by the headache providers, who collect information about previous diagnoses and treatments, and diagnose headache disorders using the ICHD-3 criteria. The diagnosis is entered by the headache provider and note of new diagnosis is made if the diagnosis was not previously established by another provider

Results 521 out of 775 (67%) patients had a new diagnosis. The main missed diagnosis included Chronic Migraine 380 patients (73.8%), episodic migraine (80, 15%), migraine with aura (39, 7.6%), cluster (3, 06%), hemicrania continue 4 0.8%, cervicogenic 31, 6%, posttraumatic 41, 8%, MOH 299, 58.1%. 50% of the patients receiving new diagnoses from the Headache clinic were seen previously by other neurologists.

Conclusions The headache clinic identified new diagnoses in 67% of patients most commonly missed diagnosis was chronic migraine and episodic migraine. As misdiagnosis of headache subtype impedes effective treatment, further education and awareness of ICHD-3 criteria are necessary.

Authors/Disclosures
PRESENTER	No disclosure on file
Melissa Schorn, ARNP, DNP (MedNorthwest)	No disclosure on file
	No disclosure on file
	No disclosure on file
Daniel Krashin, MD (Seattle VA)	Dr. Krashin has nothing to disclose.
Natalia Murinova, MD, FAAN (University Of Washington)	Dr. Murinova has nothing to disclose.

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