Volume 15 Supplement 1
EHMTI-0035. "Cervical pain" study in an Italian tertiary referral headache center
© Viana et al; licensee Springer. 2014
Published: 18 September 2014
The majority of migraine patients remain undiagnosed or misdiagnosed in Italy (Cevoli et al. 2009). In our experience, many patients affected by migraine self-diagnose it as 'cervical pain syndrome' (CP) assuming cervical spine pathology as the cause.
To phenotype and classify, in a tertiary referral headache center, the headache types of patients with self-diagnosed CP, and to describe this sample of patients.
All patients aged 18 to 75yo, referred to Mondino Headache Center for a first visit for headache, completed a questionnaire about CP. A detailed history was taken and a neurological exam was performed in each patient. Brain and cervical imaging were performed when deemed necessary. All patients finally received a diagnosis based on ICHD-IIIβ criteria.
85 patients completed the questionnaire: 47 were suffering from self-diagnosed CP, 3 had suffered from self-diagnosed CP, 35 never had self-diagnosed CP. In all of 50 CP descriptions, the pain involved the head. ICHD-IIIβ diagnoses included migraine without aura (n=30), migraine with aura (1), probable migraine without aura (n=4), chronic migraine (n=7), medication overuse headache/chronic migraine (n=5), tension type headache (n=2), hemicrania continua (n=1), no patient presented with a phenotype suggestive of cervicogenic headache. 24 out of 50 patients with CP answered the question 'who did tell you that these attacks are CP?' with: general practitioner/medical specialist. The majority of these patients underwent exams without a clear indication and ineffective treatment.
To the best of our knowledge, this is the first study that systemically assessed the headache phenotype of patients with self-diagnosed CP. The results suggest that the phenomenon of self-diagnosing CP is very common in Italy, even in patients referred to a tertiary headache center. The majority of these patients suffer from typical migraine attacks, without any evidence of pathological conditions of the cervical spine.
No conflict of interest.
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