title: When cervical pain is actually migraine: An observational study in 207 patients.
abstract: Introduction A large proportion of migraine patients remain undiagnosed or misdiagnosed in Italy. In our experience, many migraineurs self-diagnose their condition as "cervical pain attack" or "cervical pain syndrome" (CP), assuming cervical spine pathology as the cause. We aimed to phenotype and classify the headache of patients with self-diagnosed CP, and to describe this sample of patients. Methods Consecutive patients aged 18 to 75 years, referred to the Headache Center of the Mondino Institute (Pavia, Italy) for a first visit for headache, completed a questionnaire about CP and were subsequently examined by an experienced clinician. Results Out of 207 patients, 132 (64%) believed they suffered from CP. According to ICHD-IIIβ criteria, these patients suffered from migraine or probable migraine in 91% of cases. The great majority of patients who believed that they suffered from CP underwent unnecessary medical exams (including radiation exposure in 40% of cases) and used treatments that were inadequate for their real diagnosis. Conclusion The majority of patients with CP suffer from typical migraine. The misdiagnosis produces an economic burden (for patients and the health care system) and leads to impaired quality of life of patients.
authors.affiliation: 1 Headache Science Center, C. Mondino National Neurological Institute, Pavia, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Viana
authors.affiliation: 1 Headache Science Center, C. Mondino National Neurological Institute, Pavia, Italy.
authors.forename: Grazia
authors.initials: G
authors.lastname: Sances
authors.affiliation: 2 Università del Piemonte Orientale "A. Avogadro", Department of Pharmaceutical Sciences, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Terrazzino
authors.affiliation: 3 Department of Neurology, DKD HELIOS Klinik Wiesbaden, Germany.
authors.forename: Till
authors.initials: T
authors.lastname: Sprenger
authors.affiliation: 1 Headache Science Center, C. Mondino National Neurological Institute, Pavia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nappi
authors.affiliation: 1 Headache Science Center, C. Mondino National Neurological Institute, Pavia, Italy.|4 Deptartment of Brain and Behavioral Sciences, University of Pavia, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Tassorelli
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D019547:Neck Pain / Q000175:diagnosis* / Q000453:epidemiology*
keywords: Migraine; cervical pain; cervical spine; misdiagnosis; self-diagnosing; underdiagnosis