Are Two Head(ache)s Better Than One
Consequences of Diagnosing Migraine and Occipital Neuralgia
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Migraine is a common and debilitating condition that virtually all neurology clinicians see regardless of specialty. In a recent systematic review of the US adult population, 20.7% of women and 9.7% of men experience a migraine attack over a 3-month period. Migraine also disproportionately affects those with limited access to health care including the unemployed and those with lower family incomes.1 The World Health Organization studies global burden of disease (GBD) to inform health decision making. In 2016, the GBD for all diseases worldwide found that tension-type headache was the third most prevalent and migraine the sixth. In terms of years of life lived with disability, migraine ranked second globally.2 Given these statistics, it is not surprising that migraine is costly. A 2018 study found that patients with migraine had total annual direct costs (health care) plus indirect costs (missed work and short- and long-term disability) that were $8924 higher than those of demographically similar individuals without evidence of migraine.3 What these data do not capture is the impact on career trajectory, family involvement, interpersonal relationships, and identity, which is likely to be much greater.
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Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
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