What medical information should be shared during an appointment evaluating for migraine?
Reviewing all other diagnoses (comorbidities) and symptoms, even if you think they are unrelated, is an important part of first meetings with your doctor. This will help ensure accurate diagnosis of migraine or other conditions to ensure that your future treatment is as effective as possible.
“Importantly, you want to know if there's any other diagnosis. Firstly, neurological, and secondarily, whether the patient has any other major medical problems. I say this because, for instance, I saw a patient who gave a very good history of migraine. Just before the end of the interview she said, ‘I have these spells.’ I said, ‘What?’ ‘I have these spells.’ ‘What are they like?’ She said, ‘A feeling of not being there.’ I said, ‘Oh, that's very Canadian,’ but
anyway to make a long story short, I asked her husband, ‘Do you see these spells?’ He said, ‘No, I don't see anything.’ Well I ordered a test called an EEG, or brainwave test, and she clearly had seizures throughout her entire testing. Guess what? She had migraine and seizures all encompassed in the same history. Patients don't read textbooks. They're not required to follow the guidelines, we are. They can say whatever they want. It's really important, when something doesn't fit, when something is atypical, that you go into the history even more, and more, and more. I hate to go on about this, but the biggest mistakes that I see, or have made in my own career, are an inadequate time to take a good history. Because in neurology everything is in the history.”
Allan Purdy, MD
Professor of Neurology
Dalhousie University, Canada
Dr. Allan Purdy is a neurologist and a professor at Dalhousie University in Nova Scotia, Canada. Dr. Purdy is currently President of the American Headache Society. He has also served as president of the Canadian Headache Society and on the Board of Directors for the International Headache Society.
Dr. Purdy is regarded as one of the most gifted teachers in the field, developing educational programs for physicians around the world who care for patients with headache diseases. In addition to his research and education work, Dr. Purdy continues to see headache patients in his Canadian clinic on a part-time basis.