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DrGreene Content
Even though migraines are quite common, they often go undiagnosed and under-treated for years. A technique called ID migraine is a simple set of three questions that can be a powerful way to detect migraines according to a study in the August 12, 2003 Neurology. Hundreds of headache sufferers were asked nine questions. Three of the questions turned out to be the most powerful at getting to the diagnosis. Is there nausea? Is there sensitivity to light? Do the headaches limit your ability to work, study, or do what you want to do? The people in the study were then evaluated by a neurologist for a formal diagnosis. In this study, 81 percent of those diagnosed with migraines had answered at least 2 of these ID questions "yes". And 75 percent of those who answered at least two questions yes turned out to have migraines. Adding more questions to the survey, including questions about auras, did not further improve the accuracy of the screening tool. This study included both older adolescents and adults, but did not include pre-pubertal children. The power of the simple questions was consistent across all ages tested. Although we won’t know until a similar childhood study is done, I expect the same three questions would be useful in children -- perhaps even more so, because nausea is even more common in childhood migraines. For children, though, I would also add a question about family history. About 90 percent of children with common migraines have a family history of migraines, especially on the mother’s side of the family. Even though most young children with migraines will outgrow them by the 10th birthday, all those with migraines deserve to have them identified and treated. These headaches can usually be quieted or prevented.
Alan Greene MD FAAP
Orginally published: August 19, 2003
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