Migraine Among Neurologists and Headache Specialists

Key Takeaways:

• Increased prevalence of migraine has been reported in neurologists and headache specialists.

• Possible causes of higher reported prevalence of migraine in neurologists and headache specialists are underdiagnosis in the general population and occupational stress that causes migraine in susceptible individuals.

This transcript has been edited for clarity.

I have had migraines since my teens but did not go into neurology because of migraine. Over the years, I found it interesting how often other neurologist colleagues seemed to have migraine, so we did a nationwide study of neurologists finding a greatly increased 1-year and lifetime prevalence compared to the general population as follows: males, 34.7%, 46.6%; and females 58.1% and 62.8%.^[1] When I was standing by this poster at AAN, neurologists from all over the world would smile at me, reach into their pocket, and show me their acute medication. Our study has been replicated in many other countries including Australia, Canada, France, Germany, Italy, New Zealand, Norway, Portugal, Spain, Taiwan, and the United Kingdom.

As a headache specialist, it seemed that migraine was especially common among my headache colleagues, which was also correct. We did a nationwide survey of headache specialists finding that even more have migraine than neurologists.^[2] The lifetime prevalence of episodic migraine was 69.5% (85.7% in females and 60.5% in males) and 13.6% for chronic migraine (19% for females and 10.5% for males). 

The cause of the increased prevalence is not certain. One possibility is that migraine is underdiagnosed in the general population as neurologists and headache specialists can accurately diagnose their own.^[3] Another possibility is that people go into neurology because of their own history of migraine but the evidence does not support this for most.^[4] A third is that occupational stress may cause migraine in susceptible individuals. Finally, most neurologists self-treat their own acute migraines.^[5]