Objective: To compare the ability of a headache nurse specialist and consultant neurologists in diagnosing tensiontype headache and migraine. Methods: An experienced neurology ward sister was trained in the differen...Objective: To compare the ability of a headache nurse specialist and consultant neurologists in diagnosing tensiontype headache and migraine. Methods: An experienced neurology ward sister was trained in the differential diagnosis of headache disorders. Over six months, patients with nonacute headache disorders and role players trained to present with benign or sinister headaches were seen by both the nurse and a consultant neurologist. Both reached independent diagnoses of various headache disorders. Results: Consultants diagnosed 239 patients with tensiontype headache (47%), migraine (39%), or other headache disorders (14%). The nurse agreed with the consultant in 92%of cases of tensiontype headache, 91%of migraine, and 61%of other diagnoses. Where the nurse did not agree with the diagnosis, most would have been referred for a consultant opinion. Both the nurse and the doctors misdiagnosed the same three of 13 role players. The investigation rate of the consultants varied between 18%and 59%. Only one clinically relevant abnormality was found on head scans and this was strongly suspected clinically. Conclusions: A headache nurse specialist can be trained to diagnose tensiontype headache and migraine. A nationwide nurse led diagnostic headache service could lead to substantial reduction in neurology waiting times.展开更多
文摘Objective: To compare the ability of a headache nurse specialist and consultant neurologists in diagnosing tensiontype headache and migraine. Methods: An experienced neurology ward sister was trained in the differential diagnosis of headache disorders. Over six months, patients with nonacute headache disorders and role players trained to present with benign or sinister headaches were seen by both the nurse and a consultant neurologist. Both reached independent diagnoses of various headache disorders. Results: Consultants diagnosed 239 patients with tensiontype headache (47%), migraine (39%), or other headache disorders (14%). The nurse agreed with the consultant in 92%of cases of tensiontype headache, 91%of migraine, and 61%of other diagnoses. Where the nurse did not agree with the diagnosis, most would have been referred for a consultant opinion. Both the nurse and the doctors misdiagnosed the same three of 13 role players. The investigation rate of the consultants varied between 18%and 59%. Only one clinically relevant abnormality was found on head scans and this was strongly suspected clinically. Conclusions: A headache nurse specialist can be trained to diagnose tensiontype headache and migraine. A nationwide nurse led diagnostic headache service could lead to substantial reduction in neurology waiting times.
