Updated September 10, 2014.

How many of us have wished our neurologist were a Migraineur or would have a severe headache so he or she would know how we feel? A new study shows that may be the case more often than we know.

In the past year, more than four of five Canadian and Mayo Clinic neurologists have had a headache, 50% have had a Migraine, according to a study presented at the 46th Annual Scientific Meeting of the American Headache Society (AHS).*

When it comes to head pain overall, neurologists are on par with the general population. But they're way ahead of the curve for Migraines. Does that mean treating headache and Migraine patients gives neurologists Migraines or that they opt to specialize in neurology because they suffer from Migraines?

Neither, believes the researcher. "A recent study demonstrated that for the vast majority of neurologists, having Migraines did not influence their decision to become a neurologist," said lead investigator Jonathan Gladstone, M.D., a headache fellow at the Mayo Clinic in Scottsdale, Arizona, and neurology resident at the University of Toronto. "Rather, neurologists are armed with more knowledge about headache types, and are better able to understand and appreciate the spectrum of Migraine. As a result, neurologists are better able to recognize that their own headaches are Migraines."

Yes, Dr. Gladstone is counted among the neurologists with Migraines - he gets them every once in a while. "For years, I believed I had ordinary 'tension-type' headaches, but once I began specializing in neurology, I was able to recognize they were indeed Migraines," he said.

In the study, 2 out of every 3 neurologists reported that they have had at least one Migraine in their lifetime. "We believe this indicates Migraines are much more common than previous general population studies have suggested," he said.

The study involved a questionnaire answered by 135 neurologists. As is the case in the general population, Dr. Gladstone found:

• Female neurologists were more likely to get Migraines than were male neurologists.
• Overall, 50% of neurologists who participated in the study said they had at least one Migraine in the past year:
  • 74% of the 27 female neurologists surveyed
  • and 44% of the 108 male neurologists.

Dr. Gladstone also looked at headache and Migraine in medical students and family doctors. While overall 92% of medical students and 82% of family physicians reported having a headache in the past year, they were less likely to report Migraines. Neurologists were almost twice as likely as family physicians, three times as likely as final-year medical students and five times as likely as first-year medical students to report having Migraine.

So, if family doctors and medical students were less likely to call their own headaches Migraine, what were they diagnosing themselves with? Family doctors were three times more likely than neurologists to report sinus headaches and medical students were 12 times more likely to report sinus headaches. Dr. Gladstone noted that while Migraine is under-recognized, under-diagnosed and under-treated in the general population, sinus headache is over-recognized, over-diagnosed and over-treated by non-neurologists. "Clearly, physicians share some of the responsibility for this," he said.

Dr. Gladstone believes having Migraines might make neurologists more empathetic to Migraineurs. "Often in the general population those with Migraine are stigmatized. People may assume that Migraineurs are 'complainers,' don't have good coping skills or that they are just using Migraines as an excuse to get out of obligations," he said. "In contrast, through either personal or work-related experience, neurologists recognize Migraines as a real neurobiological problem, and know how disabling they can be."

How do these neurologists treat their own Migraines? Overwhelmingly with medication:

• 96% treat themselves with over-the-counter medication including acetaminophen and non-steroidal anti-inflammatories (NSAIDS) such as ibuprofen and naproxen;
• 43% use prescription medication, including 31% who have used a triptan in the past year.

"While one-third of neurologists with Migraine have taken a triptan in the past year, less than one-fifth of Migraine sufferers in the general population have been prescribed a triptan," noted Dr. Gladstone. "Considering that neurologists utilize triptans to treat their own Migraines, clearly they believe these medications are generally safe and effective. This should give patients confidence that neurologists are practicing what they preach ... "Neurologists overwhelmingly indicated that when they get a Migraine they look for a fasting-acting, consistently effective and safe treatment, and they see non-steroidal anti-inflammatories and triptans as the most important first-line treatment options."

* Please watch for a follow-up to this article coming soon as I have an interview scheduled with Dr. Gladstone.

For a more detailed version of this article, please click HERE.
Some MIgraineurs have wished for this!
How many of us have wished our neurologist were a Migraineur or would have a severe headache so he or she would know how we feel? A new study shows that may be the case more often than we know.

In the past year, more than four of five Canadian and Mayo Clinic neurologists have had a headache, 50% have had a Migraine, according to a study presented at the 46th Annual Scientific Meeting of the American Headache Society (AHS).*

When it comes to head pain overall, neurologists are on par with the general population. But they're way ahead of the curve for Migraines. Does that mean treating headache and Migraine patients gives neurologists Migraines or that they opt to specialize in neurology because they suffer from Migraines?

Neither, believes the researcher. "A recent study demonstrated that for the vast majority of neurologists, having Migraines did not influence their decision to become a neurologist," said lead investigator Jonathan Gladstone, M.D., a headache fellow at the Mayo Clinic in Scottsdale, Arizona, and neurology resident at the University of Toronto. "Rather, neurologists are armed with more knowledge about headache types, and are better able to understand and appreciate the spectrum of Migraine. As a result, neurologists are better able to recognize that their own headaches are Migraines."

Yes, Dr. Gladstone is counted among the neurologists with Migraines - he gets them every once in a while. "For years, I believed I had ordinary 'tension-type' headaches, but once I began specializing in neurology, I was able to recognize they were indeed Migraines," he said. In the study, 2 out of every 3 neurologists reported that they have had at least one Migraine in their lifetime. "We believe this indicates Migraines are much more common than previous general population studies have suggested," he said.

The study involved a questionnaire answered by 135 neurologists. As is the case in the general population, Dr. Gladstone found:

• Female neurologists were more likely to get Migraines than were male neurologists.
• Overall, 50% of neurologists who participated in the study said they had at least one Migraine in the past year:
  • 74% of the 27 female neurologists surveyed
  • and 44% of the 108 male neurologists.

Dr. Gladstone also looked at headache and Migraine in medical students and family doctors. While overall 92% of medical students and 82% of family physicians reported having a headache in the past year, they were less likely to report Migraines. Neurologists were almost twice as likely as family physicians, three times as likely as final-year medical students and five times as likely as first-year medical students to report having Migraine.

So, if family doctors and medical students were less likely to call their own headaches Migraine, what were they diagnosing themselves with? Family doctors were three times more likely than neurologists to report sinus headaches and medical students were 12 times more likely to report sinus headaches. Dr. Gladstone noted that while Migraine is under-recognized, under-diagnosed and under-treated in the general population, sinus headache is over-recognized, over-diagnosed and over-treated by non-neurologists. "Clearly, physicians share some of the responsibility for this," he said.

Dr. Gladstone believes having Migraines might make neurologists more empathetic to Migraineurs. "Often in the general population those with Migraine are stigmatized. People may assume that Migraineurs are 'complainers,' don't have good coping skills or that they are just using Migraines as an excuse to get out of obligations," he said. "In contrast, through either personal or work-related experience, neurologists recognize Migraines as a real neurobiological problem, and know how disabling they can be."

How do these neurologists treat their own Migraines? Overwhelmingly with medication:

• 96% treat themselves with over-the-counter medication including acetaminophen and non-steroidal anti-inflammatories (NSAIDS) such as ibuprofen and naproxen;
• 43% use prescription medication, including 31% who have used a triptan in the past year.

"While one-third of neurologists with Migraine have taken a triptan in the past year, less than one-fifth of Migraine sufferers in the general population have been prescribed a triptan," noted Dr. Gladstone. "Considering that neurologists utilize triptans to treat their own Migraines, clearly they believe these medications are generally safe and effective. This should give patients confidence that neurologists are practicing what they preach ... "Neurologists overwhelmingly indicated that when they get a Migraine they look for a fasting-acting, consistently effective and safe treatment, and they see non-steroidal anti-inflammatories and triptans as the most important first-line treatment options."

* Please watch for a follow-up to this article coming soon as I have an interview scheduled with Dr. Gladstone.

For a more detailed version of this article, please click HERE.