Headache in the neurology clinic: a 2-year audit

Background Headache is the most common reason for referral to neurology outpatient clinics in Ireland and represents approximately 30% of all new appointments. Aim To evaluate diagnoses and outcomes of all patients newly referred with headache to a consultant neurologist at an Irish university teaching hospital over a 2-year period. Design A retrospective analysis and audit. Methods Data including patient demographics, red flags, investigations, diagnosis, and outcome were collected on consecutive patients newly referred with headache to a consultant neurologist's outpatient clinic over a 2-year period. Results Two hundred and seventy patients with headache were seen; 75% were women with mean age of 39 years. 89.26% (241/270) were diagnosed with a primary headache disorder alone; 4.44% (12/270) with a secondary headache disorder alone; 3.33% (9/270) with both a primary and secondary headache disorders; and 2.96% (8/270) with a painful cranial neuropathy. Migraine was the most common diagnosis, frequently associated with medication overuse. Non-attendance rates were high. Although imaging abnormalities were frequently found, on no occasion was it thought to be the cause of the headache. Conclusions Most patients referred to a neurology outpatient clinic with headache have a primary headache disorder. Alternate pathways should be considered to reduce the burden on Ireland's limited neurology resources without compromising patient safety.

Automated summary

The study found that most patients referred to neurology outpatient clinics with headaches have primary headache disorders, suggesting alternative pathways should be considered to reduce the burden on Ireland's limited neurology resources without compromising patient safety.