• Huanxian Liu, Ming Dong, Kaiming Liu, Zhihua Jia, Wei Gui, Yingying Cheng, Yudan Lv, Kang Qu, Hongru Zhao, Jianjun Chen, Dan Zhang, Zhiliang Fan, Xiaosu Yang, Dongmei Hu, Hongyan Xie, Mingxin Li, Bing Wen, Sufen Chen, Peng Xu, Qingqing Rong, Qiu He, Zhanxiu Ren, Fanhong Yan, Heling Zhao, Min Chen, Tingmin Yu, Hongli Qu, Xingkai An, Huailian Guo, Xinhua Zhang, Xiaoping Pan, Xiaojuan Wang, Shi Qiu, Lvming Zhang, Hongling Zhao, Xin Pan, Qi Wan, Lanyun Yan, Jing Liu, Zhe Yu, Mingjie Zhang, Ye Ran, Xun Han, Shengyuan Yu, and Zhao Dong.
• Department of Neurology, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China.
• J Headache Pain. 2023 Sep 1; 24 (1): 119119.

BackgroundHeadache disorders are widely prevalent and pose a considerable economic burden on individuals and society. Globally, misdiagnosis and inadequate treatment of primary headache disorders remain significant challenges, impeding the effective management of such conditions. Despite advancements in headache management over the last decade, a need for comprehensive evaluations of the status of primary headache disorders in China regarding diagnosis and preventative treatments persists.MethodsIn the present study, we analyzed the established queries in the Survey of Fibromyalgia Comorbidity with Headache (SEARCH), focusing on previous diagnoses and preventative treatment regimens for primary headache disorders. This cross-sectional study encompassed adults diagnosed with primary headache disorders who sought treatment at 23 hospitals across China between September 2020 to May 2021.ResultsThe study comprised 2,868 participants who were systematically examined. Migraine and tension-type headaches (TTH) constituted a majority of the primary headache disorders, accounting for 74.1% (2,124/2,868) and 23.3% (668/2,868) of the participants, respectively. Medication overuse headache (MOH) affected 8.1% (231/2,868) of individuals with primary headache disorders. Over half of the individuals with primary headache disorders (56.6%, 1,624/2,868) remained undiagnosed. The previously correct diagnosis rates for migraine, TTH, TACs, and MOH were 27.3% (580/2,124), 8.1% (54/668), 23.2% (13/56), and 3.5% (8/231), respectively. The misdiagnosis of "Nervous headache" was found to be the most prevalent among individuals with migraine (9.9%, 211/2,124), TTH (10.0%, 67/668), trigeminal autonomic cephalalgias (TACs) (17.9%, 10/56), and other primary headache disorders (10.0%, 2/20) respectively. Only a minor proportion of individuals with migraine (16.5%, 77/468) and TTH (4.7%, 2/43) had received preventive medication before participating in the study.ConclusionsWhile there has been progress made in the rate of correct diagnosis of primary headache disorders in China compared to a decade ago, the prevalence of misdiagnosis and inadequate treatment of primary headaches remains a veritable issue. As such, focused efforts are essential to augment the diagnosis and preventive treatment measures related to primary headache disorders in the future.© 2023. Springer-Verlag Italia S.r.l., part of Springer Nature.

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