Primary headache care delivery by nonspecialists in Brazil

Headaches are common disorders usually examined by nonneurologists. In orde r to assess how primary headache patients (IHS groups 1, 2, and 3) are gene rally managed by nonspecialists, 414 patients were asked about their previo us headache care. Correct diagnosis had previously been made in only 44.9%, 6.7%, and 26.7% of the migraine, tension-type headache, and cluster headac he patients, respectively. The patients underwent 501 investigative procedu res motivated by the headache, averaging 1.21 examinations per patient, mos tly EEGs. Preventive treatment was largely overlooked irrespective of the h eadache type. It is concluded that scientific improvements in headache care may be ineffective unless educational programs improve headache knowledge in general.