August 29, 2008
Migraines Common For Military Personnel
Condition underdiagnosed, mistreated
Two new studies show that migraine headaches are very common among U.S. military personnel, yet the condition is frequently underdiagnosed. The studies, appearing in Headache, the peer-reviewed journal of the American Headache Society, examine the incidence among soldiers within 10 days of returning from a 1-year combat tour in Iraq , as well as U.S. Army officer trainees.The U.S. active-duty military population is composed chiefly of young adults, which is the age group at highest risk for migraine. However, the reported rates are higher than those of similar age and gender in the general U.S. population.
The findings show that 19 percent of soldiers returning from Iraq screened positive for migraine and an additional 17 percent screened positive for possible migraine. Soldiers with a positive migraine screen suffered a mean average of 3.1 headache days per month, headache durations of 5.2 hours and 2.4 impaired duty days per month due to headache. Soldiers with migraine contacted 3 months after returning from Iraq had a mean of 5.3 headache days per month.
18 percent of U.S. Army officer trainees experienced migraine headaches over a 1-year period (13.9 percent for males, 31.4 percent for females) and, of those, 50 percent experienced migraines during a 5-week period of intensive military training. Migraine headaches were found to significantly impede training in 4 percent of all cadets during this time. 76 percent of cadets who screened positive for migraine had never been diagnosed.
Military personnel are likely to encounter numerous physiological and psychological factors that are known to precipitate migraine attacks and exacerbate migraine disorder. The factors include disrupted sleep and meal patterns, fatigue, psychological stress, emotional strain, heat, noise and other environmental exposures. The effects of migraine have specific consequences for military personnel in that migraine can impair their ability to function and may result in soldiers being non-deployable or discharged from military service.
Migraine is frequently incapacitating, however if it is properly diagnosed and treated the ill effects of migraine can be reduced or eliminated. The findings show, however, that there is a low utilization rate of triptans, which are first line agents for treating acute migraine among this population. 75 percent of the soldiers with migraine used over-the-counter analgesics and only 4 percent used triptans.
"Our hope is that this research will improve the screening process for migraine in soldiers and increase education about migraine for soldiers and their health-care providers. U.S. military personnel should receive the best health care available, and improving the diagnosis and treatment of migraine will likely improve soldier's personal and professional functioning," say Erek K Helseth M.D. and Captain Brett J. Theeler M.D., lead authors of the two studies.
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