PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of jnnpsycJournal of Neurology, Neurosurgery and PsychiatryCurrent TOCInstructions for authors
 
J Neurol Neurosurg Psychiatry. Aug 2005; 76(8): 1170–1172.
PMCID: PMC1739753
Ability of a nurse specialist to diagnose simple headache disorders compared with consultant neurologists
C Clarke, J Edwards, D Nicholl, A Sivaguru, P Davies, and C Wiskin
Academic Department of Neurology, University of Birmingham and Department of Neurology, Sandwell, UK. c.e.clarke/at/bham.ac.uk
Abstract
Methods: An experienced neurology ward sister was trained in the differential diagnosis of headache disorders. Over six months, patients with non-acute headache disorders and role players trained to present with benign or sinister headaches were seen by both the nurse and a consultant neurologist. Both reached independent diagnoses of various headache disorders.
Results: Consultants diagnosed 239 patients with tension-type headache (47%), migraine (39%), or other headache disorders (14%). The nurse agreed with the consultant in 92% of cases of tension-type headache, 91% of migraine, and 61% of other diagnoses. Where the nurse did not agree with the diagnosis, most would have been referred for a consultant opinion. Both the nurse and the doctors misdiagnosed the same three of 13 role players. The investigation rate of the consultants varied between 18% and 59%. Only one clinically relevant abnormality was found on head scans and this was strongly suspected clinically.
Conclusions: A headache nurse specialist can be trained to diagnose tension-type headache and migraine. A nationwide nurse led diagnostic headache service could lead to substantial reduction in neurology waiting times.
Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of
BMJ Group