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Abstract Details

Fear of Brain Tumor in Patients with Migraine in an Academic Headache Clinic
Headache
P9 - Poster Session 9 (5:30 PM-6:30 PM)
15-001
Migraine is a functional brain disorder, with symptoms including pain, nausea, photophobia and phonophobia. Many patients report fear of brain cancer associated with their symptoms. This was first noted by Blau in 1984, with 28% of patients reporting this concern. Few studies have subsequently evaluated this consideration. In our practice we encounter this often, in spite of previously normal imaging via CT or MRI.  
Our objective was to analyze self-reported fear of brain tumor and related symptoms in migraineurs presenting to a university-based tertiary care headache clinic. 
All new patients at a tertiary headache clinic completed an intake questionnaire prior to their first visit. Questions regarding their medical concerns were included in the questionnaire.  
Of 7293 headache patients, 5198 were diagnosed with migraine (3885 chronic, 1313 episodic). Of the 726 (9.9%) patients who reported a fear of tumor, 70.4% were diagnosed with migraine, 55.7% reported prior brain imaging (MRI or CT), and 39.8% reported receiving the results of their imaging. Additionally, of patients with a fear of tumor and prior imaging, 35.8% reported anxious mood and 21.3% report depressed mood.  

We find many patients with migraine headache endorse a fear of tumor/cancer despite normal exam and imaging. This unaddressed fear may contribute to the burden of depressive and anxiety symptoms in this population. The ongoing fear in this population may be due to inadequate explanation of imaging or limited medical understanding. 

 

Comorbid conditions associated with fear, such as anxiety and depression need to be addressed. They are associated with increased pain perception and decreased treatment efficacy and satisfaction. We conclude that it is important to address the fear of tumor/cancer in this population and to avoid assumptions about patient’s medical literacy and understanding of “normal” imaging. 

Authors/Disclosures
Derek J. Notch, MD (CHPG Neuroscience)
PRESENTER
Dr. Notch has nothing to disclose.
Daniel Krashin, MD (Seattle VA) Dr. Krashin has nothing to disclose.
Ami Zarrillo Cuneo, MD (University of Washington) Dr. Cuneo has nothing to disclose.
Sau Mui Chan-Goh Sau Mui Chan-Goh has nothing to disclose.
Marcel Budica Marcel Budica has nothing to disclose.
Natalia Murinova, MD, FAAN (University Of Washington) Dr. Murinova has nothing to disclose.