Three common mistakes in treating the headache patient

Three of the most common mistakes in treating patients with migraine are: 1) taking an inadequate history and thereby missing the diagnosis or not acknowledging thee patient's concerns; 2) allowing the patient to overuse or misuse medication; and 3) failing to prepare the patient for a longterm course of treatment. The key to preventing or correcting each of these mistakes is establishing, as early as possible, a close physician-patient partnership for treatment. Such a partnership develops during the thorough initial patient interview, general examination, and screening neurologic assessment - at which time fears of serious organic disease can be addressed. In order to convince the patient of the practitioner's interest in his or her headache problem, one must elicit clinical details while listening to issues of disability, social support, and quality of life. This partnership forms the basis for ongoing patient education on proper medication use and realistic treatment expectations. Only when the patient becomes an active partner in ongoing therapy can the best outcomes be achieved.