Schmerz. 1999 Jun; 13(3): 196-200.

[Migraine costs and success of non-medicamentous therapy procedures. Relation of diagnostic measures]

Gendolla A, Pageler L, Diener HC.

Klinik und Poliklinik für Neurologie Universität, GH Essen.

BACKGROUND: Migraine is a common neurological disorder (16% women, 6% men) associated with high direct and indirect costs. We evaluated the diagnostic and paramedical therapeutic measures by estimating the expenditure per patient and the effect of treatment. METHODS: A questionnaire was sent to 1000 patients attending the Essen outpatient headache centre in 1995. A total of 293 patients responded, of whom 165 were eligible and could be evaluated. Patients were asked to report diagnostic tests, paramedical treatments applied, average duration of success (defined as meaningfuly reduction in migraine frequency) and costs of paramedical therapy. RESULTS: Paramedical methods of therapy most frequently used were acupuncture, special pads, relaxation methods and herbal therapy. A total of 579 (3.5 on average) diagnostic procedures such as brain or cervical spine CT and MRI or EEG was performed. The average cost for acupuncture was $&emsp14;465, while the success was maintained for 3.2 months. $&emsp14;1510 was spent on psychotherapy, which was successful for 1.7 months. Patients spent $&emsp14;93 for relaxation methods, achieving migraine relief for 7.4 months. CONCLUSION: Paramedical treatments lack scientific proof, while both acute and prophylactic treatment strategies have been successfully tested in many clinical trials. Paramedical treatment shows a good temporally effect in individual patients.