Which diagnostic tests for migraine headache may be unnecessary according to the American Headache Society's Choosing Wisely recommendations?

Updated: Oct 21, 2019
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

The American Headache Society released a list of 5 commonly performed tests or procedures that are not always necessary in the treatment of migraine and headache, as part of the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely campaign. The recommendations include: [2, 3]

  • Don't perform neuroimaging studies in patients with stable headaches that meet criteria for migraine.

  • Don't perform computed tomography (CT) imaging for headache when magnetic resonance imaging (MRI) is available, except in emergency settings.

  • Don't recommend surgical deactivation of migraine trigger points outside of a clinical trial.

  • Don't prescribe opioid or butalbital-containing medications as first-line treatment for recurrent headache disorders.

  • Don't recommend prolonged or frequent use of over-the-counter (OTC) pain medications for headache.


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