Understanding Migraine Burden and Underdiagnosis

In the first video of the series, PA Christina Lindemann examines the burden of migraine and why it remains widely underdiagnosed. She highlights the scope of migraine, the complexity of its presentation, and the factors that can delay recognition in clinical practice.

PA Lindemann also explores migraine’s impact on daily life—from functioning and fatigue to stigma and emotional strain—and emphasizes the important role PAs can play in recognizing symptoms earlier and improving care.

Key Takeaways:

Migraine is a very common neurologic disorder; however, it is underdiagnosed.
Migraine has a substantial impact on patient quality of life.
Individuals with migraine experience bias and stigma which increases disease burden.

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Speaker

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Christina Lindemann, MSPAS, PA-C

References and Additional Resources:

Law HZ, Chung MH, Nissan G, Janis JE, et al. Hospital burden of migraine in United States adults: A 15-year national inpatient sample analysis. Plast Reconstr Surg Glob Open. 2020;8(4):e2790. https://pmc.ncbi.nlm.nih.gov/articles/PMC7209847/

Lipton RB, Nicholson RA, Reed ML, et al. Diagnosis, consultation, treatment, and impact of migraine in the US: Results of the OVERCOME (US) study. Headache. 2022;62(2):122-140. https://pmc.ncbi.nlm.nih.gov/articles/PMC9305407/

Lipton RB, Munjal S, Alam A, et al. Migraine in America Symptoms and Treatment (MAST) study: Baseline study methods, treatment patterns, and gender differences. Headache. 2018;58(9):1408-1426. https://pubmed.ncbi.nlm.nih.gov/30341895/

Bron C, Sutherland HG, Griffiths LR. Exploring the hereditary nature of migraine. Neuropsychiatri Dis Treat. 2021; 17:1183-1194. https://pmc.ncbi.nlm.nih.gov/articles/PMC8075356/

Martin VT, Feoktistov A, Solomon GD. A rational approach to migraine diagnosis and management in primary care. Ann Med. 2021;53(1):1979-1990. https://pmc.ncbi.nlm.nih.gov/articles/PMC8567924/

Al-Hashel JY, Ahmed SF, Alroughani R, et al. Migraine misdiagnosis as a sinusitis, a delay that can last for many years. J Headache Pain. 2013;14(1):97. https://pmc.ncbi.nlm.nih.gov/articles/PMC4028747/

Gibbs SN, Shah S, Deshpande CG, et al. United States patients’ perspective of living with migraine: Country-specific results from the global “My Migraine Voice” survey. Headache. 2020;60(7):1351-1364. https://pubmed.ncbi.nlm.nih.gov/32369201/

Martelletti P. The journey from genetic predisposition to medication overuse headache to its acquisition as sequela of chronic migraine. J Headache Pain. 2018;19(1):2. https://pubmed.ncbi.nlm.nih.gov/29322261/

Buse DC, Fanning KM, Reed ML, et al. Life with migraine: Effects on relationships, career, and finances from the Chronic Migraine Epidemiology and Outcomes (CaMEO) study. Headache. 2019;59(8):1286-1299. https://pubmed.ncbi.nlm.nih.gov/31407321/

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Christina Lindemann, MSPAS, PA-C

Christina Lindemann is a board-certified physician associate specializing in neurology and headache medicine. She received her Bachelor of Science in neuroscience from the University of Minnesota in 2016 and Master of Science in Physician Assistant Studies from the University of Wisconsin – La Crosse – Gundersen – Mayo PA Program in 2019.

Following graduation from PA school, she built a clinical foundation for medical and procedural management of headache disorders working in neurology at Mayo Clinic. She later transitioned to the UC San Diego Health Headache Center in 2021, where she continues to treat patients with complex headache disorders, including migraine. She has an additional interest in education, authoring papers on headache disorders, presenting CME lectures on headache management, and precepting students.