A retrospective, epidemiological review of hemiplegic migraines in a military population

Brian A. Moore, Willie J. Hale, Paul S. Nabity, Tyler R. Koehn, Donald McGeary, Alan L. Peterson

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Introduction: Headaches are one of the world's most common disabling conditions. They are alsoboth highly prevalent and debilitating among military personnel and can have a significant impact on fitness forduty. Hemiplegic migraines are an uncommon, yet severely incapacitating, subtype of migraine with aura for whichthere has been a significant increase amongst US military personnel over the past decade. To date, there has notbeen a scientific report on hemiplegic migraine in United States military personnel. Materials and Methods: The aimof this study was to provide an overview of hemiplegic migraine, to analyze data on the incidence of hemiplegicmigraine in US military service members, and to evaluate demographic factors associated with hemiplegic migrainediagnoses. First time diagnoses of hemiplegic migraine were extracted from the Defense Medical EpidemiologicalDatabase according to ICD-9 and ICD-10 codes for hemiplegic migraine. One sample Chi-Square goodness of fittests were conducted on weighted demographic samples to determine whether significant proportional differencesexisted between gender, age, military grade, service component, race, and marital status. Results: From 1997 to2007 there were no cases of hemiplegic migraine recorded in the Defense Medical Epidemiological Database.However, from 2008 to 2017 there was a significant increase in the number of initial diagnoses of hemiplegic migraine,from 4 in 2008 to a high of 101 in 2016. From 2008 to 2017, 597 new cases of hemiplegic migraine were reportedamong US military service members. Disproportional incidence of hemiplegic migraine was observed for gender,X2 (1, 597) = 297.37, p <.001, age, X2 (5, 597) = 62.60, p <.001, service component, X2 (3, 597) = 31.48, p <.001, paygrade X2 (3, 597) = 57.96, p <.001, and race, X2 (2, 597) = 37.32, p <.001, but not for marital status X2(1, 597) = 2.57, p >.05. Conclusion: Over the past decade, there has been a significant increase in the number ofinitial diagnoses of hemiplegic migraine in Active Duty United States military personnel. Based on these diagnosisrates, there is evidence to suggest that hemiplegic migraine has a higher incidence and prevalence rate among post9/11 service members of the United States military as compared to the general population. Given the sudden increasein new patients diagnosed with hemiplegic migraine in the past decade, the global prevalence estimates of hemiplegicmigraine should be reconsidered. Additionally, the impact of hemiplegic migraine on service member's duties andresponsibilities deserves further consideration.

Original languageEnglish (US)
Pages (from-to)781-787
Number of pages7
JournalMilitary medicine
Volume184
Issue number11-12
DOIs
StatePublished - Nov 1 2019

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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