Classification of Chronic Daily Headache by International Headache Society Criteria: Limits and New Proposals

Cephalalgia ◽  
1995 ◽  
Vol 15 (1) ◽  
pp. 37-43 ◽  
Author(s):  
GC Manzoni ◽  
F Granella ◽  
G Sandrini ◽  
A Cavallini ◽  
C Zanferrari ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Chronic Daily Headache ◽  
International Headache Society ◽  
Tension Type Headache ◽  
Clear Cut ◽  
Ihs Classification ◽  
Daily Headache ◽  
Type Headache ◽  
Headache Centres

We conducted a retrospective study of 150 patients with chronic daily headache (CDH) to determine how to categorize their headache according to the classification of the International Headache Society (IHS). All patients were first evaluated at Parma and Pavia Headache Centres (from January 1992 to March 1993) and had had headache for at least 15 days a month during the previous 6 months. Four patients were thereafter excluded due to poor reliability. The 146 patients who met our CDH criteria (92 with and 54 without clear-cut migraine attacks) could be classified into four groups: (i) chronic tension-type headache (CTTH)-27 patients; (ii) coexisting migraine plus CTTH-65 patients; (iii) unclassifiable daily headache-27 patients; and (iv) migraine and an unclassifiable interval headache-27 patients. Seventy-two percent of patients with CDH had migraine as the initial form of their headache. We therefore propose to revise the IHS classification for migraine, taking into account its evolution, and add two subcategories, migraine with interparoxysmal headache and chronic migraine.

Evaluation of Chronic Daily Headache—Comparison to Criteria for Chronic Tension-Type Headache

Cephalalgia ◽  
1992 ◽  
Vol 12 (6) ◽  
pp. 365-368 ◽  
Author(s):  
Seymour Solomon ◽  
Richard B Lipton ◽  
Lawrence C Newman
Keyword(s):  
Chronic Daily Headache ◽  
Medication Overuse ◽  
International Headache Society ◽  
Tension Type Headache ◽  
Chronic Tension Type Headache ◽  
Ihs Classification ◽  
Analgesic Medication ◽  
Daily Headache ◽  
Ihs Criteria ◽  
Type Headache

The purpose of this study was to evaluate the adequacy of the International Headache Society (IHS) criteria for chronic tension-type headache and, if appropriate, suggest modifications of the IHS classification. We evaluated 100 consecutive patients with chronic daily headache. Approximately two-thirds of our patients fulfilled the criteria for chronic tension-type headache. Most of the patients who failed to meet the criteria did so because they had more than one migrainous feature. Approximately 50% of patients took excessive amounts of analgesic medication. We conclude that the IHS criteria should be modified to include chronic daily headache evolving from migraine; subtypes with and without medication overuse should be distinguished.

Chronic Daily Headache in A Tertiary Care Population: Correlation Between the International Headache Society Diagnostic Criteria and Proposed Revisions of Criteria for Chronic Daily Headache

Cephalalgia ◽  
2002 ◽  
Vol 22 (6) ◽  
pp. 432-438 ◽  
Author(s):  
ME Bigal ◽  
FD Sheftell ◽  
AM Rapoport ◽  
RB Lipton ◽  
SJ Tepper
Keyword(s):  
Chronic Migraine ◽  
Chronic Daily Headache ◽  
International Headache Society ◽  
Tertiary Care ◽  
Tension Type Headache ◽  
Classification Systems ◽  
Common Diagnosis ◽  
Ihs Classification ◽  
Daily Headache

The International Headache Society (IHS) has been criticized for its approach to classification of chronic daily headache (CDH); Silberstein and Lipton criteria provide an alternative to this approach. The aim of this study is to apply the alternative diagnostic approaches to a sample of CDH patients consulting in specialty care. Our sample consisted of 638 patients with CDH. Patients were classified according to both classification systems. Patients were predominantly female (65.0%), with ages ranging from 11 to 88 years. According to the Silberstein and Lipton classification, we found eight different diagnoses. The most common diagnosis was chronic migraine (87.4%), followed by new daily persistent headache (10.8%). Just six patients had chronic tension- type headache (CTTH). Applying the IHS criteria we found 14 different diagnoses. Migraine was found in 576 (90.2%) patients. CTTH occurred in 621 (97.3%), with only 10 (1.57%) having this as the sole diagnosis. We conclude that both systems allow for the classification of most patients with CDH when daily headache diaries are available. The main difference is that the IHS classification is cumbersome and requires multiple diagnoses. The Silberstein and Lipton system is easier to apply, and more parsimonious. These findings support revision of the IHS classification system to include chronic migraine.

The International Headache Society Classification of Chronic Daily and Near-Daily Headaches

Cephalalgia ◽  
1996 ◽  
Vol 16 (6) ◽  
pp. 407-411 ◽  
Author(s):  
J Olesen ◽  
BK Rasmussen
Keyword(s):  
Chronic Daily Headache ◽  
International Headache Society ◽  
Sudden Onset ◽  
Hemicrania Continua ◽  
Transformed Migraine ◽  
Ihs Classification ◽  
Daily Headache ◽  
Future Revision ◽  
International Headache Society Classification

The classification of the International Headache Society (IHS) published in 1988 has been positively received throughout the world. However, the classification of headaches occurring daily or almost daily has been criticized repeatedly. This criticism is discussed in the present review. It is possible to classify virtually all chronic headache patients using the IHS Classification and there seems to be more need for emphasizing a correct application of the classification than for a revision in this regard. The entity of transformed migraine is disputed and so is the existence of hemicrania continua. Neither of these syndromes has been adequately defined nor studied. Chronic daily headache of sudden onset (new persistent daily headache) is not adequately classified at present and should be included as a separate entity in the next edition of the IHS Classification. In a future revision it should also be possible to classify drug-related headache simply on the basis of drug consumption and without mandatory demands for withdrawal. Better longitudinal studies of patients with chronic daily headache are necessary to evaluate finally whether a revision of the classification of these headache syndromes is necessary. Eventually the ongoing discovery of migraine genes is likely to change radically the classification of migraine.ÿ

A Comparison of Disability and Psychological Factors in Migraine and Transformed Migraine

Cephalalgia ◽  
2002 ◽  
Vol 22 (3) ◽  
pp. 172-178 ◽  
Author(s):  
JE Magnusson ◽  
WJ Becker
Keyword(s):  
Chronic Daily Headache ◽  
Psychological Factors ◽  
Tension Type Headache ◽  
Transformed Migraine ◽  
Headache Intensity ◽  
Daily Headache ◽  
Type Headache

The classification of patients with migraine who develop chronic daily headache is controversial, with some classifying such patients as ‘transformed migraine’. We compared patients with intermittent migraine attacks and patients with transformed migraine in terms of mean headache intensity on days with headache, depression, pain-related anxiety and headache-related disability. Patients classified clinically as also having tension-type headache were excluded. Aside from the number of days with headache per month, patients with intermittent migraine attacks and patients with transformed migraine were very similar in terms of all parameters studied. Our results support the concept that these two headache groups are closely related.

The Global Burden of Headache: A Documentation of Headache Prevalence and Disability Worldwide

Cephalalgia ◽  
2007 ◽  
Vol 27 (3) ◽  
pp. 193-210 ◽  
Author(s):  
LJ Stovner ◽  
K Hagen ◽  
R Jensen ◽  
Z Katsarava ◽  
RB Lipton ◽  
...  
Keyword(s):  
Chronic Daily Headache ◽  
International Headache Society ◽  
Adult Population ◽  
Tension Type Headache ◽  
World Health ◽  
Headache Disorders ◽  
Burden Of Headache ◽  
The World ◽  
Daily Headache ◽  
Type Headache

This study, which is a part of the initiative 'Lifting The Burden: The Global Campaign to Reduce the Burden of Headache Worldwide', assesses and presents all existing evidence of the world prevalence and burden of headache disorders. Population-based studies applying International Headache Society criteria for migraine and tension-type headache, and also studies on headache in general and 'chronic daily headache', have been included. Globally, the percentages of the adult population with an active headache disorder are 46% for headache in general, 11% for migraine, 42% for tension-type headache and 3% for chronic daily headache. Our calculations indicate that the disability attributable to tension-type headache is larger worldwide than that due to migraine. On the World Health Organization's ranking of causes of disability, this would bring headache disorders into the 10 most disabling conditions for the two genders, and into the five most disabling for women.

Chronic Tension-Type Headache in Children and Adolescents

Cephalalgia ◽  
2001 ◽  
Vol 21 (8) ◽  
pp. 830-836 ◽  
Author(s):  
Ishaq Abu-Arafeh
Keyword(s):  
Children And Adolescents ◽  
Clinical Features ◽  
Chronic Daily Headache ◽  
Adult Population ◽  
Tension Type Headache ◽  
Stressful Events ◽  
Chronic Tension Type Headache ◽  
Daily Headache ◽  
Ihs Criteria ◽  
Type Headache

In this study, the causes, predisposing factors and clinical features of chronic daily headache in children and adolescents were studied within the population of patients attending a specialist headache. The International Headache Society's (IHS) criteria for the diagnosis of chronic tension type headache (CTTH) were assessed for their applicability in the paediatric age group. Over a period of three years, demographic and clinical data were collected prospectively on all children who attended the clinic and suffered from daily attacks of headache. One hundred and fifteen children and adolescents (32% of all clinic population) had chronic daily headache, of whom 93 patients (81%) fulfilled the IHS criteria for the diagnosis of CTTH. They were between 3-15 years of age (mean: 11.1, SD: 2.3) and their female to male ratio was 1.2: 1. Around one third of the patients also suffered from migraine (mainly migraine without aura). The headache was described as mild in 60.9%, moderate 36.5% and severe 2.6%. Headache was located at the forehead in 53% or over the whole of the head in 29.6%. Pain was described as ‘just sore’ or dull by 73.9%. During attacks of headache, at least half the patients reported light intolerance, noise intolerance, anorexia or nausea. Thirty-two percent of patients had at least one underlying chronic disease that may have contributed to the pathogenesis of the CTTH. Eleven percent had serious stressful events related to family illnesses and in four patients headaches were triggered by family bereavement. Fourteen percent were investigated with neuroimaging and 22% were referred for clinical psychology assessment and management. In conclusion, CTTH is a common cause of headache in children attending a specialist headache clinic. The clinical features closely match those of adult population and the IHS criteria for the diagnosis of CTTH can be adapted for use in children. Predisposing stressful risk factors, physical or emotional, are present in a large proportion.

An epidemiological approach to the nosography of chronic daily headache

Cephalalgia ◽  
1993 ◽  
Vol 13 (12_suppl) ◽  
pp. 72-77 ◽  
Author(s):  
Giorgio Sandrini ◽  
Gian Camillo Manzoni ◽  
Carla Zanferrari ◽  
Giuseppe Nappi
Keyword(s):  
Clinical Features ◽  
Chronic Daily Headache ◽  
Tension Type Headache ◽  
Chronic Tension Type Headache ◽  
Transformed Migraine ◽  
Daily Headache ◽  
Ihs Criteria ◽  
Recent Classification ◽  
Type Headache ◽  
Epidemiological Approach

Chronic daily headache (CDH), a heterogeneous group of headaches, includes different forms that occur daily, or almost daily, over a prolonged period of time. The nosography of this group is still a matter of debate, and in the most recent classification of the IHS (1988) only a few types of CDH are included: chronic tension-type headache, coexisting migraine. This study is an epidemiological approach to identifying the clinical features of CDH and the possible factors involved in changing episodic headache in CDH. Ninety CDH outpatients were investigated using a computerized record chart. The main observed forms were: (a) chronic tension-type headache–migraine with interparoxysmal headache, an evolved form of migraine in which a constant low severity headache develops between attacks; (b) transformed migraine, an evolved form of migraine with progressive worsening of the disease which reaches the level of continuous pain with the disappearance of typical migraine attacks. Interval headaches in migraine with interparoxysmal headache partly fulfil the IHS criteria for chronic tension-type headache. Analgesic drug abuse plays a prominent role in inducing CDH and in determining its clinical features.

Transformed migraine

Cephalalgia ◽  
1993 ◽  
Vol 13 (12_suppl) ◽  
pp. 78-83 ◽  
Author(s):  
Ninan T Mathew
Keyword(s):  
Chronic Daily Headache ◽  
Tension Type Headache ◽  
Drug Induced ◽  
Chronic Tension Type Headache ◽  
Transformed Migraine ◽  
Mixed Features ◽  
History Of ◽  
Daily Headache ◽  
International Headache Classification ◽  
Type Headache

Chronic tension-type headache, which is included in the International Headache Classification, is present in only a minority of patients who present with chronic daily headache. The majority have what is termed transformed migraine, with a history of distinct episodes of migraine in the initial years which progresses into chronic daily headache. These patients with transformed migraine exhibit mixed features of migraine and chronic tension-type headache. Two distinct types of transformed migraine are identifiable, namely those related to excessive intake of medications (drug-induced transformed migraine) and those unrelated to excessive use of medications. The clinical features of transformed migraine and the drug-induced variety are described. The need for revision of the International Classification to include chronic daily headache and the subtypes of transformed migraine is pointed out.

scholarly journals Study of Sleep Disorders and Polysomnographic Evaluation among Primary Chronic Daily Headache Patients

2016 ◽  
Vol 07 (S 01) ◽  
pp. S072-S075 ◽  
Author(s):  
Rajesh Verma ◽  
Kamal Kumar Nagar ◽  
Ravindra Kumar Garg ◽  
Ravi Uniyal ◽  
Praveen Kumar Sharma ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Sleep Disorder ◽  
Chronic Daily Headache ◽  
Daytime Sleepiness ◽  
Structured Interview ◽  
Tension Type Headache ◽  
Chronic Tension Type Headache ◽  
Daily Headache ◽  
Type Headache ◽  
Headache Patients

ABSTRACT Objective: Studies related to sleep disorders and polysomnography (PSG) among chronic daily headache patients are rare. We studied this and compared chronic migraine (CM) with chronic tension-type headache. Methods: Eighty-three patients were recruited. They were evaluated by semi-structured interview, headache, and sleep diaries along with Epworth Sleepiness Scale score and insomnia symptom score. Overnight PSG was performed and data compared. Results: Chronic tension-type headache was more common than CM, both having female preponderance. Insomnia followed by excessive daytime sleepiness was prevalent sleep disorder. Sleep efficiency and Stage 3 sleep were lower in CM compared to chronic tension-type. ESSS was significantly increased among chronic tension-type patients. No significant correlation was found among PSG parameters in patients with or without sleep disorders. Conclusion: Insomnia being most common sleep disorder among chronic headache population. Chronic tension-type headache had slightly better slow-wave sleep than CM and significantly increased daytime sleepiness.

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