Application of the International Headache Society Classification Criteria in 652 Cluster Headache Patients

Cephalalgia ◽  
2001 ◽  
Vol 21 (2) ◽  
pp. 145-150 ◽  
Author(s):  
P Torelli ◽  
D Cologno ◽  
C Cademartiri ◽  
GC Manzoni

We applied the International Headache Society (IHS) classification coding parameters to a study population of 652 cluster headache (CH) patients, in order to determine how many patients did not fulfil the diagnostic criteria for group 3.1 and to find out any diagnostic elements that could be changed in the upcoming revision of the classification to make it more relevant to current clinical practice. Ninety-nine patients were found to have cluster-like disorder (3.3), including 74 (74.7%) who did not fulfil the diagnostic criteria for CH, because either pain was not associated with any of the accompanying autonomic phenomena listed in the classification or it was not located orbitally, supraorbitally and/or temporally. A review of our total sample showed that 72.0% of patients reported frontal and occipital pain location; in 61.8%, 33.4% and 39.1% of cases, attacks were also accompanied by restlessness/agitation, nausea and photophobia, respectively. In a coding system that took into account the diagnostic elements that we considered in our study, group 3.1 of the existing IHS classification would actually include 51 of the 99 patients currently coded as 3.3.

Cephalalgia ◽  
1999 ◽  
Vol 19 (4) ◽  
pp. 201-206 ◽  
Author(s):  
PC Honkoop ◽  
MJ Sorbi ◽  
GLR Godaert ◽  
ELH Spierings

Fifty-six adult female patients with the clinical diagnosis of MwoA kept a diary 6 times per day for 10 consecutive weeks to record the occurrence, pain characteristics, and accompanying symptoms of headache. In order to avoid bias due to retrospection or expectancy the diary was programmed into palmtop computers which signaled the patients with a beep to enter the diary with a random-fixed time schedule: two signals occurred in, respectively, the morning, the afternoon, and the evening, but at different times for each day. The palmtop computers also warranted flawless data storage and automatic computations of response delay and missing values. Of the 339 attacks, 75% had a duration of 4-72 h and 94% confirmed the International Headache Society classification criteria for MwoA concerning pain characteristics and accompanying symptoms. Our results obtained for attacks in treated patients are highly comparable with the results of Rasmussen, Jensen, and Olesen (1991) obtained in the general population with unknown treatment of headache. Together, both studies support the IHS classification criteria for MwoA. The electronic Experience Sampling Method also allowed for an unbiased description of the course of treated MwoA attacks: 67% subsided in the first day. In the 16 attacks the characteristics and accompanying symptoms were present in 60-80% of the attacks at the first assessment (9.30 a.m.) with the exception of moderate to severe pain intensity (37%) and nausea or vomiting (31%). A waxing and waning of characteristics and symptoms over the day remained in about 30-40% of the attacks with a tendency towards increases in the evening (7.30 p.m. and 10 p.m.). The method is there for a replication of this study in untreated MwoA patients.


Cephalalgia ◽  
2006 ◽  
Vol 26 (12) ◽  
pp. 1427-1433 ◽  
Author(s):  
E Marchioni ◽  
E Tavazzi ◽  
G Bono ◽  
L Minoli ◽  
S Bastianello ◽  
...  

The aim of this study was to revise some topics in the chapter ‘Headache attributed to infections’ in the last International Headache Society (IHS) classification. The authors searched for original studies and reviews about headache associated with infections. A checklist was submitted to 15 neurologists to quantify the relevance, comprehensibility and coherence between definitions, criteria and comments for each paragraph. The following paragraphs were fully discussed: (1) headache attributed to lymphocytic meningitis. This topic, being rather heterogeneous, should be divided into different subgroups; (2) headache attributed to HIV/AIDS. Distinctive features are not specified and diagnostic criteria are rather confusing; and (3) chronic post-infection headache. Diagnostic criteria should be reconsidered as the symptom ‘pain’ is not the main diagnostic criterion. The authors propose the revision of three paragraphs of the new IHS classification to better define the most likely headache profile in specific CNS infections. The authors also underline the need to plan further ad hoc prospective studies.


Cephalalgia ◽  
1996 ◽  
Vol 16 (6) ◽  
pp. 407-411 ◽  
Author(s):  
J Olesen ◽  
BK Rasmussen

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


Cephalalgia ◽  
2011 ◽  
Vol 31 (10) ◽  
pp. 1101-1105 ◽  
Author(s):  
Denys Fontaine ◽  
Jean Christophe Sol ◽  
Sylvie Raoul ◽  
Nelly Fabre ◽  
Gilles Geraud ◽  
...  

Background: Greater occipital nerve stimulation (ONS) has been recently proposed to treat severe chronic cluster headache patients (CCH) refractory to medical treatment. We report the results of a French multidisciplinary cohort study. Methods: Thirteen CCH patients were operated and data were collected prospectively. All of them suffered from CCH according to the International Headache Society classification, lasting for more than 2 years, refractory to pharmacological prophylactic treatment with adequate trials, with at least one daily attack. Chronic ONS was delivered through a subcutaneous occipital electrode connected to an implanted generator, in order to induce paraesthesias perceived locally in the lower occipital region. Results: After surgery (mean follow-up 14,6 months), the mean attack frequency and intensity decreased by 68% and 49%, respectively. At last follow-up, 10/13 patients were considered as responders (improvement >50%). Prophylactic treatment could be stopped or reduced in 8/13 cases. Local infection occurred in one patient, leading to hardware removal. Conclusions: Our data confirmed the results of the 36 similar cases reported in the literature, suggesting that ONS may act as a prophylactic treatment in chronic CH. Considering their respective risks, ONS should be proposed before deep brain stimulation in severe refractory CCH patients.


Cephalalgia ◽  
2009 ◽  
Vol 29 (4) ◽  
pp. 445-452 ◽  
Author(s):  
C Sun-Edelstein ◽  
ME Bigal ◽  
AM Rapoport

Despite the recent advances in the understanding and classification of the chronic daily headaches, considerable controversy still exists regarding the classification of individual headaches, including chronic migraine (CM) and medication overuse headache (MOH). The original criteria, published in 2004, were difficult to apply to most patients with these disorders and were subsequently revised, resulting in broader clinical applicability. Nonetheless, they remain a topic of debate, and the revisions to the criteria have further added to the confusion. Even some prominent headache specialists are unsure which criteria to use. We aimed to explain the nature of the controversies surrounding the entities of CM and MOH. A clinical case will be used to illustrate some of the problems faced by clinicians in diagnosing patients with chronic daily headache.


Cephalalgia ◽  
2002 ◽  
Vol 22 (3) ◽  
pp. 205-208 ◽  
Author(s):  
M El Amrani ◽  
H Massiou ◽  
MG Bousser

We report the result of a double-blind placebo controlled study of sodium valproate (SV) (1000-2000 mg/day) in the prophylaxis of cluster headache CH. Episodic and chronic CH were defined according to the International Headache Society classification. Ninety- six patients were included, 50 in the SV group and 46 in the placebo group. After a 7-day run-in period, patients were treated for 2 weeks. The primary efficacy criterion was the percentage of patients successfully improved, i.e having an at least 50% reduction in the average number of attacks per week between the run-in period and the last week of treatment. Whatever the type of CH, there was no difference between the two groups: 50% of subjects in the SV group and 62% in the placebo group were successfully improved ( P = 0.23). This high success rate observed in the placebo group, which is likely to be due to the spontaneous remission of the episode, does not allow us to draw any valid conclusion with regard to the true efficacy of SV in the prophylaxis of CH.


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