Migraine without aura and migrainous disorder in children; International Headache Society (IHS) and revised IHS criteria

Cephalalgia ◽  
2000 ◽  
Vol 20 (7) ◽  
pp. 617-620 ◽  
Author(s):  
A Cano ◽  
E Palomeras ◽  
S Alfonso ◽  
D Ortega ◽  
P Sanz ◽  
...  
Keyword(s):  
Prospective Study ◽  
Migraine Without Aura ◽  
International Headache Society ◽  
Tension Headaches ◽  
Ihs Criteria ◽  
Increased Sensitivity ◽  
Time Required ◽  
A Prospective Study ◽  
Headache Patients

The widely used criteria of the IHS to define migraine without aura in children are highly specific but show poor sensitivity, with a large percentage of headaches being classified as migrainous disorder (MD). The objective of this study was to assess how many headache patients in a series of children met the diagnostic criteria of the IHS for migraine without aura or MD and to determine the changes required to convert the greatest number of MD into migraine without aura, without affecting classification of the remaining headache types. A prospective study was undertaken of 131 patients under 15 years old referred to our centre for headache. Patients were classified according to the IHS criteria and according to a modification of these criteria consisting of: (1) reduction of minimum time required for classification into migraine without aura from 2 h to 1 h; (2) acceptance of bifrontal location in addition to hemicranial; (3) acceptance of either phonophobia or photophobia as valid criteria instead of requiring presence of both. Using the IHS criteria, 51 (39%) children were diagnosed as having migraine without aura and 26 (20%) as having MD. According to our revised IHS criteria, 68 (52%) were diagnosed as migraine without aura and nine (7%) as MD. When the three modified criteria were applied, three tension headaches and one unclassifiable headache changed category. When only reduced duration and bifrontal location were applied, none of the headaches other than MD changed category. Application of two modifications to the IHS criteria—reduction in duration of headache to 1 h and acceptance of bifrontal location—increased sensitivity without reducing specificity in classifying migraine without aura in children.

Headache in Acute Stroke. A Prospective Study in the First 8 Days

Cephalalgia ◽  
2008 ◽  
Vol 28 (4) ◽  
pp. 346-354 ◽  
Author(s):  
A Verdelho ◽  
JM Ferro ◽  
T Melo ◽  
P Canhão ◽  
F Falcão
Keyword(s):  
Prospective Study ◽  
Acute Stroke ◽  
Stroke Unit ◽  
International Headache Society ◽  
Primary Headache ◽  
Haemorrhagic Stroke ◽  
Headache Disorders ◽  
Ihs Criteria ◽  
A Prospective Study

We aimed to describe and classify headaches associated with acute stroke, by interviewing patients consecutively admitted to a stroke unit using a validated headache questionnaire and the International Classification of Headache Disorders of the International Headache Society (IHS). One hundred and twenty-four patients (61% ischaemic and 39% haemorrhagic stroke) reported headache. Headaches started mostly on the day of stroke, were more often continuous, pressure-type, bilateral and located in the anterior region, were increased by movement and by cough and lasted for a mean of 3.8 days. Tension-type was the most frequent type of headache. Eleven per cent of headaches could not be classified using the criteria of the IHS. Previous primary headache was documented in 71 patients. The presence of nausea/vomiting due to acute stroke can confound headache classification using the IHS criteria. In up to half of the patients, headache seems to be a reactivation of previous primary headache.

A prospective study on osmophobia in migraine versus tension-type headache in a large series of attacks

Cephalalgia ◽  
2019 ◽  
Vol 40 (4) ◽  
pp. 337-346 ◽  
Author(s):  
Alberto Terrin ◽  
Federico Mainardi ◽  
Carlo Lisotto ◽  
Edoardo Mampreso ◽  
Matteo Fuccaro ◽  
...  
Keyword(s):  
Prospective Study ◽  
Diagnostic Criteria ◽  
Migraine Without Aura ◽  
Tension Type Headache ◽  
Headache Disorders ◽  
Headache Attack ◽  
Accompanying Symptoms ◽  
Type Headache ◽  
A Prospective Study

Background In literature, osmophobia is reported as a specific migrainous symptom with a prevalence of up to 95%. Despite the International Classification of Headache Disorders 2nd edition proposal of including osmophobia among accompanying symptoms, it was no longer mentioned in the ICHD 3rd edition. Methods We conducted a prospective study on 193 patients suffering from migraine without aura, migraine with aura, episodic tension-type headache or a combination of these. After a retrospective interview, each patient was asked to describe in detail osmophobia, when present, in the following four headache attacks. Results In all, 45.7% of migraine without aura attacks were associated with osmophobia, 67.2% of migraineurs reported osmophobia in at least a quarter of the attacks. No episodic tension-type headache attack was associated with osmophobia. It was associated with photophobia or phonophobia in 4.3% of migraine without aura attacks, and it was the only accompanying symptom in 4.7% of migraine without aura attacks. The inclusion of osmophobia in the ICHD-3 diagnostic criteria would enable a 9.0% increased diagnostic sensitivity. Conclusion Osmophobia is a specific clinical marker of migraine, easy to ascertain and able to disentangle the sometimes challenging differential diagnosis between migraine without aura and episodic tension-type headache. We recommend its inclusion among the diagnostic criteria for migraine as it increases sensitivity, showing absolute specificity.

Migraine without aura and migrainous disorder in children; International Headache Society (IHS) and revised IHS criteria

Cephalalgia ◽  
2000 ◽  
Vol 20 (7) ◽  
pp. 617-620 ◽  
Author(s):  
A Cano ◽  
E Palomeras ◽  
S Alfonso ◽  
D Ortega ◽  
P Sanz ◽  
...  
Keyword(s):  
Migraine Without Aura ◽  
International Headache Society ◽  
Ihs Criteria

A prospective study to validate various clinical criteria used in classification of leprosy: a study from a tertiary care center in India

2018 ◽  
Vol 57 (9) ◽  
pp. 1107-1113 ◽  
Author(s):  
Manisha Thapa ◽  
Muthu Sendhil Kumaran ◽  
Tarun Narang ◽  
Uma N. Saikia ◽  
Gitesh U. Sawatkar ◽  
...  
Keyword(s):  
Prospective Study ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Clinical Criteria ◽  
A Prospective Study

Evaluation of Clinical Criteria for Cluster Headache With Special Reference to The Classification of The International Headache Society

Cephalalgia ◽  
1990 ◽  
Vol 10 (4) ◽  
pp. 195-197 ◽  
Author(s):  
Karl Ekbom
Keyword(s):  
Cluster Headache ◽  
International Headache Society ◽  
World Federation ◽  
Definite Diagnosis ◽  
Conjunctival Injection ◽  
Clinical Criteria ◽  
Ihs Criteria ◽  
The Difference ◽  
Symptoms And Signs

The diagnostic criteria issued by the International Headache Society (IHS) (1988) and those of the World Federation of Neurology (WFN) (1969) were evaluated vis-à-vis 163 consecutive cases of cluster headache diagnosed according to the criteria of Ekbom (1970). The agreement between the IHS and Ekbom criteria was very good (96.9%). The difference was explained by five patients who all lacked local autonomous symptoms and signs (conjunctival injection, lacrimation, etc.). At least one of these signs is mandatory according to the IHS and thus the patients escaped a definite diagnosis. Agreement between the WFN and Ekbom criteria was 84.0% ( n= 163) and between the WFN and IHS criteria only 76.0% ( n= 158).

scholarly journals Ultrasonography Classification of the American Thyroid Association for Predicting Malignancy in Thyroid Nodules >1cm with Indeterminate Cytology: A Prospective Study

2018 ◽  
Vol 50 (08) ◽  
pp. 597-601 ◽  
Author(s):  
Tiara Rocha ◽  
Pedro Rosario ◽  
Alexandre Silva ◽  
Maurício Nunes ◽  
Tulio Silva ◽  
...  
Keyword(s):  
Prospective Study ◽  
Thyroid Nodules ◽  
Thyroid Neoplasms ◽  
Needle Aspiration ◽  
American Thyroid Association ◽  
Molecular Tests ◽  
Indeterminate Cytology ◽  
A Prospective Study ◽  
Doppler Analysis

AbstractThe objective of this prospective study was to evaluate the ultrasonography classification of the American Thyroid Association (ATA) for predicting malignancy in thyroid nodules >1 cm with indication for fine-needle aspiration (FNA) whose cytology was indeterminate. Additionally, the combination of the ATA classification with Doppler analysis was evaluated. All patients with thyroid nodules >1 cm were eligible. Each nodule was assigned to one of the ATA categories. Exclusively or predominantly intranodular vascularity was considered suspicious. One hundred and thirty-seven patients with 143 nodules underwent FNA and those with indeterminate cytology (Bethesda category III or IV) were selected. All patients were referred for surgery. Among the 143 nodules evaluated, 92 were benign, 33 were malignant, 13 were noninvasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP), and 5 were tumors of uncertain malignant potential (TUMP). The rate of malignancy, including NIFTP and TUMP in this definition, was 80%, 42.8%, 13%, 10%, and 23% for nodules with a high suspicion, intermediate suspicion, low suspicion, very low suspicion, and undefined ultrasonographic pattern, respectively. Considering NIFPT and TUMP as benign, these rates were 72%, 22.4%, 4.3%, 0%, and 15.4%, respectively. The addition of Doppler analysis did not significantly improve the prediction of malignancy obtained with the ATA classification alone. The results of this prospective study show the usefulness of the ATA ultrasonographic classification for predicting malignancy specifically in thyroid nodules >1 cm with indeterminate cytology. The ATA category of the nodule should influence the decision for follow-up, molecular tests, or surgery.

Clavien Classification of Semirigid Ureteroscopy Complications: A Prospective Study

Urology ◽  
2012 ◽  
Vol 80 (5) ◽  
pp. 995-1001 ◽  
Author(s):  
Swarnendu Mandal ◽  
Apul Goel ◽  
Manish Kumar Singh ◽  
Rohit Kathpalia ◽  
Deepak S. Nagathan ◽  
...  
Keyword(s):  
Prospective Study ◽  
Clavien Classification ◽  
A Prospective Study

Central 5-Ht Receptor Hypersensitivity in Migraine Without Aura

Cephalalgia ◽  
2003 ◽  
Vol 23 (1) ◽  
pp. 29-34 ◽  
Author(s):  
EM Cassidy ◽  
E Tomkins ◽  
T Dinan ◽  
O Hardiman ◽  
V O'Keane
Keyword(s):  
Migraine Without Aura ◽  
International Headache Society ◽  
Test Group ◽  
Significant Rise ◽  
Serum Prolactin ◽  
Healthy Female ◽  
Daily Headache ◽  
Ihs Criteria ◽  
Neuroendocrine Challenge ◽  
Prolactin Response

Serotonin has long been implicated as a key neurotransmitter in migraine. There is a dearth of research specifically examining 5-HT1A receptor sensitivity in migraine despite the importance of this receptor in regulating central serotonergic tone. In this study we examined the hypothesis that migraine without aura is associated with hypersensitivity of central 5-HT1A receptors, using a 5-HT1A neuroendocrine challenge drug and comparing serum prolactin responses between a test group with migraine and a matched group of healthy controls. Twelve female subjects fulfilling International Headache Society (IHS) criteria for migraine without aura were evaluated. Following an overnight fast, subjects presented for testing at 9am. An intravenous canula was inserted and serum prolactin was assessed at baseline and every 30 min for 3 h following a single dose of 30 mg oral buspirone, a 5-HT1A-receptor agonist. Subjects were assessed during the first 5 days of the menstrual cycle. No subjects were taking psychotropic medication or migraine prophylactic treatment. Patients with current or previous psychiatric disorder, daily headache or analgesic overuse were excluded. 16 healthy female volunteers matched for age and menstrual status were also evaluated and served as controls. There was no difference in baseline prolactin between groups. There was a significant rise in prolactin following buspirone in both groups. Subjects with migraine had a significantly increased prolactin response to buspirone (delta max) compared to controls ( P < 0.001). This study supports the hypothesis that migraine without aura is associated with a relative hypersensitivity of central 5-HT1A receptors. This is of relevance given the role of the 5-HT1A receptor in controlling raphe 5-HT tone and in the possible association between migraine and anxiety and depression.

A Prospective Study of the Headache Phase in 32 Migraine with Aura Patients

Cephalalgia ◽  
2002 ◽  
Vol 22 (6) ◽  
pp. 411-415 ◽  
Author(s):  
D Cologno ◽  
P Torelli ◽  
GC Manzoni
Keyword(s):  
Prospective Study ◽  
Clinical Features ◽  
Migraine With Aura ◽  
International Headache Society ◽  
Case Series ◽  
Tension Type Headache ◽  
Pain Location ◽  
Headache Centre ◽  
Type Headache ◽  
A Prospective Study

For an accurate description of the clinical features of the headache phase in migraine with aura (MA) attacks, we thought it useful to conduct a prospective study of consecutively referred MA patients seeking treatment at the Headache Centre of the University of Parma Institute of Neurology. The case series included 32 patients (22 women and 10 men). At the time of the first visit, each patient was given a questionnaire to be filled in at the next MA attack. Six patients (four women and two men) had attacks of migraine aura without headache. Among the remaining 26 patients (18 women and eight men), the duration of the headache phase was < 24 h in 23 (88.5%); pain location was bilateral in 14 (53.8%) and unilateral in 12, but occurring on the opposite side to aura only in one patient; pain intensity was mild or moderate in 13 (50.0%). The headache phase of MA appeared to have clinical features that differed widely from patient to patient and was consistent with the International Headache Society diagnostic criteria for migraine without aura in 26.9% of patients and for tension-type headache (TTH) in 23.1%.

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