Critical Analysis of the International Classification of Headache Disorders Diagnostic Criteria (ICHD I-1988) and (ICHD II-2004), for Migraine in Children and Adolescents

Cephalalgia ◽  
2005 ◽  
Vol 25 (11) ◽  
pp. 1042-1047 ◽  
Author(s):  
MMF Lima ◽  
NAMR Padula ◽  
LCA Santos ◽  
LDB Oliveira ◽  
S Agapejev ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Diagnostic Criteria ◽  
Predictive Value ◽  
Gold Standard ◽  
Critical Analysis ◽  
High Specificity ◽  
Classification Criteria ◽  
Headache Disorders ◽  
Current Classification

The present study analyzed the (ICHD I-1988) and (ICHD II-2004) diagnostic criteria in children and adolescents. Our population consisted of 496 patients of the Headache Outpatient Ward for Children and Adolescents retrospectively studied from 1992 to 2002. Individuals were classified according to three diagnostic groups: Intuitive Clinical Diagnosis (Gold Standard), ICHD I-1988 and ICHD II-2004. They were statistically compared using the variables: Sensitivity (S), Specificity (Sp), Positive Predictive Value (PPV), Negative Predictive Value (NPV). When ICHD I-1988 was used, the sensitivity of migraine without and with aura was 21% and 27%, respectively, whereas in ICHD II-2004 it changed to 53% and 71% without affecting specificity. As a conclusion, the current classification criteria (ICHD II-2004) showed greater sensitivity and high specificity for migraine than ICHD I-1988, although it improved migraine diagnosis in children and adolescents, the sensitivity remains poor.

scholarly journals International Classification of Headache Disorders - ICHD-4. Will medication-overuse headache survive?

2021 ◽  
pp. 72-74
Author(s):  
Mario Fernando Prieto Peres ◽  
Thaiza Agostini Córdoba de Lima ◽  
Marcelo Moraes Valença
Keyword(s):  
Clinical Practice ◽  
Diagnostic Criteria ◽  
Critical Analysis ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
International Classification ◽  
Headache Disorders ◽  
Critical View

The article is a critical analysis of the diagnostic criteria for medication-overuse headache. This is an important discussion to improve the criteria in the next update, as well as providing a critical view for neurologists when applying the criteria to their clinical practice.

scholarly journals Diagnostic value of combinations of symptoms of migraine and tension-type headache included in the diagnostic criteria for children and adolescents in the international classification of headache disorders 2nd edition

Folia Medica ◽  
2013 ◽  
Vol 55 (3-4) ◽  
pp. 46-55 ◽  
Author(s):  
Iliyana H. Pacheva ◽  
Ivan G. Milanov ◽  
Ivan S. Ivanov ◽  
Rumen S. Stefanov
Keyword(s):  
Physical Activity ◽  
Children And Adolescents ◽  
Diagnostic Criteria ◽  
Diagnostic Value ◽  
Tension Type Headache ◽  
Headache Disorders ◽  
Recurrent Headache ◽  
Severe Intensity ◽  
Type Headache

ABSTRACT AIM: To suggest diagnostic combinations of symptoms for migraine and tension type headache (TTH), and for differentiation of overlapping headache (classified as either migraine or TTH) through evaluation of the diagnostic value of combinations of characteristics included in the International Headache Society diagnostic criteria for migraine and TTH in children and adolescents. PATIENTS AND METHODS: The study comprised an epidemiological school-based study (412 of 1029 pupils with chronic / recurrent headache) and a clinical study conducted in the Pediatric Neurology Ward and outpatient clinic at Plovdiv Medical University Hospital (203 patients with chronic / recurrent headache). An inclusion criterion was at least two episodes of headache during the last year. Exclusion criteria were: headache occurring only during acute infections; withdrawal of informed consent. Headache was classified according to the International Classification of Headache Disorders 2nd edition (ICHD-II) The diagnostic value of all combinations of items in criteria C and D for migraine and TTH was measured by sensitivity, specificity, and odds ratio. RESULTS: The combination “unilateral location, severe intensity, aggravation by physical activity” had 100% specificity for migraine. The combination “bilateral location, pressingtightening quality, mild intensity, no aggravation by physical activity” had 100% specificity for TTH. The combinations: “migrainous location, severe intensity, aggravation by physical activity”, “severe intensity, nausea”, “pulsating quality, nausea”, “pulsating quality, migrainous location, aggravation by physical activity” seemed to pose the greatest risk for developing migraine. These combinations - “no nausea, no photophobia”, “bilateral location, mild intensity and either no aggravation by physical activity or pressing-tightening quality, or no nausea or no photophobia” increased the most the TTH risk. Using these combinations as additional criteria for overlapping headache we classi ed 50% of overlapping headache as TTH and 8.3% as migraine. CONCLUSIONS: Some combinations of symptoms clarify the diagnosis of migraine and TTH. More than 50% of overlapping headache could be differentiated as TTH or MWA by the proposed combinations.

scholarly journals Agreement in the diagnosis of dental fluorosis in central incisors performed by a standardized photographic method and clinical examination

2009 ◽  
Vol 25 (5) ◽  
pp. 1017-1024 ◽  
Author(s):  
Carolina Castro Martins ◽  
Loliza Chalub ◽  
Ynara Bosco Lima-Arsati ◽  
Isabela Almeida Pordeus ◽  
Saul Martins Paiva
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Clinical Examination ◽  
Predictive Value ◽  
Gold Standard ◽  
Dental Fluorosis ◽  
Digital Camera ◽  
High Specificity ◽  
Photographic Method ◽  
Pediatric Dentists

The aim of this study was to assess agreement in the diagnosis of dental fluorosis performed by a standardized digital photographic method and a clinical examination (gold standard). 49 children (aged 7-9 years) were clinically evaluated by a trained examiner for the assessment of dental fluorosis. Central incisors were evaluated for the presence or absence of dental fluorosis and were photographed with a digital camera. Photographs were presented to three pediatric dentists, who examined the images. Data were analyzed using Cohen's kappa and validity values. Agreement in the diagnosis performed by the photographic method and clinical examination was good (0.67) and accuracy was 83.7%. The prevalence of dental fluorosis was reported to be higher in the clinical examination (49%) compared with the photographic method (36.7%). The photographic method presented higher specificity (96%) than sensitivity (70.8%), a positive predictive value (PPV) of 94.4% and a negative predictive value (NPV) of 77.4%. The diagnosis of dental fluorosis performed using the photographic method presented high specificity and PPV, which indicates that the method is reproducible and reliable for recording dental fluorosis.

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.

scholarly journals Nested-PCR using MPB64 fragment improves the diagnosis of pleural and meningeal tuberculosis

2000 ◽  
Vol 33 (3) ◽  
pp. 253-257 ◽  
Author(s):  
Luiz C. Martins ◽  
Ilma A. Paschoal ◽  
Angela Von Nowakonski ◽  
Silvana A.B. Silva ◽  
Fernando F. Costa ◽  
...  
Keyword(s):  
Predictive Value ◽  
Gold Standard ◽  
Positive Culture ◽  
High Specificity ◽  
Pcr Assay ◽  
Tuberculous Pleural Effusion ◽  
Tuberculosis Diagnosis ◽  
Pcr Techniques ◽  
Meningeal Tuberculosis ◽  
Gold Standards

Fluids in which Mycobacterium tuberculosis are seldom found, such as pleural and cerebrospinal liquids, are good candidates to be studied using PCR techniques. We detail our experience with a PCR assay applied to pleural and cerebrospinal fluids using the primer MPB64. Seventy three specimens were analyzed: 30 pleural fluids (PF), 26 pleural biopsies (PB) and 17 cerebrospinal fluids (CSF). The gold standard for the diagnosis of tuberculous meningitis was the positive culture for M. tuberculosis in CSF. Tuberculous pleural effusion was diagnosed when cultures of PF and/or PB were positive for M. tuberculosis, or the PB histology showed granulomas. Our results, compared to the gold standards employed, showed a sensitivity of 70%, specificity of 88%, positive predictive value of 82% and negative predictive value of 80%. The high specificity of the MPB64 fragment while still retaining a good sensitivity makes it very well suited for pleural and cerebrospinal tuberculosis diagnosis.

scholarly journals Migraine in children and adolescents: modern principles of diagnostics and treatment

2021 ◽  
Vol 13 (6) ◽  
pp. 111-116
Author(s):  
V. A. Golovacheva ◽  
A. A. Golovacheva ◽  
L. M. Antonenko
Keyword(s):  
Children And Adolescents ◽  
School Performance ◽  
Daily Activity ◽  
Migraine Treatment ◽  
Headache Disorders ◽  
Nonpharmacological Treatment ◽  
Common Cause ◽  
Lifestyle Recommendations ◽  
System Disorder

Migraine is a nervous system disorder that affects 7.7% of children and can debut before the age of 3 years. As they get older, the incidence of migraine increases, and among adolescents, its prevalence reaches 15%. The disease can significantly reduce the child's daily activity, school performance. Migraine is the most common cause of headache in children and adolescents, but it is not always diagnosed; it is not uncommon for patients with migraine to be misdiagnosed and given ineffective treatment. An effective approach to the diagnosis of migraine in children is presented, diagnostic criteria for migraine according to the 3rd edition of International Classification of Headache Disorders are described. Special disorders in childhood are described – episodic syndromes in children associated with migraine. Migraine treatment in children includes four main approaches: 1) lifestyle recommendations; 2) migraine attack treatment; 3) nonpharmacological treatment; 4) migraine preventive pharmacotherapy. All of the listed approaches for the treatment of migraine in childhood are discussed in detail.

Persistent Idiopathic Facial Pain

2018 ◽  
pp. 279-286
Author(s):  
Trevor Van Oostrom
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Criteria ◽  
Psychological Factors ◽  
Facial Pain ◽  
Treatment Options ◽  
Headache Disorders ◽  
Diagnostic Challenge ◽  
Persistent Idiopathic Facial Pain ◽  
Case Based

Persistent idiopathic facial pain (PIFP) is an enigmatic condition which has caused a great deal of suffering yet has been difficult to define and remains a challenging disorder to treat. In addition, the presentation of PIFP has considerable overlap with many other causes of facial pain making the malady a diagnostic challenge. The condition is often resistant to treatment and patients often have comorbid syndromes or psychological factors. This chapter reviews the history and development of the current diagnostic criteria of PIFP according to the latest edition of the International Classification of Headache Disorders (ICHD). Using a case-based approach, the pathophysiology, epidemiology, differential diagnosis, and treatment options of PIFP are explored.

scholarly journals ICHD-3 is significantly more specific than ICHD-3 beta for diagnosis of migraine with aura and with typical aura

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Carl H. Göbel ◽  
Sarah C. Karstedt ◽  
Thomas F. Münte ◽  
Hartmut Göbel ◽  
Sebastian Wolfrum ◽  
...  
Keyword(s):  
Emergency Room ◽  
Diagnostic Criteria ◽  
Migraine With Aura ◽  
University Hospital ◽  
Headache Disorders ◽  
Ischemic Attack ◽  
Diagnostic Work ◽  
The University ◽  
Work Up

Abstract Background In the emergency room, distinguishing between a migraine with aura and a transient ischemic attack (TIA) is often not straightforward and mistakes can be harmful to both the patient and to society. To account for this difficulty, the third edition of the International Classification of Headache disorders (ICHD-3) changed the diagnostic criteria of migraine with aura. Methods One hundred twenty-eight patients referred to the emergency room at the University Hospital of Lübeck, Germany with a suspected TIA were prospectively interviewed about their symptoms leading to admission shortly after initial presentation. The diagnosis that resulted from applying the ICHD-3 and ICHD-3 beta diagnostic criteria was compared to the diagnosis made independently by the treating physicians performing the usual diagnostic work-up. Results The new ICHD-3 diagnostic criteria for migraine with aura and migraine with typical aura display an excellent specificity (96 and 98% respectively), and are significantly more specific than the previous ICHD-3 beta classification system when it comes to diagnosing a first single attack (probable migraine with aura and probable migraine with typical aura). Conclusions The ICHD-3 is a highly useful tool for the clinical neurologist in order to distinguish between a migraine with aura and a TIA, already at the first point of patient contact, such as in the emergency department or a TIA clinic.

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