Chronic Daily Headache: Correlation Between the 2004 and the 1988 International Headache Society Diagnostic Criteria

2004 ◽  
Vol 44 (7) ◽  
pp. 684-691 ◽  
Author(s):  
Marcelo E. Bigal ◽  
Stewart J. Tepper ◽  
Fred D. Sheftell ◽  
Alan M. Rapoport ◽  
Richard B. Lipton
2009 ◽  
Vol 28 (07) ◽  
pp. 440-447
Author(s):  
S. Evers

ZusammenfassungIn diesem Artikel wird eine aktuelle Übersicht über die Prinzipien der modernen Schmerztherapie gegeben. Folgende Neuerungen der letzten Jahre sind von besonderer Bedeutung. Bei der Therapie chronischer Schmerzen erzielt die Kombination medikamentöser und nicht medikamentöser Maßnahmen die besten Erfolge. Der Einsatz von Opioiden kann unter Beachtung der evidenzbasierten Leitlinien auch bei Nichttumorschmerzen erfolgen. Die neuen Opioide sind nebenwirkungsärmer geworden, insbesondere im gastrointestinalen Bereich. Neuerdings steht ein spezifisches Naltrexon-Analogon zur Behandlung der opioidinduzierten Obstipation zur Verfügung. Neue Substanzen gegen neuropathische Schmerzen sind Oxcarbazepin, Pregabalin, Duloxetin und Lacosamid. Akupunktur bei chronischen Schmerzen ist besser als Warteliste. Für die Diagnostik von Kopfschmerzen ist 2004 eine neue Klassifikation der International Headache Society erschienen. Vor allem das Konzept des Chronic Daily Headache ist dabei weiterentwickelt worden. In der Attackenbehandlung der Migräne erzielt der frühzeitige Einsatz von Triptanen den besten Therapieerfolg. Eine Kombination von Triptanen und NSAR ist in Einzelfällen insbesondere beim Wiederkehrkopfschmerz sinnvoll. Substanzen der ersten Wahl in der Migräneprophylaxe sind die Betablocker Propranolol und Metoprolol, Flunarizin, Valproat und Topiramat.


Cephalalgia ◽  
1992 ◽  
Vol 12 (6) ◽  
pp. 365-368 ◽  
Author(s):  
Seymour Solomon ◽  
Richard B Lipton ◽  
Lawrence C Newman

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.


Cephalalgia ◽  
2001 ◽  
Vol 21 (5) ◽  
pp. 584-595 ◽  
Author(s):  
JC Rains ◽  
DB Penzien ◽  
GL Lipchik ◽  
NM Ramadan

The International Headache Society (IHS) diagnostic criteria for headache improved the accuracy of primary headache diagnoses, including migraine. However, many migraineurs receive an ‘atypical migraine’ diagnosis according to the IHS nosology (IHS 1.7), indicating that they approximate but do not fully meet all IHS criteria. This study characterized and sub-classified patients with atypical migraine. Within a clinical sample of 382 headache sufferers, 83 patients met IHS criteria for ‘atypical migraine’. Patients receiving the IHS 1.7 designation did not converge to form a homogeneous group. Rather, distinct and clinically relevant subgroups were empirically derived (e.g. migraine with atypical pain parameters, brief migraine, chronic migraine). The results call for revisions of the IHS diagnostic criteria for migraine that would minimize the number of patients receiving an atypical diagnosis. Revisions would include decreasing the minimum headache duration criteria from 4 h to 2 h, and developing a classification for ‘chronic migraine’ for migraine greater than 15 days per month. The proposed revision provides a means of diagnosing the daily and near-daily headache commonly observed in clinical populations.


Cephalalgia ◽  
1995 ◽  
Vol 15 (1) ◽  
pp. 37-43 ◽  
Author(s):  
GC Manzoni ◽  
F Granella ◽  
G Sandrini ◽  
A Cavallini ◽  
C Zanferrari ◽  
...  

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.


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 ◽  
2007 ◽  
Vol 27 (3) ◽  
pp. 193-210 ◽  
Author(s):  
LJ Stovner ◽  
K Hagen ◽  
R Jensen ◽  
Z Katsarava ◽  
RB Lipton ◽  
...  

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.


Cephalalgia ◽  
2010 ◽  
Vol 31 (5) ◽  
pp. 530-536 ◽  
Author(s):  
Roy G Beran ◽  
Paul J Spira

Introduction: Chronic daily headache (CDH) represents a temporal profile of headache (15+ days/month; 4+ hours/day; >6 months). We report the first comprehensive and largest levetiracetam (LEV) trial in CDH. Methods: A 27-week, multi-centre, randomised, placebo-controlled, cross-over, phase III B study assessed efficacy of a target of 3 g/day LEV of 6 placebo tablets/day in CDH. Primary efficacy was headache-free rate (HFR) while secondary parameters were loss of diagnostic criteria; severity; duration; disability; associated features; pain; and quality of life. Results: Ninety-six patients were recruited (baseline HFR 10.4 ± 14.6%; median 0%). At onset of history 73 (74.1%) had migraine +/− aura and 35 (36.5%) had tension-type headache (TTH). Over the six months preceding recruitment 54 (56.3%) had migraine and 42 (43.8%) had TTH. Headache history was 22.6 ± 15.0 years (median 20.0). Eighty-eight received placebo and 89 received LEV with >80 receiving stable dose in either arm. LEV achieved 3.9% increased HFR over placebo, showing a trend but not significance. There was 9.9% increase in loss of CDH diagnostic criteria re: headache days/month for LEV over placebo ( p = .0325), reduced disability ( p = .0487) and reduced pain severity for LEV ( p = .0162). The Short-Form Quality of Life assessment instrument (SF-36) showed impaired mental health on LEV ( p = .001). Discussion: These findings conflict with reports of LEV efficacy, mandating placebo control in headache trials. Primary efficacy equated to one extra headache-free day/month with reduced disability and pain intensity. Mental health was reduced on LEV. The 10% loss of diagnostic criteria, decreased intensity and disability suggest a subpopulation with CDH where LEV remains a therapeutic option.


2007 ◽  
Vol 28 (1) ◽  
pp. 2-8 ◽  
Author(s):  
E. Sancisi ◽  
S. Cevoli ◽  
G. Pierangeli ◽  
S. Zanigni ◽  
D. Grimaldi ◽  
...  

Cephalalgia ◽  
2005 ◽  
Vol 25 (10) ◽  
pp. 795-800 ◽  
Author(s):  
A Chakravarty

Chronic Daily Headache (CDH) is uncommon in Indian children compared to their adult counterpart. This is a retrospective study looking at the headache phenomenology of CDH in Indian children and adolescents. The validity of the case definitions of subtypes of chronic primary headaches mentioned in the HIS 2004 classification have been evaluated. 22 children (age range 8-15 years; M : F-16 : 6) diagnosed as having primary CDH using a modified definition seen between 2002 and 2003 have been studied. CDH has been defined as daily or near daily headaches > 15d/month for > 6 weeks. The rationale for this modified definition has been discussed. Majority of children (15/22) had a more or loss specified time of onset of regular headache spells resembling New Daily Persistent Headache (NDPH) but did not fulfil totally the diagnostic criteria of NDPH as laid down by IHS 2004. In all cases headache phenomenology included a significant vascular component. Headache phenomenology closely resembled Chronic Tension Type Headache (CTTH) in 4 patients and Chronic Migraine in 3 patients. However, in no patient in these groups, a history of evolution from the episodic forms of the diseases could be elicited. Heightened level of anxiety mostly related to academic stress and achievement was noted in the majority (19/22). Only a minority of patients (3/22) had anxiety and depression related to interpersonal relationships in the family. Medication overuse was not implicated in any patient. CDH in children in India is very much different from CDH in adults with the vast majority of patients exhibiting overlapping features of migraine and tension-type headache. There is need for a modified diagnostic criteria and terminology for chronic primary headaches in children.


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