Common Migraine: Criteria for Diagnosis

Solomon, Seymour; Cappa, Karen Guglielmo; Smith, Charles R.

doi:10.1111/j.1526-4610.1988.hed2802124.x

Cited by 18 publications

(11 citation statements)

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“…A previous study validated the IH S criteria on a clinical sample of 81 headache sufferers, but its aim was to compare diagnosis using IHS criteria and previous N IH criteria [10]. The authors found a good correlation between the two classifications [11]; the IH S criteria can not, however, be considered as the reference for the diagnosis of migraine [12,13].…”

Section: Discussionmentioning

confidence: 96%

Validity of the International Headache Society Criteria for Migraine

et al. 1993

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For general practitioners and in epidemiological studies, migraine poses diagnostic problems. It is a polymorphous disease, with diagnosis based on a subjective description of symptoms. The International Headache Society (IHS) proposed a set of rigorous criteria for the diagnosis of migraine. We studied its validity on 171 outpatients of headache clinics and on 96 headache sufferers detected during an annual checkup for workers. The criteria showed an excellent specificity, however sensitivity in both samples was <50%. This lack of validity could be due to IHS criteria being too restrictive. We therefore elaborated and validated our own diagnostic tool, based on the IHS criteria, to a sensitivity of 95% and a specificity of 78%. We propose our tool for epidemiological studies.

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Section: Discussionmentioning

confidence: 96%

Validity of the International Headache Society Criteria for Migraine

et al. 1993

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“…This abnormal power spectrum may provide an additional criteria for the diagnosis of migraine. 20,22 Migraine patients treated with propranolol (group A) present a clear reduction to normal level, in the power of HR fluctuations in the frequency range below 0.1 Hz. 20 This low frequency range is mediated by combined vagal and sympathetic nervous control.…”

Section: Discussionmentioning

confidence: 99%

“…In establishing the diagnosis, criteria based on the Ad-Hoc Committee (1962) were utilized. 21,22 All patients had their ECG recorded with the same Holter recorder. All of them were admitted to the hospital 24h prior to the Holter study, which took place during a headache free interval.…”

Section: Subjectsmentioning

confidence: 99%

Propranolol in the Prophylaxis of Migraine ‐ Evaluation by Spectral Analysis of Beat‐to‐Beat Heart Rate Fluctuations

et al. 1992

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Migraine patients seem to suffer from a continuous autonomic imbalance. Sympathetic instability, expressed by enhanced low frequency fluctuations, which exists during the headache free intervals, was observed in our previous study by spectral analysis of heart rate (HR) fluctuations. Propranolol--a beta adrenoceptor antagonist, is widely used in migraine prophylaxis. In order to specify and quantitate propranolol efficacy in migraine, spectral analysis of heart rate fluctuations was performed on 10 migraine patients before and during the treatment with propranolol. They were compared to 10 healthy control patients and 6 migraine patients who were treated for several months with propranolol and then discontinued the medication. The analysis was carried out on a 24h Holter ECG recording, which was performed for each subject during a headache free interval. Short 256 sec subtraces, taken every 30 min from the 24h ECG signal, were submitted to A/D conversion, R wave detection and computation of heart rate power spectrum. Propranolol achieved a marked effect, when comparing the power spectra of HR fluctuations in treated versus untreated migraine patients. A strong reduction (to normal level) in the low frequency HR fluctuations in the range below 0.1 Hz., was apparent in patients treated with propranolol. Subjects who had received propranolol in the past and discontinued the drug, displayed a carry-over effect of reduced fluctuations even 2-3 months after its discontinuation. It seems that the propranolol efficacy in migraine is associated with the mechanism of stabilizing the fluctuations within the frequency band related to sympathetic activity, hereby moderating the vascular instability in migraine.

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“…19,20 No cluster headache or mixed vascular headache patients were included. All patients suffered from migraine, diagnosed according to the Ad-Hoc Committee on Classification of Headache.…”

Section: Subjectsmentioning

confidence: 99%

Evidence for Instability of the Autonomic Nervous System in Patients With Migraine Headache

et al. 1992

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Autonomic impairment in migraine is well documented. In order to evaluate the autonomic control in migraine, spectral analysis of heart rate fluctuations was performed on ten migraine patients, drug-free and during the inter-headache phase. They were compared to nine healthy controls and eight tension headache patients. A 24h Holter recording of ECG was performed for each subject. Every half hour, a short ECG subtrace was digitized and submitted to R wave detection, followed by computation of heart rate power spectrum. The spectral analysis of heart rate fluctuations disclosed significant differences between control subjects and patients with migraine. The migraine patients displayed markedly enhanced low frequency fluctuations (below 0.1 sec-1), during day hours (p less than 0.01) and especially at night (p less than 0.0006). In the respiratory frequency band (between 0.2 and 0.4 sec-1) no significant change was observed. Tension headache patients however, resembled the controls in that they did not display enhanced low frequency fluctuations. The enhancement at low frequencies fluctuations only, a frequency range known to be related to vasomotor control, suggests that the migraine patients are characterized by a clear sympathetic instability. This finding supports the hypothesis that migraine is of neural origin and is consistent with the observation of large variations in regional cerebral flow. Spectral analysis of heart rate fluctuations allows us to specify and quantitate this autonomic imbalance and may provide a useful tool for the evaluation of drug therapy in migraine.

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Common Migraine: Criteria for Diagnosis

Cited by 18 publications

References 0 publications

Validity of the International Headache Society Criteria for Migraine

Validity of the International Headache Society Criteria for Migraine

Propranolol in the Prophylaxis of Migraine ‐ Evaluation by Spectral Analysis of Beat‐to‐Beat Heart Rate Fluctuations

Evidence for Instability of the Autonomic Nervous System in Patients With Migraine Headache

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