The International Classification of Headache Disorders, 3rd Edition (ICHD III) – Changes and Challenges

Abstract

In order to effectively study and manage headache disorders, diagnosis is essential. In both research and clinical arenas, separating secondary causes from primary headache disorders is a crucial first step, followed by further specificity within these broader categories. Historical approaches to classifying headache disorders culminated in the International Classification of Headache Disorders (ICHD), completed and published in 1988. This was revised as the International Classification of Headache Disorders, 2nd Edition (ICHD II) in 2004. The International Headache Society's Subcommittee on Classification began work on the 3rd edition in 2010, and has just published this online and in the journal Cephalalgia. The diagnostic criteria for more than 200 causes of headaches are based upon evidence when available, and fortunately, recent research in the field of headache medicine has produced data applicable to the refinement of classification of a number of primary and secondary headache disorders. Some areas, however, await further study, making classification more challenging. This article will attempt to provide an overview of the rationale behind the ICHD, a guide to its use, and a summary of important diagnostic features of the primary and secondary headaches, particularly where these have changed significantly in the ICHD III from ICHD II.

Prolonged Effect of OnabotulinumtoxinA on Chronic Migraine in 87 Koreans

“…OnabotulinumtoxinA (BOTOX) has been approved for prophylaxis in chronic migraine (CM) since 20101 based on the findings of the Phase 3 REsearch Evaluating Migraine Prophylaxis Therapy (PREEMPT) trial 2. The duration of BOTOX efficacy is known to be 3 months, but prolonged efficacy (>3 months) after a single cycle of BOTOX has not been evaluated thoroughly.…”

Migraines in Women: Current Evidence for Management of Episodic and Chronic Migraines

“…The pathophysiology of medication overuse headache is unclear; however, hyperexcitability of neurons in the cerebral cortex and the trigeminal system have been demonstrated . It may be difficult to determine whether medication overuse headache is a cause or effect of chronic migraines, and the International Classification of Headache Disorders, 3rd Edition (beta version) recommends diagnosing both if someone meets the criteria …”

“…Risk factors for progression of episodic migraines to chronic migraines are older age, female gender, Caucasian, low education and socioeconomic status, and a family history of migraine. Obesity, snoring, depression, and stressful life events have also been noted as risk factors for developing chronic migraines …”

Klassifikation von Kopfschmerzen

“…Diagnostische Sicherheit Um in der klinischen Praxis eine Kopfschmerzart anhand der ICHD-Kopfschmerz-Klassifikation zu diagnostizieren, müssen ausnahmslos alle diesbezüglichen diagnostischen ICHD-Kriterien erfüllt sein. Falls sämtliche Kriterien bis auf eines erfüllt sind, kann eine Diagnose als "wahrscheinlich" gelten [6]. Demgemäß kann dann als Diagnose bspw.…”