Use of the ICHD‐II Criteria in the Diagnosis of Pediatric Migraine

Abstract

Modification of ICHD-II criteria to include bilateral headache, headache duration of 1 to 72 hours, and nausea and/or vomiting plus two of five other associated symptoms (photophobia, phonophobia, difficulty thinking, lightheadedness, or fatigue), in addition to the usual description of moderate to severe pain of a throbbing or pulsating nature worsening or limiting physical activity, improved sensitivity of migraine diagnosis to 84.4%.

Novel Mutation Confirms Seizure Locus SCN1A is Also Familial Hemiplegic Migraine Locus FHM3

“…The difference in phenotype of Patient 1 and 2, while potentially attributable to the well-recognized variant presentation of migraine in children [17], is substantial even though they share the same major pathogenic allele and half of the alleles at other, potentially modifying, loci. This family also presents the second SCN1A allele associated with a migraine syndrome that, while not itself strictly FHM, is similar to syndromes caused at the two other established FHM loci, confirming that the SCN1A gene itself is the FHM3 locus, not some other gene in tight linkage disequilibrium.…”

Prevalences of primary headache symptoms at school-entry: a population-based epidemiological survey of preschool children in Germany

“…Nevertheless there are many recognised problems within the diagnostic process. The 2004 IHS classification for headaches [25] and the ROME-II criteria for abdominal pain [26], to be revised as Rome-III in 2006, are widely accepted but also criticised examples [27][28][29][30]. When reimplementing resulting descriptive classification rules to clinical practice, the paediatrist, for example, in his attempt to diagnose the observed pain symptoms of a certain child at a given time, meets problems, which have been described earlier [8,11,28,[30][31][32].…”

“…The 2004 IHS classification for headaches [25] and the ROME-II criteria for abdominal pain [26], to be revised as Rome-III in 2006, are widely accepted but also criticised examples [27][28][29][30]. When reimplementing resulting descriptive classification rules to clinical practice, the paediatrist, for example, in his attempt to diagnose the observed pain symptoms of a certain child at a given time, meets problems, which have been described earlier [8,11,28,[30][31][32]. Additionally, results from epidemiological studies of headache and abdominal pain vary not only due to differences between study populations, methods, diagnostic criteria and their interpretations, but also because pain symptoms show extremely diverse interindividual variations over time [27][28][29][30][31][32][33][34].…”

“…When reimplementing resulting descriptive classification rules to clinical practice, the paediatrist, for example, in his attempt to diagnose the observed pain symptoms of a certain child at a given time, meets problems, which have been described earlier [8,11,28,[30][31][32]. Additionally, results from epidemiological studies of headache and abdominal pain vary not only due to differences between study populations, methods, diagnostic criteria and their interpretations, but also because pain symptoms show extremely diverse interindividual variations over time [27][28][29][30][31][32][33][34]. According to Sillanpää and Abu-Arafeh [11], problems in defining and classifying primary headache in children proliferate because the clinical phenomenology is not always clear enough and sometimes overlaps.…”

“…The aim of a recently published article [30] was to compare the power of different classification systems (clinical diagnosis, ICHD-I, ICHD-II, ICHD-IIA [25,38] using the expert opinion as the gold standard) when retrospectively rediagnosing 260 children treated in two headache centres assuming that "the criteria were not changed to allow these exceptions, but rather introduced with the assumption that further investigation was needed before these could be adopted" [30].…”