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Headache classification: criticism and suggestions.
Neurol Sci. 2004 Oct; 25 Suppl 3:S67-9.NS

Abstract

The International Classification of Headache Disorders 2nd Edition (ICHD-II), published in 2004, marks an unquestionable progress from the preceding 1988 edition, but the in-depth analysis it offers is not immune from drawbacks and shortcomings. First of all, it is still basically a classification of attacks and not of syndromes. For the migraine group, while the revised classification more accurately characterises migraine with aura, it fails to provide a sufficiently structured description of those forms of migraine without aura that over the years evolve to so-called daily chronic forms. These forms are not adequately recognised as chronic migraine, which ICHD-II includes among the complications of migraine. The inclusion of short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) in the cluster headache group is bound to generate some perplexity, while the recognition of new daily persistent headache (NDPH) included in the group of other primary headaches as a separate clinical entity appears somewhat premature. Doubts are also raised by the actual existence of triptan-overuse headache, which ICHD-II includes in Group 8 among medication-overuse headaches. Finally, the addition of headache attributed to psychiatric disorder, which is certainly a good option in perspective, is not yet supported by an adequate systematisation.

Authors+Show Affiliations

Manzoni GC
Headache Centre, Section of Neurology, Department of Neuroscience, University of Parma, I-43100 Parma, Italy. manzoni@ipruniv.cce.unipr.it
Torelli P
No affiliation info available

MeSH

Cluster HeadacheDiagnosis, DifferentialHeadache DisordersHumansMental DisordersMigraine DisordersMigraine with AuraTension-Type HeadacheTerminology as Topic

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15549572

Citation

Manzoni, G C., and P Torelli. "Headache Classification: Criticism and Suggestions." Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, vol. 25 Suppl 3, 2004, pp. S67-9.
Manzoni GC, Torelli P. Headache classification: criticism and suggestions. Neurol Sci. 2004;25 Suppl 3:S67-9.
Manzoni, G. C., & Torelli, P. (2004). Headache classification: criticism and suggestions. Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 25 Suppl 3, S67-9.
Manzoni GC, Torelli P. Headache Classification: Criticism and Suggestions. Neurol Sci. 2004;25 Suppl 3:S67-9. PubMed PMID: 15549572.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Headache classification: criticism and suggestions. AU - Manzoni,G C, AU - Torelli,P, PY - 2004/11/19/pubmed PY - 2005/1/6/medline PY - 2004/11/19/entrez SP - S67 EP - 9 JF - Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology JO - Neurol Sci VL - 25 Suppl 3 N2 - The International Classification of Headache Disorders 2nd Edition (ICHD-II), published in 2004, marks an unquestionable progress from the preceding 1988 edition, but the in-depth analysis it offers is not immune from drawbacks and shortcomings. First of all, it is still basically a classification of attacks and not of syndromes. For the migraine group, while the revised classification more accurately characterises migraine with aura, it fails to provide a sufficiently structured description of those forms of migraine without aura that over the years evolve to so-called daily chronic forms. These forms are not adequately recognised as chronic migraine, which ICHD-II includes among the complications of migraine. The inclusion of short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) in the cluster headache group is bound to generate some perplexity, while the recognition of new daily persistent headache (NDPH) included in the group of other primary headaches as a separate clinical entity appears somewhat premature. Doubts are also raised by the actual existence of triptan-overuse headache, which ICHD-II includes in Group 8 among medication-overuse headaches. Finally, the addition of headache attributed to psychiatric disorder, which is certainly a good option in perspective, is not yet supported by an adequate systematisation. SN - 1590-1874 UR - https://www.unboundmedicine.com/medline/citation/15549572/Headache_classification:_criticism_and_suggestions_ DB - PRIME DP - Unbound Medicine ER -