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Field testing of the ICHD-3β and expert opinion criteria for chronic migraine.
J Headache Pain. 2016 Dec; 17(1):85.JH

Abstract

BACKGROUND

Chronic headache (CrH) occurs commonly in the population, and chronic migraine (CM) accounts for much of the CrH. Diagnostic criteria for CM remain controversial, and this could lead to undertreatment of CM. The purpose of this study was to analyze the clinical profiles of CM and to field test the International Classification of Headache Disorders-3β criteria (ICHD-3β) and Expert Opinion criteria (EO) for CM application.

METHODS

We retrospectively reviewed the medical records of CrH patients in our headache clinic during the period. Eligible patients were selected from CrH population based on Silberstein and Lipton criteria (S-L) for CM, and meanwhile fulfilled with migraine days at least 8 days/month. Then we evaluated the characteristics of clinic profiles and outcomes between patients diagnosed CM using ICHD-3β and EO criteria. Field tested the CM criteria Of ICHD-3β and EO.

RESULTS

In a total of 710 CrH patients , 261 (36.8 %) were recruited with CM based on both S-L criteria and fulfilled at least 8 migraine days/month. Be understandable, all the 261 patients met the EO criteria, and only 185 (70.9 %) met ICHD-3β for CM. For the 76 patients who met EO but not ICHD-3β, 70 had atypical migraine attacks (probable migraine, PM), and another 6 had typical migraine attacks but less than a total history of 5 attacks. Although 173 (66.3 %) were concurrent with medication overuse, just one patient overused triptans and none used ergot agents. Clinical features were not significantly different between the ICHD-3β and EO criteria groups (P > 0.05), and neither were outcomes of prophylaxis (P = 0.966). Total migraine prophylaxis effectiveness was 73 %.

CONCLUSION

Migraine-specific analgesics are rarely used in China, permitting patients with PM to avail themselves of "migraine days" is a reasonable accommodation for this difficult condition. In our hands, use of the new EO criteria for diagnosis of CM increases the sensitivity and maintains the specificity of decision making, and therefore should be adopted in CM management practice.

Authors+Show Affiliations

Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1st You Yi Road, Yu Zhong District, Chongqing, 400016, China.Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1st You Yi Road, Yu Zhong District, Chongqing, 400016, China.Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1st You Yi Road, Yu Zhong District, Chongqing, 400016, China.Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1st You Yi Road, Yu Zhong District, Chongqing, 400016, China.Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1st You Yi Road, Yu Zhong District, Chongqing, 400016, China.Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1st You Yi Road, Yu Zhong District, Chongqing, 400016, China.Department of Neurology, The first people's Hospital of Jintang County, Sichuan, China.Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1st You Yi Road, Yu Zhong District, Chongqing, 400016, China. zheadache@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27644255

Citation

Jiang, Huahua, et al. "Field Testing of the ICHD-3β and Expert Opinion Criteria for Chronic Migraine." The Journal of Headache and Pain, vol. 17, no. 1, 2016, p. 85.
Jiang H, Deng Y, Zhang Y, et al. Field testing of the ICHD-3β and expert opinion criteria for chronic migraine. J Headache Pain. 2016;17(1):85.
Jiang, H., Deng, Y., Zhang, Y., Jin, J., Kong, X., Zhu, Q., Wang, K., & Zhou, J. (2016). Field testing of the ICHD-3β and expert opinion criteria for chronic migraine. The Journal of Headache and Pain, 17(1), 85. https://doi.org/10.1186/s10194-016-0678-x
Jiang H, et al. Field Testing of the ICHD-3β and Expert Opinion Criteria for Chronic Migraine. J Headache Pain. 2016;17(1):85. PubMed PMID: 27644255.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Field testing of the ICHD-3β and expert opinion criteria for chronic migraine. AU - Jiang,Huahua, AU - Deng,Yong, AU - Zhang,Yixin, AU - Jin,Jieli, AU - Kong,Xueying, AU - Zhu,Qiuwen, AU - Wang,Kuiyun, AU - Zhou,Jiying, Y1 - 2016/09/19/ PY - 2016/07/27/received PY - 2016/09/13/accepted PY - 2016/9/21/entrez PY - 2016/9/21/pubmed PY - 2017/1/4/medline KW - Chronic disease KW - Humans KW - International classification of diseases KW - Migraine disorders/classifications KW - Migraine disorders/diagnosis SP - 85 EP - 85 JF - The journal of headache and pain JO - J Headache Pain VL - 17 IS - 1 N2 - BACKGROUND: Chronic headache (CrH) occurs commonly in the population, and chronic migraine (CM) accounts for much of the CrH. Diagnostic criteria for CM remain controversial, and this could lead to undertreatment of CM. The purpose of this study was to analyze the clinical profiles of CM and to field test the International Classification of Headache Disorders-3β criteria (ICHD-3β) and Expert Opinion criteria (EO) for CM application. METHODS: We retrospectively reviewed the medical records of CrH patients in our headache clinic during the period. Eligible patients were selected from CrH population based on Silberstein and Lipton criteria (S-L) for CM, and meanwhile fulfilled with migraine days at least 8 days/month. Then we evaluated the characteristics of clinic profiles and outcomes between patients diagnosed CM using ICHD-3β and EO criteria. Field tested the CM criteria Of ICHD-3β and EO. RESULTS: In a total of 710 CrH patients , 261 (36.8 %) were recruited with CM based on both S-L criteria and fulfilled at least 8 migraine days/month. Be understandable, all the 261 patients met the EO criteria, and only 185 (70.9 %) met ICHD-3β for CM. For the 76 patients who met EO but not ICHD-3β, 70 had atypical migraine attacks (probable migraine, PM), and another 6 had typical migraine attacks but less than a total history of 5 attacks. Although 173 (66.3 %) were concurrent with medication overuse, just one patient overused triptans and none used ergot agents. Clinical features were not significantly different between the ICHD-3β and EO criteria groups (P > 0.05), and neither were outcomes of prophylaxis (P = 0.966). Total migraine prophylaxis effectiveness was 73 %. CONCLUSION: Migraine-specific analgesics are rarely used in China, permitting patients with PM to avail themselves of "migraine days" is a reasonable accommodation for this difficult condition. In our hands, use of the new EO criteria for diagnosis of CM increases the sensitivity and maintains the specificity of decision making, and therefore should be adopted in CM management practice. SN - 1129-2377 UR - https://www.unboundmedicine.com/medline/citation/27644255/Field_testing_of_the_ICHD_3β_and_expert_opinion_criteria_for_chronic_migraine_ DB - PRIME DP - Unbound Medicine ER -