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Chronically evolving headaches: classification and terminology.

G C Manzoni1, G Lambru, P Torelli

  • 1Istituto di Neurologia, Dipartimento di Neuroscienze, Ospedale Maggiore di Parma, Viale Gramsci 14, I-43100, Parma, Italy. giancamillo.manzoni@unipr.it

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|May 12, 2006
PubMed
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The International Classification of Headache Disorders (ICHD-II) criteria for chronic migraine need revision. Current definitions may not fully capture migraine evolution, necessitating updates to include transformed migraine.

Area of Science:

  • Neurology
  • Headache Medicine

Background:

  • Chronic migraine was first classified in the International Classification of Headache Disorders (ICHD-II) in 2004 as a complication of migraine.
  • Current ICHD-II diagnostic criteria for chronic migraine may inaccurately equate it with high-frequency migraine attacks, rather than a progression of the condition.

Purpose of the Study:

  • To propose a revision of the ICHD-II diagnostic criteria for migraine.
  • To refine the classification of chronic migraine and introduce 'transformed migraine' as a distinct complication.

Main Methods:

  • Analysis of existing diagnostic criteria for chronic migraine within the ICHD-II framework.
  • Review of clinical descriptions and terminology related to migraine evolution, including 'transformed migraine'.

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Main Results:

  • The current ICHD-II criteria for chronic migraine require revision to better reflect disease progression.
  • A distinction is needed between high-frequency episodic migraine and migraine with a loss of symptom-free intervals.

Conclusions:

  • The ICHD-II should be revised to subdivide migraine into infrequent episodic, frequent episodic, and chronic categories at the three-digit level.
  • Transformed migraine should be formally introduced as a complication of migraine within the ICHD-II classification.