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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

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Proposal for a new classification of chronic headache.

G C Manzoni¹, P Torelli

¹Centro Cefalee, Istituto di Neurologia, Dipartimento di Neuroscienze, University of Parma, c/o Azienda Ospedaliero-Universitaria (Padiglione Barbieri, 3 degrees piano), Via Gramsci, 14, 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 14, 2010

Summary

This study proposes revisions to the International Classification of Headache Disorders (ICHD-2) to refine diagnoses for chronic daily headache, chronic migraine, and medication overuse headache, enhancing diagnostic clarity.

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Area of Science:

Neurology
Headache Medicine

Background:

The International Classification of Headache Disorders (ICHD-2) has been a subject of debate since its 2004 publication, particularly concerning chronic daily headache, chronic migraine, and medication overuse headache.
Current classifications may not fully capture the nuances of these headache types, leading to diagnostic challenges.

Purpose of the Study:

To propose specific modifications to the ICHD-2 diagnostic criteria.
To improve the classification and diagnosis of chronic migraine and medication overuse headache.

Main Methods:

Review and analysis of existing knowledge and observations on chronic daily headache disorders.
Proposal of specific changes to the ICHD-2 criteria, including frequency-based differentiation and reclassification of certain headache types.

Main Results:

Recommends differentiating migraine without aura into infrequent, frequent, and very frequent categories based on attack frequency.
Suggests including transformed migraine as a complication of migraine (coded 1.5.1), replacing chronic migraine, with modified temporal criteria.
Proposes differentiating transformed migraine based on symptomatic medication overuse (≥20 days/month) and moving medication overuse headache to an appendix for further definition.

Conclusions:

The proposed changes aim to enhance the precision of headache disorder classification.
These revisions are expected to improve the clinical diagnosis and management of patients with chronic daily headache, chronic migraine, and medication overuse headache.