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Hemicrania continua: towards a new classification?
Fabio Antonaci1, Ottar Sjaastad
1Headache Centre, C, Mondino National Institute of Neurology Foundation, IRCCS, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy. fabio.antonaci@unipv.it.
The Journal of Headache and Pain
|February 15, 2014
Summary
The original description of hemicrania continua (HC) requires adherence. Proposed criteria for HC incorrectly include non-core symptoms, necessitating revision to accurately identify this distinct headache disorder.
Area of Science:
- Neurology
- Headache Medicine
- Clinical Classification
Background:
- Hemicrania continua (HC) was first described in 1984.
- Subsequent cases should align with the original clinical description.
- Current proposed classification criteria (ICHD 3rd edition beta) may misrepresent HC.
Purpose of the Study:
- To advocate for the preservation of the original definition of hemicrania continua.
- To argue for the removal of non-core symptoms from proposed HC classification criteria.
- To emphasize the need for revising the current beta version of HC diagnostic criteria.
Main Methods:
- Comparative analysis of original HC description versus proposed ICHD-3 beta criteria.
- Identification of core symptomatology versus extraneous features in HC.
- Literature review and clinical reasoning to support definitional accuracy.
Main Results:
- Proposed criteria incorporate localized, autonomic, and 'vascular' features not part of the original HC description.
- These added features do not represent the genuine, core symptomatology of HC.
- The current proposed criteria inaccurately label a different headache presentation as HC.
Conclusions:
- The original description of hemicrania continua is essential for accurate diagnosis.
- Features such as localized pain, autonomic features, and 'vascular' symptoms should be removed from HC criteria.
- A mandatory revision of the proposed ICHD-3 beta criteria for HC is required to reflect the genuine disorder.
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