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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
PubMed

Insights

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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