Diagnosis of Migraine: Empirical Analysis of a Large Clinical Sample of Atypical Migraine (IHS 1.7) Patients and Proposed Revision of the IHS Criteria
The International Headache Society (IHS) diagnostic criteria for headache improved the accuracy of primary headache diagnoses, including migraine. However, many migraineurs receive an ‘atypical migraine’ diagnosis according to the IHS nosology (IHS 1.7), indicating that they approximate but do not f...
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| Veröffentlicht in: | Cephalalgia 2001-06, Vol.21 (5), p.584-595 |
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| creator | Rains, JC Penzien, DB Lipchik, GL Ramadan, NM |
| description | The International Headache Society (IHS) diagnostic criteria for headache improved the accuracy of primary headache diagnoses, including migraine. However, many migraineurs receive an ‘atypical migraine’ diagnosis according to the IHS nosology (IHS 1.7), indicating that they approximate but do not fully meet all IHS criteria. This study characterized and sub-classified patients with atypical migraine. Within a clinical sample of 382 headache sufferers, 83 patients met IHS criteria for ‘atypical migraine’. Patients receiving the IHS 1.7 designation did not converge to form a homogeneous group. Rather, distinct and clinically relevant subgroups were empirically derived (e.g. migraine with atypical pain parameters, brief migraine, chronic migraine). The results call for revisions of the IHS diagnostic criteria for migraine that would minimize the number of patients receiving an atypical diagnosis. Revisions would include decreasing the minimum headache duration criteria from 4 h to 2 h, and developing a classification for ‘chronic migraine’ for migraine greater than 15 days per month. The proposed revision provides a means of diagnosing the daily and near-daily headache commonly observed in clinical populations. |
| doi_str_mv | 10.1046/j.1468-2982.2001.00210.x |
| format | Article |
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However, many migraineurs receive an ‘atypical migraine’ diagnosis according to the IHS nosology (IHS 1.7), indicating that they approximate but do not fully meet all IHS criteria. This study characterized and sub-classified patients with atypical migraine. Within a clinical sample of 382 headache sufferers, 83 patients met IHS criteria for ‘atypical migraine’. Patients receiving the IHS 1.7 designation did not converge to form a homogeneous group. Rather, distinct and clinically relevant subgroups were empirically derived (e.g. migraine with atypical pain parameters, brief migraine, chronic migraine). The results call for revisions of the IHS diagnostic criteria for migraine that would minimize the number of patients receiving an atypical diagnosis. Revisions would include decreasing the minimum headache duration criteria from 4 h to 2 h, and developing a classification for ‘chronic migraine’ for migraine greater than 15 days per month. 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However, many migraineurs receive an ‘atypical migraine’ diagnosis according to the IHS nosology (IHS 1.7), indicating that they approximate but do not fully meet all IHS criteria. This study characterized and sub-classified patients with atypical migraine. Within a clinical sample of 382 headache sufferers, 83 patients met IHS criteria for ‘atypical migraine’. Patients receiving the IHS 1.7 designation did not converge to form a homogeneous group. Rather, distinct and clinically relevant subgroups were empirically derived (e.g. migraine with atypical pain parameters, brief migraine, chronic migraine). The results call for revisions of the IHS diagnostic criteria for migraine that would minimize the number of patients receiving an atypical diagnosis. Revisions would include decreasing the minimum headache duration criteria from 4 h to 2 h, and developing a classification for ‘chronic migraine’ for migraine greater than 15 days per month. The proposed revision provides a means of diagnosing the daily and near-daily headache commonly observed in clinical populations.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age of Onset</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>chronic daily headache</subject><subject>Diagnosis, Computer-Assisted</subject><subject>Diagnosis, Differential</subject><subject>Diagnosis-Related Groups</subject><subject>Drug Utilization</subject><subject>Female</subject><subject>Headache</subject><subject>Headache - classification</subject><subject>Headache Disorders - diagnosis</subject><subject>Headache Disorders - epidemiology</subject><subject>Humans</subject><subject>IHS</subject><subject>Male</subject><subject>Middle Aged</subject><subject>migraine</subject><subject>Migraine Disorders - classification</subject><subject>Migraine Disorders - diagnosis</subject><subject>Migraine Disorders - epidemiology</subject><subject>Migraine with Aura - diagnosis</subject><subject>Migraine with Aura - epidemiology</subject><subject>Migraine without Aura - diagnosis</subject><subject>Migraine without Aura - epidemiology</subject><subject>nosology</subject><subject>Pain Clinics - statistics & numerical data</subject><subject>Tension-Type Headache - diagnosis</subject><subject>Tension-Type Headache - epidemiology</subject><subject>Time Factors</subject><issn>0333-1024</issn><issn>1468-2982</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUcuO0zAUtRCIKQO_gLxCsGi4tlMnRmJRhUJHKqJiYG3dJE5xlcQZO4Xpj_C9OG2BJax85fOw7zmEUAYJg1S-3icslfmcq5wnHIAlADxi9w_I7A_wkMxACDFnwNMr8iSEPQAsJMjH5IqxNOMiX8zIz3cWd70LNlDX0I9259H25g1ddYP1tsKWLntsjxcc6Qb9ztCitf0JvMVuaM0ELcfjcLr67UFf3qxvKUuyV3SLozX9GCj2Nd16N7hgavrZfLfBun5Sj98MneiFt6PxFp-SRw22wTy7nNfk6_vVl2I933z6cFMsN_MqlQzinqlSnENeYiYNSm5EVTWZqlipBKicqUamTVnXAHldgixrwFxkKatTWQqF4pq8OPsO3t0dTBh1Z0Nl2hZ74w5BZzFuyBSLxPxMrLwLwZtGD9526I-agZ460Xs9Ra-n6PXUiT51ou-j9PnljUPZmfqv8FJCJLw9E37Y1hz_21gXq-06TlG_OOsD7ozeu4OPlYV_f-wXWv2pcQ</recordid><startdate>200106</startdate><enddate>200106</enddate><creator>Rains, JC</creator><creator>Penzien, DB</creator><creator>Lipchik, GL</creator><creator>Ramadan, NM</creator><general>SAGE Publications</general><general>Blackwell Science Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200106</creationdate><title>Diagnosis of Migraine: Empirical Analysis of a Large Clinical Sample of Atypical Migraine (IHS 1.7) Patients and Proposed Revision of the IHS Criteria</title><author>Rains, JC ; Penzien, DB ; Lipchik, GL ; Ramadan, NM</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4610-294992208ba76ea62e3ccf79c1b9309819f64fbdd008db06bd0a83741d46b39a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age of Onset</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>chronic daily headache</topic><topic>Diagnosis, Computer-Assisted</topic><topic>Diagnosis, Differential</topic><topic>Diagnosis-Related Groups</topic><topic>Drug Utilization</topic><topic>Female</topic><topic>Headache</topic><topic>Headache - classification</topic><topic>Headache Disorders - diagnosis</topic><topic>Headache Disorders - epidemiology</topic><topic>Humans</topic><topic>IHS</topic><topic>Male</topic><topic>Middle Aged</topic><topic>migraine</topic><topic>Migraine Disorders - classification</topic><topic>Migraine Disorders - diagnosis</topic><topic>Migraine Disorders - epidemiology</topic><topic>Migraine with Aura - diagnosis</topic><topic>Migraine with Aura - epidemiology</topic><topic>Migraine without Aura - diagnosis</topic><topic>Migraine without Aura - epidemiology</topic><topic>nosology</topic><topic>Pain Clinics - statistics & numerical data</topic><topic>Tension-Type Headache - diagnosis</topic><topic>Tension-Type Headache - epidemiology</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rains, JC</creatorcontrib><creatorcontrib>Penzien, DB</creatorcontrib><creatorcontrib>Lipchik, GL</creatorcontrib><creatorcontrib>Ramadan, NM</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cephalalgia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Rains, JC</au><au>Penzien, DB</au><au>Lipchik, GL</au><au>Ramadan, NM</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnosis of Migraine: Empirical Analysis of a Large Clinical Sample of Atypical Migraine (IHS 1.7) Patients and Proposed Revision of the IHS Criteria</atitle><jtitle>Cephalalgia</jtitle><addtitle>Cephalalgia</addtitle><date>2001-06</date><risdate>2001</risdate><volume>21</volume><issue>5</issue><spage>584</spage><epage>595</epage><pages>584-595</pages><issn>0333-1024</issn><eissn>1468-2982</eissn><abstract>The International Headache Society (IHS) diagnostic criteria for headache improved the accuracy of primary headache diagnoses, including migraine. However, many migraineurs receive an ‘atypical migraine’ diagnosis according to the IHS nosology (IHS 1.7), indicating that they approximate but do not fully meet all IHS criteria. This study characterized and sub-classified patients with atypical migraine. Within a clinical sample of 382 headache sufferers, 83 patients met IHS criteria for ‘atypical migraine’. Patients receiving the IHS 1.7 designation did not converge to form a homogeneous group. Rather, distinct and clinically relevant subgroups were empirically derived (e.g. migraine with atypical pain parameters, brief migraine, chronic migraine). The results call for revisions of the IHS diagnostic criteria for migraine that would minimize the number of patients receiving an atypical diagnosis. Revisions would include decreasing the minimum headache duration criteria from 4 h to 2 h, and developing a classification for ‘chronic migraine’ for migraine greater than 15 days per month. 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| source | Sage Journals GOLD Open Access 2024 |
| subjects | Adolescent Adult Age of Onset Aged Aged, 80 and over chronic daily headache Diagnosis, Computer-Assisted Diagnosis, Differential Diagnosis-Related Groups Drug Utilization Female Headache Headache - classification Headache Disorders - diagnosis Headache Disorders - epidemiology Humans IHS Male Middle Aged migraine Migraine Disorders - classification Migraine Disorders - diagnosis Migraine Disorders - epidemiology Migraine with Aura - diagnosis Migraine with Aura - epidemiology Migraine without Aura - diagnosis Migraine without Aura - epidemiology nosology Pain Clinics - statistics & numerical data Tension-Type Headache - diagnosis Tension-Type Headache - epidemiology Time Factors |
| title | Diagnosis of Migraine: Empirical Analysis of a Large Clinical Sample of Atypical Migraine (IHS 1.7) Patients and Proposed Revision of the IHS Criteria |
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