Categories
Change Password!
Reset Password!
Diagnostic criteria shape clinical trial inclusion and treatment. International Classification of Headache Disorders-Third Edition (ICHD-3) distinguishes migraine from tension-type headaches based on symptoms, requiring features like photophobia, phonophobia, or nausea/vomiting for diagnosis.
Broadening the diagnostic criteria for migraine in youth could better capture the full range of migraine symptoms, urging updates to the International Classification of Headache Disorders-4th edition (ICHD-4).
Diagnostic criteria shape clinical trial inclusion and treatment. International Classification of Headache Disorders-Third Edition (ICHD-3) distinguishes migraine from tension-type headaches based on symptoms, requiring features like photophobia, phonophobia, or nausea/vomiting for diagnosis.
Cluster Analysis of Migraine-associated Symptoms (CAMS) suggests a broader spectrum of symptoms which may better capture migraine burden in the young population. This multisite retrospective cross-sectional study was performed to evaluate the current ICHD-3 migraine-associated symptoms benchmarks utilising CAMS.
The ICHD-3 migraine criteria were assessed in children (aged 6 to 17 years) with migraine (including migraine-like headache or probable migraine) or tension-type headaches (TTH). CAMS was used to analyze the migraine-associated symptom criterion and gauge how modifications to it impacted the migraine diagnosis.
This study included 9,017 participants (66.7% female; median age of 13 years). The majority had migraine or probable migraine (99%), while the remaining 1% had TTH. Among those with migraine, 10.1% were diagnosed with probable migraine due to not meeting criterion D for migraine-associated symptoms, though many reported additional non-ICHD symptoms.
Modifying criterion D based on CAMS reclassified 55.6% of youth as having migraine when photophobia (fear of light) or phonophobia (fear of or aversion to loud sound) were considered, although some had only 1 symptom.
Including lightheadedness or both lightheadedness and spinning reclassified 19.7% and 25.8% of youth with migraine, respectively, all of whom had at least 2 symptoms related to migraine.
Many common migraine-associated symptoms have been included in the ICHD-3. Still, many youths with probable migraine who don't meet the full criteria due to a lack of sufficient associated symptoms encounter several non-ICHD symptoms. Amendments to criterion D should be deliberated for the ICHD-4.
Headache
A critical appraisal of the International Classification of Headache Disorders migraine diagnostic criteria based on a retrospective multicenter cross-sectional headache registry study in youth
Carlyn Patterson Gentile et al.
Comments (0)