Evaluation of diagnostic and prognostic value of clinical characteristics of Migraine and Tension type headache included in the diagnostic criteria for children and adolescents in International Classification of Headache Disorders - second edition

2012 ◽  
Vol 66 (12) ◽  
pp. 1168-1177 ◽  
Author(s):  
I. Pacheva ◽  
I. Milanov ◽  
I. Ivanov ◽  
R. Stefanov
Keyword(s):  
Children And Adolescents ◽  
Diagnostic Criteria ◽  
Prognostic Value ◽  
Clinical Characteristics ◽  
Tension Type Headache ◽  
International Classification ◽  
Headache Disorders ◽  
Type Headache ◽  
Diagnostic And Prognostic Value

scholarly journals Diagnostic value of combinations of symptoms of migraine and tension-type headache included in the diagnostic criteria for children and adolescents in the international classification of headache disorders 2nd edition

Folia Medica ◽  
2013 ◽  
Vol 55 (3-4) ◽  
pp. 46-55 ◽  
Author(s):  
Iliyana H. Pacheva ◽  
Ivan G. Milanov ◽  
Ivan S. Ivanov ◽  
Rumen S. Stefanov
Keyword(s):  
Physical Activity ◽  
Children And Adolescents ◽  
Diagnostic Criteria ◽  
Diagnostic Value ◽  
Tension Type Headache ◽  
Headache Disorders ◽  
Recurrent Headache ◽  
Severe Intensity ◽  
Type Headache

ABSTRACT AIM: To suggest diagnostic combinations of symptoms for migraine and tension type headache (TTH), and for differentiation of overlapping headache (classified as either migraine or TTH) through evaluation of the diagnostic value of combinations of characteristics included in the International Headache Society diagnostic criteria for migraine and TTH in children and adolescents. PATIENTS AND METHODS: The study comprised an epidemiological school-based study (412 of 1029 pupils with chronic / recurrent headache) and a clinical study conducted in the Pediatric Neurology Ward and outpatient clinic at Plovdiv Medical University Hospital (203 patients with chronic / recurrent headache). An inclusion criterion was at least two episodes of headache during the last year. Exclusion criteria were: headache occurring only during acute infections; withdrawal of informed consent. Headache was classified according to the International Classification of Headache Disorders 2nd edition (ICHD-II) The diagnostic value of all combinations of items in criteria C and D for migraine and TTH was measured by sensitivity, specificity, and odds ratio. RESULTS: The combination “unilateral location, severe intensity, aggravation by physical activity” had 100% specificity for migraine. The combination “bilateral location, pressingtightening quality, mild intensity, no aggravation by physical activity” had 100% specificity for TTH. The combinations: “migrainous location, severe intensity, aggravation by physical activity”, “severe intensity, nausea”, “pulsating quality, nausea”, “pulsating quality, migrainous location, aggravation by physical activity” seemed to pose the greatest risk for developing migraine. These combinations - “no nausea, no photophobia”, “bilateral location, mild intensity and either no aggravation by physical activity or pressing-tightening quality, or no nausea or no photophobia” increased the most the TTH risk. Using these combinations as additional criteria for overlapping headache we classi ed 50% of overlapping headache as TTH and 8.3% as migraine. CONCLUSIONS: Some combinations of symptoms clarify the diagnosis of migraine and TTH. More than 50% of overlapping headache could be differentiated as TTH or MWA by the proposed combinations.

scholarly journals Nosographic analysis of osmophobia and field testing of diagnostic criteria including osmophobia

Cephalalgia ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Mona Ameri Chalmer ◽  
Thomas Folkmann Hansen ◽  
Jes Olesen
Keyword(s):  
Diagnostic Criteria ◽  
Migraine Without Aura ◽  
Field Testing ◽  
Tension Type Headache ◽  
International Classification ◽  
Headache Disorders ◽  
Probable Migraine ◽  
Type Headache ◽  
Headache Patients

Introduction Osmophobia has been suggested as an additional symptom of migraine without aura, and a high prevalence of osmophobia of up to 50% has been reported in the literature. We conducted a nosographic study of osmophobia in all migraineurs and tension-type headache patients and a field testing of suggested diagnostic criteria of osmophobia, presented in the appendix of the second edition of The International Classification of Headache Disorders and suggested by Silva-Néto et al. and Wang et al ., in migraine without aura and tension-type headache patients (n = 1934). Materials and methods Each patient received a validated semi-structured interview. All subjects fulfilled the diagnostic criteria of the second edition of The International Classification of Headache Disorders for migraine or tension-type headache. Statistical analyses were performed using statistical software R. The statistical R package “Caret” was used to construct a confusion matrix and retrieve sensitivity, which is defined as the suggested criteria’s ability to correctly diagnose migraine without aura patients, and specificity, defined as the suggested criteria’s ability to not wrongly diagnose tension-type headache patients. Results Osmophobia was present in 33.5% of patients with migraine with aura, in 36.0% of patients with migraine without aura, and in 1.2% of patients with tension-type headache. All migraineurs with osmophobia also fulfilled the current criteria for migraine by having nausea or photophobia and phonophobia. The appendix criteria had a sensitivity of 0.96 and a specificity of 0.99 for migraine without aura, and a sensitivity of 0.65 and a specificity of 0.99 for probable migraine without aura. Both the criteria by Silva-Néto et al. and Wang et al. had a sensitivity of 0.98 and a specificity of 0.99 for migraine without aura, and a sensitivity of 0.66 and a specificity of 0.99 for probable migraine without aura. Discussion This study demonstrates the remarkable specificity of osmophobia. The criteria by Silva-Néto et al. and Wang et al. both had a higher sensitivity than the appendix criteria for migraine without aura; all three criteria had a low sensitivity for probable migraine without aura. However, neither the appendix criteria nor the criteria by Silva-Néto et al. or Wang et al. added any extra patients that would not have been diagnosed by the current diagnostic criteria for migraine. Osmophobia is a valuable symptom that may be useful to differentiate between migraine without aura and tension-type headache in difficult clinical cases. Conclusion Our results do not suggest that alterations of the current diagnostic criteria for migraine without aura are needed.

A prospective study on osmophobia in migraine versus tension-type headache in a large series of attacks

Cephalalgia ◽  
2019 ◽  
Vol 40 (4) ◽  
pp. 337-346 ◽  
Author(s):  
Alberto Terrin ◽  
Federico Mainardi ◽  
Carlo Lisotto ◽  
Edoardo Mampreso ◽  
Matteo Fuccaro ◽  
...  
Keyword(s):  
Prospective Study ◽  
Diagnostic Criteria ◽  
Migraine Without Aura ◽  
Tension Type Headache ◽  
Headache Disorders ◽  
Headache Attack ◽  
Accompanying Symptoms ◽  
Type Headache ◽  
A Prospective Study

Background In literature, osmophobia is reported as a specific migrainous symptom with a prevalence of up to 95%. Despite the International Classification of Headache Disorders 2nd edition proposal of including osmophobia among accompanying symptoms, it was no longer mentioned in the ICHD 3rd edition. Methods We conducted a prospective study on 193 patients suffering from migraine without aura, migraine with aura, episodic tension-type headache or a combination of these. After a retrospective interview, each patient was asked to describe in detail osmophobia, when present, in the following four headache attacks. Results In all, 45.7% of migraine without aura attacks were associated with osmophobia, 67.2% of migraineurs reported osmophobia in at least a quarter of the attacks. No episodic tension-type headache attack was associated with osmophobia. It was associated with photophobia or phonophobia in 4.3% of migraine without aura attacks, and it was the only accompanying symptom in 4.7% of migraine without aura attacks. The inclusion of osmophobia in the ICHD-3 diagnostic criteria would enable a 9.0% increased diagnostic sensitivity. Conclusion Osmophobia is a specific clinical marker of migraine, easy to ascertain and able to disentangle the sometimes challenging differential diagnosis between migraine without aura and episodic tension-type headache. We recommend its inclusion among the diagnostic criteria for migraine as it increases sensitivity, showing absolute specificity.

scholarly journals Analysis of the International Classification of Headache Disorders for diagnosis of migraine and tension-type headache in children

2008 ◽  
Vol 50 (4) ◽  
pp. 305-310 ◽  
Author(s):  
Livia N Rossi ◽  
Stefania Vajani ◽  
Ivan Cortinovis ◽  
Federica Spreafico ◽  
Lucia Menegazzo
Keyword(s):  
Tension Type Headache ◽  
International Classification ◽  
Headache Disorders ◽  
Type Headache

scholarly journals Tension-Type Headache in Children: The Cinderella of Headache Disorders!

2009 ◽  
Vol 36 (6) ◽  
pp. 687-695 ◽  
Author(s):  
Shashi S. Seshia ◽  
Ishaq Abu-Arafeh ◽  
Andrew D. Hershey
Keyword(s):  
Children And Adolescents ◽  
Headache Disorder ◽  
Tension Type Headache ◽  
Psychosocial Stressors ◽  
Headache Disorders ◽  
Behavioral Therapies ◽  
Cognitive Behavioral Therapies ◽  
Genetic And Environmental Factors ◽  
Type Headache

Tension-type headache (TTH) may be as common a headache disorder as migraine in children and adolescents. TTH has a neurobiological basis with genetic and environmental factors making variable contributions to the different sub-types. The diagnostic criteria for TTH in the second edition of the “International Classification of Headache Disorders” appear to be applicable to children. Anxiety and mood disorders may be co-morbid with frequent episodic and chronic TTH. Psychosocial stressors play an important role in precipitating and maintaining TTH. Hence, a biopsychosocial approach should be adopted for care. Standardized histories and examinations together with prospective headache diaries are the foundations for good management; attention to ‘red flags’ will help identify secondary causes that present with headache similar to TT. There are no randomized controlled drug trials for the treatment of TTH. Relaxation and cognitive behavioral therapies are effective. TTH in children and adolescents warrants greater recognition from the clinician and scientist. Studies focusing on TTH are overdue.

Odorant substances that trigger headaches in migraine patients

Cephalalgia ◽  
2013 ◽  
Vol 34 (1) ◽  
pp. 14-21 ◽  
Author(s):  
RP Silva-Néto ◽  
MFP Peres ◽  
MM Valença
Keyword(s):  
High Specificity ◽  
Tension Type Headache ◽  
International Classification ◽  
Lifetime Prevalence ◽  
Headache Disorders ◽  
Type Headache ◽  
Low Sensitivity ◽  
Beauty Products ◽  
Headache Patients

Objectives Our objective was to determine odorants that trigger migraine attacks and the time of onset of headache after exposure. Methods Migraine or tension-type headache patients, diagnosed according to the criteria of the International Classification of Headache Disorders-II, were interviewed about lifetime prevalence of headaches triggered by odors and time of onset of pain, after exposure of the patient to the odor. Results We studied 200 migraine patients and 200 tension-type headache patients. There were odor-triggered headaches after 25.5 ± 1.9 minutes of exposure in 70.0% (140/200) of migraine patients and none with tension-type headache, which ran at low sensitivity (70.0%, 95% CI 63.1–76.2) and high specificity (100.0%, 95% CI 97.6–100.0). Odor-triggered headaches are distributed in the following order of frequency: perfumes (106/140, 75.7%), paints (59/140, 42.1%), gasoline (40/140, 28.6%) and bleach (38/140, 27.1%). There was significance in the association of odor-triggered migraine, especially among perfume with cleaning (phi = –0.459), cooking (phi = 0.238), beauty products (phi = –0.213) and foul odors (phi = –0.582). Conclusions Odorants, isolated or in association, especially perfume, may trigger migraine attacks after a few minutes of exposure.

Use of the International Classification of Headache Disorders, Second Edition, criteria in the diagnosis of primary headache in schoolchildren: Epidemiology study from eastern Turkey

Cephalalgia ◽  
2010 ◽  
Vol 30 (7) ◽  
pp. 868-877 ◽  
Author(s):  
Recep Alp ◽  
Selen Ilhan Alp ◽  
Yılmaz Palanci ◽  
Haydar Sur ◽  
Ulku Turk Boru ◽  
...  
Keyword(s):  
Primary Headache ◽  
Tension Type Headache ◽  
International Classification ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Cross Sectional ◽  
Eastern Turkey ◽  
Probable Migraine ◽  
Type Headache

We aimed to determine the prevalence of primary headache among schoolchildren in the city of Agri, located in eastern Turkey, where geographical, climatic and socio-economic conditions differ greatly from those of other regions of Turkey. A cross-sectional school-based (ages ranging from 11 to 18) study was conducted from January to April 2006. Diagnosis was based on the second edition of the International Classification of Headache Disorders. This population was evaluated by a two-stage clustered sampling procedure. In the first phase, 1385 children were asked whether they had had a headache within the past year. For the second-step interview, 540 children (38.9%) with a complaint of headache were selected. Five children who had complained of headaches in the first interview did not agree to participate in the second stage. Of the remaining 535, 473 were identified as having primary headache and 62 as having secondary headache. Overall, one-year prevalence of headache subtypes was 14.3% for migraine, 3.5% for probable migraine, 8.6% for pure tension-type headache, 4.6% for migraine plus tension-type headache, and 3.0% for probable migraine plus tension-type headache. The prevalence of migraine was higher in our study than in previous studies.

Testing of diagnosis criteria of tension-type headache: A multicenter clinical study

Cephalalgia ◽  
2018 ◽  
Vol 38 (12) ◽  
pp. 1833-1840 ◽  
Author(s):  
Xueying Kong ◽  
Jinjin Chen ◽  
Huahua Jiang ◽  
Qin Li ◽  
Yuhua Lv ◽  
...  
Keyword(s):  
Physical Activity ◽  
Tension Type Headache ◽  
International Classification ◽  
Headache Disorders ◽  
Face To Face ◽  
Associated Symptoms ◽  
Headache Diary ◽  
Type Headache ◽  
Diagnosis Criteria

Objective Tension-type headache is *These authors contributed equally to this work. usually manifested as head pain without associated symptoms, and the validation of diagnostic criteria presented are lacking and highly required in the International Classification of Headache Disorders. The aim of the present study was to explore the diagnosis criteria of tension-type headache in a multicenter-based sample from Chongqing, China. Methods Clinical characteristics and demographics were systematically and prospectively collected between March 2014 and December 2015 from 15 participating hospitals in Chongqing, using a semi-structured face-to-face interview. All patients were asked to complete a headache diary for at least 4 weeks. Results Out of 1832 patients with headache, 150 patients (97 female/53 male, 44.56 ± 11.9 years old) were diagnosed with tension-type headache based on the standard International Classification of Headache Disorders, 3rd edition beta version, and interestingly, 114 (76%) patients were diagnosed with tension-type headache based on the alternative criteria. One patient was excluded because only two of the four characteristics were fulfilled. Thirty-five (23.3%) patients did not meet the alternative criteria because of associated symptoms, including mild nausea (n = 6), photophobia (n = 1), and phonophobia (n = 28). All patients with TTH had mild or moderate headaches, 98.0% of patients suffered from non-pulsating headaches, 99.3% of patients said their headaches were not aggravated by routine physical activity, and 77.3% of patients had bilateral headache. Conclusions Non-pulsating headaches and headaches that are not aggravated by routine physical activity may represent core criteria for screening patients with tension-type headache. Nausea might not be an exclusion feature for diagnosis of TTH, but an important criterion for screening. Further studies are needed.

scholarly journals Global Burden of Headache Disorders in Children and Adolescents 2007–2017

2020 ◽  
Vol 18 (1) ◽  
pp. 250
Author(s):  
Matilde Leonardi ◽  
Licia Grazzi ◽  
Domenico D’Amico ◽  
Paolo Martelletti ◽  
Erika Guastafierro ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Tension Type Headache ◽  
Global Burden ◽  
Specific Information ◽  
Headache Disorders ◽  
Substantial Impact ◽  
Public Health Policies ◽  
School Activities ◽  
Type Headache ◽  
Years Lived With Disability

Headache disorders are prevalent and disabling conditions impacting on people of all ages, including children and adolescents with substantial impact on their school activities and leisure time. Our study aims to report specific information on headaches in children and adolescents based on the Global Burden of Disease (GBD) study, that provides estimates for incidence, prevalence, fatal and non-fatal outcomes. We relied on 2007 and 2017 GBD estimates for prevalence and Years Lived with Disability (YLDs) at the global level and in WHO regions. The results show that, migraine and tension-type headache (TTH) together account for 37.5% of all-cause prevalence and for 7% of all-cause YLDs. Over the past decade, prevalence rates showed a mild increase of TTH in all ages and of migraine alone for adolescents. The YLDs increased among females of all ages with some regional differences that might be connected to the unequal availability of effective acute and prophylactic treatments across world regions. GBD data support the need to promote public health policies and strategies including diagnosis, pharmacological and non-pharmacological treatments that are expected to help reduce the disability and burden associated to migraine and TTH among children and adolescents.

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