Short-term diagnostic stability of probable headache disorders based on the International Classification of Headache Disorders, 3rd edition beta version, in first-visit patients: a multicenter follow-up study

Abstract

BackgroundA “Probable headache disorder” is diagnosed when a patient’s headache fulfills all but one criterion of a headache disorder in the 3rd beta edition of the International Classification of Headache Disorder (ICHD-3β). We investigated diagnostic changes in probable headache disorders in first-visit patients after at least 3 months of follow-up.MethodsThis was a longitudinal study using a prospective headache registry from nine headache clinics of referral hospitals. The diagnostic change of probable headache disorders at baseline was assessed at least 3 months after the initial visit using ICHD-3β.ResultsOf 216 patients with probable headache disorders at baseline, the initial probable diagnosis remained unchanged for 162 (75.0 %) patients, while it progressed to a definite diagnosis within the same headache subtype for 45 (20.8 %) by fulfilling the criteria during a median follow-up period of 6.5 months. Significant difference on the proportions of constant diagnosis was not found between headache subtypes (P < 0.935): 75.9 % for probable migraine, 73.7 % for probable tension-type headache (TTH), and 76.0 % for probable other primary headache disorders (OPHD). Among patients with headache recurrence, the proportion of constant diagnosis was higher for probable migraine than for probable TTH plus probable OPHD (59.2 vs. 23.1 %; P < 0.001). The proportions of constant diagnosis did not significantly differ by follow-up duration (>3 and ≤ 6 months vs. > 6 and ≤ 10 months) in probable migraine, probable TTH, and probable OPHD, respectively.ConclusionsIn this study, a probable headache diagnosis, based on ICHD-3β, remained in approximately three-quarters of the outpatients; however, diagnostic stability could differ by headache recurrence and subtype. Probable headache management might have to consider these differences.

Clinical Features of Probable Cluster Headache: A Prospective, Cross-Sectional Multicenter Study

“…This research design may help to strengthen the diagnosis of patients with probable CH. The previous longitudinal follow-up study investigated the diagnostic stability of all probable diagnoses using the multicenter headache registry ( 15 ). The initial probable headache diagnosis remained unchanged in three-quarters of the patients, with a median follow-up period of 6.5 months.…”

“…In terms of unmet criteria, the prevalence of diagnostic stability was lower in subgroups lacking data on time-based criteria, such as number of attacks or total headache period. This lack of data was particularly evident among migraine and tension type headache patients due to the fact that a larger proportion of these patients than of other subgroups of patients progress to a definite diagnosis ( 15 ). In our study, the most common unmet criteria were symptom-based, which may be related to atypical presentation.…”

Botulinum neurotoxin type A for the treatment of pain: not just in migraine and trigeminal neuralgia

“…It is noteworthy that the classification of a patient in a given PH subtype may change in a quarter of cases, especially when the diagnosis is probable, even in expert centers [40]. Patients suffering from chronic migraine frequently report other types of pain (i.e., fibromyalgia), and both types of pain are usually more or less refractory to common treatments [41].…”

Hematological Risk Factors for High-Altitude Headache in Chinese Men Following Acute Exposure at 3,700 m

“…Headache is the fundamental symptom for a diagnosis of acute mountain sickness (AMS) according to the Lake Louise Scoring System (Imray et al, 2010 ; Bartsch and Swenson, 2013 ; Davis and Hackett, 2017 ). In this context, high-altitude headache (HAH) is a defined and recognized headache disorder, which occurs within 24 h after ascending to an altitude of >2,500 m, based on the International Classification of Headache Disorders 3β criteria (Marmura and Hernandez, 2015 ; Kim et al, 2016 ). Approximately 80% of people are thought to experience headache after rapidly ascending to high altitudes, which is associated with disturbances in their daily life and work that create an important public health problem (Carod-Artal, 2014 ).…”