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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sporadic hemiplegic migraine (SHM) is defined as migraine attacks associated with some degree of motor weakness/hemiparesis during the aura phase and where no first degree relative (parent, sibling or child) has identical attacks. The present review deals with recent scientific studies according to which: The SHM prevalence is estimated to be 0.005%; SHM patients have clinical symptoms identical to patients with familial hemiplegic migraine (FHM) and significantly different from patients with migraine with typical aura (typical MA); SHM affected had no increased risk of migraine without aura (MO), but a highly increased risk of typical MA compared to the general population; SHM patients only rarely have mutations in the FHM gene CACNA1A; SHM attacks in some cases can be treated with Verapamil. The reviewed data underlie the change in the International Classification of Headache Disorders 2nd edition where SHM became separated from migraine with typical aura or migraine with prolonged aura. All cases with motor weakness should be classified as either FHM or SHM.
Cephalalgia 2004 Dec
PMID:Sporadic hemiplegic migraine. 1556 15

Over the years, there has been much confusion and conflict regarding when a post-traumatic headache (PTH) should be classified as chronic. Chronic pain usually is described as pain persisting for longer than 6 months. For many years, a chronic PTH was considered to be a headache lasting longer than 2 months. Some useful definitions and criteria were published in 2003 by the International Headache Society, in the Second Edition of the Classification and Diagnostic Criteria for Headache Disorders. These criteria are reviewed and discussion follows regarding the problem of when a chronic PTH should be classified as permanent. This becomes very important in a medical-legal context. Management of chronic PTH often will require a multifactorial approach.
Curr Pain Headache Rep 2005 Feb
PMID:Current concepts in chronic post-traumatic headache. 1562 27

It has been almost 15 years since the first edition of the International Headache Classification appeared in 1988. It was widely accepted and well tolerated. However, rapid progress of the headache research is pushing for a drastic revision of the classification. The new International Classification of Headache Disorders (ICHD-II) was disclosed in September 2003 as a preprinted version and formally published in January 2004. The ICDH-II classifies headache disorders into 3 parts: the primary headache, the secondary headache and cranial neuralgia, central and primary facial pain and other headaches. Basically, the most important diagnostic criteria, those of migraine and tension-type headache, remain unchanged. Several new entities such as chronic migraine, hypnic headache, hemicrania continua, benign thunderclap headache and medication overuse headache have been added. This will encourage intensified headache researches in the future.
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PMID:[New international classification of headache disorders (ICHD-II)]. 1565 38

Cluster headache (CH), also known as "suicide headache," is characterized by a distinctive behavior during attacks. In 80% to 90% of cases, patients are restless and constantly moving in a vain attempt to relieve pain. They often perform complex, stereotyped actions. During attacks, CH sufferers do not want to be touched, stroked, or comforted and frequently moan a great deal, cry, or even scream. They sometimes indulge in violent, self-hurting behavior. Restlessness is a highly sensitive and highly specific parameter for CH and has been included among the signs and symptoms accompanying pain of the disorder in the Second Edition of the International Classification of Headache Disorders. A few hypotheses on pathophysiology of restlessness are addressed in this paper.
Curr Pain Headache Rep 2005 Apr
PMID:Behavior during cluster headache. 1574 21

Migraine disorders are largely unrecognized and untreated, despite the heavy burden they impose on individuals and society. Studies have shown that the symptom severity and disability associated with undiagnosed migraine are as burdensome as those associated with diagnosed migraine. Of those persons with migraine identified in population-based surveys, many were previously unaware that they had migraine. Furthermore, coexisting headache types and comorbid conditions contribute to misdiagnosis among those who consult a physician for headache. Patients who do seek medical attention for headaches usually visit their primary care providers. The purpose of this review is to highlight the distinguishing characteristics of migraine compared with other headache disorders, based on the new International Classification of Headache Disorders. To aid in diagnosis, simple screening tools, such as ID Migraine (Pfizer Inc., New York, NY), are recommended. The clinical interview and headache diary aid in refining the diagnosis or suggesting the need for further evaluation. Improved recognition of migraine in primary care will increase the rate of successful treatment with effective migraine-specific therapies. This will result in improved functionality and decreased pain, and may help prevent disease progression.
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PMID:Identifying migraine in primary care settings. 1584 83

Headache in the pediatric population remains substantially underdiagnosed and undertreated. The recently revised International Headache Society (IHS) criteria, The International Classification of Headache Disorders, is a step in the right direction to improve our diagnostic accuracy. In this article, the diagnostic issues related to childhood periodic syndromes and migraine in the IHS 2004 revisions are reviewed.
Curr Pain Headache Rep 2005 Jun
PMID:Childhood periodic syndromes and migraine. 1590 58

Optic neuritis (ON) refers to any inflammatory disorder of the optic nerve. In clinical practice ON is mainly diagnosed by ophthalmologists and less frequently by neurologists. ON diagnostic criteria are included in different classification systems both in neurologic and ophthalmologic fields. Diagnosis of ON is still very unsatisfactory. Indeed diagnostic criteria are not uniform and therefore the diagnosis is still mainly formulated according to the clinical experience only. A consensus on practice guidelines for ON diagnosis might be useful. Ocular pain is a milestone in ON diagnosis, but it is too often mistreated by both the patient and the clinician. The International Headache Society (IHS) Classification of Headache Disorders provides in its 1988 and 2004 versions the diagnostic criteria for ON. These criteria are not spread and followed by the large majority of neurologists, but they are mainly applied by the experts in headache disorders. On the other hand, ON is a disorder widely encountered by neurologists and ophthalmologists. The latest IHS version defines the criteria of the pain features more precisely, but it is still unsatisfactory. In a future revision, the pain should be further detailed. Further studies aimed at validation of the diagnostic criteria of ON are strongly needed.
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PMID:Controversies in optic neuritis pain diagnosis. 1592 26

Recent efforts to make headache diagnostic classification and clinical trial methodology more consistent provide valuable advice to trialists generating new evidence on effectiveness of treatments for headache; however, interpreting older trials that do not conform to new standards remains problematic. Systematic reviewers seeking to utilize historical data can adapt currently recommended diagnostic classification and clinical trial methodological approaches to interpret all available data relative to current standards. In evaluating study populations, systematic reviewers can: (i) use available data to attempt to map study populations to diagnoses in the new International Classification of Headache Disorders; and (ii) stratify analyses based on the extent to which study populations are precisely specified. In evaluating outcome measures, systematic reviewers can: (i) summarize prevention studies using headache frequency, incorporating headache index in a stratified analysis if headache frequency is not available; (ii) summarize acute treatment studies using pain-free response as reported in directly measured headache improvement or headache severity outcomes; and (iii) avoid analysis of recurrence or relapse data not conforming to the sustained pain-free response definition.
Headache 2005 May
PMID:Methodological issues in systematic reviews of headache trials: adapting historical diagnostic classifications and outcome measures to present-day standards. 1595 62

The comorbidity of headache and psychiatric disorders is a well-recognized clinical phenomenon warranting further systematic research. Affective disorders occur with at least three-fold greater frequency among migraineurs than among the general population, and the prevalence increases in clinical populations, especially with chronic daily headache. When present, psychiatric comorbidity complicates headache management and portends a poorer prognosis for headache treatment. However, the relationship between headache and psychopathology has historically been misunderstood, and measures of psychopathology have not always met the standard of formal Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria. In some cases, headache has been inappropriately attributed to psychological or psychiatric features, based on anecdotal observations. The challenge for future studies is to employ research methods and designs that accurately identify and classify the subset of headache patients with psychiatric disorders, evaluate their impact on headache symptoms and treatment, and identify optimal behavioral and pharmacologic treatment strategies. This article offers methodological considerations and recommendations for future research including: (i) ascribing dual-International Classification of Headache Disorders, 2nd ed. (ICHD-2) headache and DSM-IV psychiatric diagnoses according to reliable and valid diagnostic criteria, (ii) differentiating subclinical levels of depression and anxiety from major psychiatric disorders, (iii) encouraging validation studies of the recently published ICHD-2 diagnoses for "headache attributed to psychiatric disorder," (iv) expanding epidemiological research to address the range of DSM-IV Axis I and II psychiatric diagnoses among various headache populations, (v) identifying relevant psychiatric and behavioral mediator/moderator variables, and (vi) developing empirically based screening and treatment algorithms.
Headache 2005 May
PMID:Headache and psychiatric comorbidity: historical context, clinical implications, and research relevance. 1595 66

The International Classification of Headache Disorders, second edition (ICHD-II) was the result of 4 years' work by a large number of headache experts from different parts of the world. This article summarizes the main new features of ICHD-II, compared with the original International Headache Society classification: better definition of migraine with aura, inclusion of chronic migraine, inclusion of a number of new primary headaches (SUNCT, hypnic headache, benign thunderclap headache, new daily-persistent headache, hemicrania continua), better definition of the secondary headaches, introduction of medication-overuse headache and of headache attributed to psychiatric disorder. An appendix defines a number of entities for research purposes. The new classification has already been translated into many of the world's major languages and many more are in the pipeline. It is enormously important that headache experts support and encourage the use of the new classification in order to develop a common knowledge base, and that they research ways of further improving it.
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PMID:The International Classification of Headache Disorders, 2nd edition: application to practice. 1596 68


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