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, 31 (1), 106-13

Comprehensive Application of the International Classification of Headache Disorders Third Edition, Beta Version

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Comprehensive Application of the International Classification of Headache Disorders Third Edition, Beta Version

Byung-Kun Kim et al. J Korean Med Sci.

Abstract

The purpose of this study was to test the feasibility and usefulness of the International Classification of Headache Disorders, third edition, beta version (ICHD-3β), and compare the differences with the International Classification of Headache Disorders, second edition (ICHD-2). Consecutive first-visit patients were recruited from 11 headache clinics in Korea. Headache classification was performed in accordance with ICHD-3β. The characteristics of headaches were analyzed and the feasibility and usefulness of this version was assessed by the proportion of unclassified headache disorders compared with ICHD-2. A total of 1,627 patients were enrolled (mean age, 47.4±14.7 yr; 62.8% female). Classification by ICHD-3β was achieved in 97.8% of headache patients, whereas 90.0% could be classified by ICHD-2. Primary headaches (n=1,429, 87.8%) were classified as follows: 697 migraines, 445 tension-type headaches, 22 cluster headaches, and 265 other primary headache disorders. Secondary headache or painful cranial neuropathies/other facial pains were diagnosed in 163 patients (10.0%). Only 2.2% were not classified by ICHD-3β. The main reasons for missing classifications were insufficient information (1.6%) or absence of suitable classification (0.6%). The diagnoses differed from those using ICHD-2 in 243 patients (14.9%). Among them, 165 patients were newly classified from unclassified with ICHD-2 because of the relaxation of the previous strict criteria or the introduction of a new diagnostic category. ICHD-3β would yield a higher classification rate than its previous version, ICHD-2. ICHD-3β is applicable in clinical practice for first-visit headache patients of a referral hospital.

Keywords: Diagnosis; Headache; Migraine Disorders; Outpatients.

Conflict of interest statement

DISCLOSURE: The authors declared no conflict of interest in this work.

Figures

Fig. 1
Fig. 1. Distribution of headaches diagnosed according to ICHD-3β. Headache attributed to a substance or its withdrawal (ICHD-3β code 8., 5.2%) consisted of headache attributed to the use of or exposure to a substance (ICHD-3β code 8.1, 0.74%) and medication overuse headaches accompanied by primary headaches (ICHD-3β code 8.2, 4.43%). ICHD-3β indicates International Classification of Headache Disorders third edition, beta version: 1, Migraine; 2, Tension-type headache; 3, Trigeminal autonomic cephalalgias; 4, Other primary headache disorders; 5, Headache attributed to trauma or injury to the head and/or neck; 6, Headache attributed to cranial or cervical vascular disorder; 7, Headache attributed to non-vascular intracranial disorder; 8, Headache attributed to a substance or its withdrawal; 9, Headache attributed to infection; 10, Headache attributed to disorder of homoeostasis; 11, Headache or facial pain attributed to disorder of the cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cervical structure; 12, Headache attributed to psychiatric disorder; 13, Painful cranial neuropathies and other facial pains; 14, Other headache disorders.

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