Headache Classifica-on

Transcription

1 Headache Classifica-on

2 2 Tension-Type Headache Criteria -Infrequent episodic tension-type headache- A. At least 10 episodes occurring on < 1 day per month on average (< 12 days per year) and fulfilling criteria B- D B. Headache las-ng from 30 minutes to 7 days C. Headache has at least two of the following characteris-cs: 1. Bilateral loca-on 2. Pressing/-ghtening (non- pulsa-ng) quality 3. Mild or moderate intensity 4. Not aggravated by rou-ne physical ac-vity such as walking or climbing stairs D. Both of the following: 1. No nausea or vomi-ng (anorexia may occur) 2. No more than one of photophobia or phonophobia E. Not arributed to another disorder

3 3 Tension-Type Headache Criteria -Frequent episodic tension-type headache- A. At least 10 episodes occurring on 1 but less than < 15 days per month for at least 3 months and fulfilling criteria B- D B. Headache las-ng from 30 minutes to 7 days C. Headache has at least two of the following characteris-cs: 1. Bilateral loca-on 2. Pressing/-ghtening (non- pulsa-ng) quality 3. Mild or moderate intensity 4. Not aggravated by rou-ne physical ac-vity such as walking or climbing stairs D. Both of the following: 1. No nausea or vomi-ng (anorexia may occur) 2. No more than one of photophobia or phonophobia E. Not arributed to another disorder

4 4 Tension-Type Headache Criteria -Chronic tension-type headache- A. Headache occurring on 15 days per month on average for > 3 months and fulfilling criteria B- D B. Headache lasts hours or may be con-nuous C. Headache has at least two of the following characteris-cs: 1. Bilateral loca-on 2. Pressing/-ghtening (non- pulsa-ng) quality 3. Mild or moderate intensity 4. Not aggravated by rou-ne physical ac-vity such as walking or climbing stairs D. Both of the following: 1. No more than one of photophobia, phonophobia, or mild nausea 2. Neither moderate or severe nausea nor vomi-ng E. Not arributed to another disorder

5 5 Tension-Type Headache Criteria -Chronic tension-type headache associated with pericranial tenderness- A. Headache fulfilling criteria A- E for Chronic tension- type headache B. Increased pericranial tenderness on manual palpa-on

6 6 Tension-Type Headache Criteria -Chronic tension-type headache not associated with pericranial tenderness- A. Headache fulfilling criteria A- E for Chronic tension- type headache B. No increased pericranial tenderness

7 7 Migraine Headache Criteria -Migraine without aura- A. At least five aracks fulfilling criteria B- D B. Headache aracks las-ng 4-72 hours (untreated or unsuccessfully treated) C. Headache has at least two of the following characteris-cs: 1. Unilateral loca-on 2. Pulsa-ng quality 3. Moderate or severe pain intensity 4. Aggrava-on by or causing avoidance of rou-ne physical ac-vity (e.g., walking or climbing stairs) D. During headache at least one of the following: 1. Nausea and/or vomi-ng 2. Photophobia and phonophobia E. Not arributed to another disorder

8 A. At least two aracks fulfilling criteria B- D Migraine Headache Criteria -Typical migraine with aura- B. Aura consis-ng of at least one of the following, but no motor weakness: 1. Fully reversible visual symptoms including posi-ve features (e.g., flickering lights, sports or lines) and/or nega-ve features (i.e. loss of vision) 2. Fully reversible sensory symptoms including posi-ve features (i.e., pins and needles and/or nega-ve features (i.e. numbness) 3. Fully reversible dysphasic speech disturbance C. At least two of the following: 1. Homonymous visual symptoms and/or unilateral sensory symptoms 2. At least one aura symptom develops gradually over 5 minutes and/or different aura symptoms occur in succession over 5 minutes 3. Each symptoms lasts 5 minutes and 60 minutes D. Headache fulfilling criteria B- D for migraine without aura begins during the aura or follows aura within 60 minutes. E. Not arributed to another disorder 8

9 Migraine Headache Criteria -Chronic migraine- A. Headache fulfilling criteria C and D for migraine without aura on 15 days/month for > 3 months B. Not arributed to another disorder 9

10 Migraine Headache Criteria -Probable migraine without aura- A. ARacks fulfilling all but one of criteria A- D for migraine without aura B. Not arributed to another disorder 10

11 Cervicogenic Headache Criteria -International Classification of Headache Disorders Criteria- A. Pain, referred from a source in the neck and perceived in one or more regions of the head and/or face, fulfilling criteria C and D B. Clinical, laboratory, and/or imaging evidence of a disorder or lesion within the cervical spine or so_ -ssues of the neck known to be, or generally accepted as, a valid cause of headache C. Evidence that the pain can be arributed to the neck disorder or lesion based on at least one of the following: 1. Demonstra-on of clinical signs that implicate a source of pain in the neck 2. Aboli-on of headache following diagnos-c blockade of a cervical structure or its nerve supply using placebo or other adequate controls. D. Pain resolves within 3 months a_er successful treatment of the causa-ve disorder or lesion 11

12 Cervicogenic Headache Criteria -Cervicogenic Headache International Study Group Criteria- I. Symptoms and signs of neck involvement a. Precipita-on of head pain, similar to the usually occurring one: 1. By neck movement and/or sustained awkward head posturing, and or 2. By external pressure over the upper cervical or occipital region on the symptoma-c side b. Restric-on of the range of mo-on in the neck c. Ipsilateral neck, shoulder, or arm pain of a rather vague non- radicular nature or, occasionally, arm pain of a radicular nature II. Confirmatory evidence by diagnos-c anesthe-c blockades III. Unilaterality of the head pain, without side shi_ For a diagnosis of CGH to be appropriate, one or more aspects of Point I must be present, with Ia sufficient to serve as a sole criterion for posi>vity or Ib and Ic combined. For scien>fic work, Point II is obligatory, while Point III is preferable obligatory. 12 Modified from Sjaastad et al 1998

13 Occipital Neuralgia Criteria -Occipital neuralgia- A. Paroxysmal stabbing pain with or without persistent aching between paroxysms in the distribu-on(s) of the greater, lesser and/or third occipital nerves B. Tenderness over the affected nerve C. Pain is eased temporarily by local anesthe-c block of the involved nerve 13

14 14 Headache Attributed to TMD Criteria A. Recurrent pain in one or more regions of the head and/or face fulfilling criteria C and D B. X- ray, MRI, and/or bone scin-graphy demonstrates TMJ disorder C. Evidence that pain can be arributed to the TMJ disorder, based on at least one of the following: 1. Pain is precipitated by jaw movements and/or chewing of hard or tough feed 2. Reduces range of or irregular jaw movements 3. Noise from one or both TMJs during jaw movements 4. Tenderness of the joint capsule(s) of one or both TMJs D. Headache resolves within 3 months, and does not recur, a_er successful treatment of the TMJ disorder