1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-19-93 10.15844/pedneurbriefs-19-12-6 Headache Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant ICHD-II Criteria in Diagnosis of Pediatric Migraine http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 12 2005 01 03 2016 19 12 93 93 Copyright: © 2005 The Author(s) 2005 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Use of the ICHD-II criteria in the diagnosis of pediatric migraine

The sensitivity of the new International Classification of Headache Disorders-2nd edition (ICHD-II) criteria in the diagnosis of childhood migraine was evaluated in 260 patients, ages 18 and under, seen at 2 large pediatric headache centers, and reported from Children’s Hospital Medical Center, Cincinnati, OH; The Cleveland Clinic, OH; and other centers.

 International Classification of Headache Disorders-2nd Edition Childhood Migraine Tension Type Headaches

The sensitivity of the new International Classification of Headache Disorders-2nd edition (ICHD-II) criteria in the diagnosis of childhood migraine was evaluated in 260 patients, ages 18 and under, seen at 2 large pediatric headache centers, and reported from Children’s Hospital Medical Center, Cincinnati, OH; The Cleveland Clinic, OH; and other centers. Each headache characteristic in ICHD-II was analyzed individually. ICHD-II criteria were met in 183 (70.4%) of 260 patients. When headache duration was included, the sensitivity was 71.9% for short duration (2 hours) and 73.9% for 1-hour duration headaches. When data were reanalyzed using more relaxed criteria, sensitivity improved to 84.4%. These modified criteria included bilateral headache, duration of 1 to 72 hours, and nausea and/or vomiting plus 2 of 5 other associated symptoms (photophobia, phonophobia, difficulty thinking, lightheadedness, or fatigue), in addition to moderate to severe, throbbing or pulsating pain worsening or limiting physical activity. [1]

COMMENT. Childhood migraine has unique characteristics, including bilateral location, shorter duration, and difficulty with description of headache quality and associated symptoms. Specificity of a migraine diagnosis is required to separate headaches of a secondary type. The separation of tension type headaches (TTH) is debatable, since some regard TTH and migraine as a continuum, from mild to severe. More inclusiveness in diagnosis could lead to a greater sensitivity than the 85% obtained using the ICHD-II criteria, and improvement in treatment and outcome.

In a comparison of ICHD-I-1988 and ICHD-II-2004 criteria in diagnosis of migraine in 496 children studied from 1992-2002, the current (ICHD-II) classification criteria showed greater sensitivity (71% cf 27%) without affecting specificity, but sensitivity was still poor. [2]

Hershey AD Winner P Kabbouche MA Gladstein J Yonker M Lewis D Use of the ICHD-II criteria in the diagnosis of pediatric migraine Headache 2005 Nov-Dec 45 10 1288 1297 10.1111/j.1526-4610.2005.00260.x 16324160 Lima MM Padula NA Santos LC Oliveira LD Agapejev S Padovani C Critical analysis of the international classification of headache disorders diagnostic criteria (ICHD I-1988) and (ICHD II-2004), for migraine in children and adolescents Cephalalgia 2005 Nov 25 11 1042 1047 10.1111/j.1468-2982.2005.00954.x 16232155