[The validity of the classification criteria of the International Headache Society for migraine, episodic tension headache and chronic tension headache]

Abstract

Introduction: We analysed the value of the diagnostic criteria of the International Headache Society (IHS) for the classification of the primary headaches in a headache clinic.

Patients and methods: The IHS criteria were applied to classify 208 headaches in 194 patients. Forty-two had migraine, 18 tension type headache and 76 chronic daily headaches (CDH).

Results: The value of IHS criteria in order to distinguish migraine from tension type headache have a specificity of 94% and a predictive positive value of 99%. The predictive negative value is 63%. The more specific symptoms for migraine were severity, photophobia, phonofobia and vomits. IHS criteria for chronic tension type headache have a very low sensibility; only the 45% of these headaches meet criteria. If we applied the criteria of Silberstein et al we can see that, without the patient history, symptoms don't distinguish between chronic tension type headache, transformed migraine and new daily persistent headache. The most specific features for distinguishing the transformed migraine were worsening with activity, vomiting and pulsating. A 62% of the CDH have analgesic overuse.

Conclusions: IHS criteria distinguish accurately between migraine and tension type headache. Symptoms do not differenciate the different kinds of CDH.