ICHD-3: what changes do we need regarding migraine?

Abstract

Based on publications on migraine in the medical literature after 2004, the third edition of the International Classification of Headache Disorders (ICHD-3), with publication date early in 2013, will provide a framework to systematize those migraine forms that the second edition (ICHD-2) included in its Appendix. The most needed changes concern so-called chronic migraine. The revised ICHD-2 (ICHD-2R) did introduce appreciable changes to the ICHD-2 diagnostic criteria for chronic migraine. To be more relevant to actual clinical practice, the classification should discriminate between forms of migraine without aura depending on low, medium, or high frequency of attacks. The classification should include transformed migraine, an appellation that seems preferable to chronic migraine, in the group of migraine complications using extended time parameters compared with those currently used in ICHD-2R for chronic migraine. Finally, it should assess the opportunity of a different classification for medication-overuse headache.