J Korean Med Sci.  2016 Jan;31(1):106-113. 10.3346/jkms.2016.31.1.106.

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

• Kim BK
• Cho SJ
• Kim BS
• Sohn JH
• Kim SK
• Cha MJ
• Song TJ
• Kim JM
• Park JW
• Chu MK
• Park KY
• Moon HS

• KMID: 2359999
• DOI: http://doi.org/10.3346/jkms.2016.31.1.106

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-3beta), 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-3beta. 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-3beta 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-3beta. 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-3beta would yield a higher classification rate than its previous version, ICHD-2. ICHD-3beta is applicable in clinical practice for first-visit headache patients of a referral hospital.

Keyword

Headache; Diagnosis; Migraine Disorders; Outpatients

MeSH Terms

Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Guidelines as Topic
Headache Disorders/classification/*diagnosis
Humans
Male
Middle Aged
Migraine Disorders/classification/diagnosis/epidemiology
Registries
Republic of Korea
Tension-Type Headache/classification/diagnosis/epidemiology
Young Adult

Figure

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  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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