当前位置:首页 >> 调查/报告 >>

Pt1 - Primary Headaches


Part 1: The primary headaches Part 1. Migraine 1: The primary headaches 2. Tension-type headache
3. Cluster headache and other trigeminal autonomic cephalalgias 4. Other primary headaches

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

1. Migraine
1.1 Migraine without aura 1.2 Migraine with aura 1.3 Childhood 1. Migraine that are periodic syndromes commonly precursors of migraine 1.4 Retinal migraine 1.5 Complications of migraine 1.6 Probable migraine

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

1. Migraine
Reclassification 1988-2004
1988 2004 1.1 Migraine without aura 1.1 Migraine without aura 1.2 Migraine with aura 1.2 Migraine 1. Migraine with aura 1.3 Ophthalmoplegic 13.17 Ophthalmoplegic Reclassification 1988-2004 migraine ‘migraine’ 1.4 Retinal migraine 1.4 Retinal migraine 1.5 Childhood periodic 1.3 Childhood periodic syndromes syndromes 1.6 Complications of 1.5 Complications of migraine migraine 1.7 Migrainous disorder 1.6 Probable migraine
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

1.1 Migraine without aura
A. At least 5 attacks fulfilling criteria B-D B. Headache attacks lasting 4-72 h (untreated or unsuccessfully treated) C. Headache has ≥2 of the following characteristics: 1.1 Migraine without aura 1. unilateral location 2. pulsating quality 3. moderate or severe pain intensity 4. aggravation by or causing avoidance of routine physical activity (eg, walking, climbing stairs) D. During headache ≥1 of the following: 1. nausea and/or vomiting 2. photophobia and phonophobia E. Not attributed to another disorder
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

1.1 Migraine without aura
Notes
? If <5 attacks but criteria B-E otherwise met, code as 1.6.1 Probable migraine without aura 1.1 Migraine without aura ? When attacks occur on ≥15 d/mo for >3 mo, code as 1.1 Migraine without Notes aura + 1.5.1 Chronic migraine ? Pulsating means varying with the heartbeat ? In children: – attacks may last 1-72 h – occipital headache requires caution ? In young children: – photophobia and/or phonophobia may be inferred from their behaviour
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

‘Not attributed to another disorder’
Note For all primary headaches, this criterion means:
? History and physical/neurological examinations do Note not suggest any of the disorders listed in groups 5-12, or history and/or physical/ neurological examinations do suggest such disorder but it is ruled out by appropriate investigations, or such disorder is present but headache does not occur for the first time in close temporal relation to the disorder
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

‘Not attributed to another disorder’

1.2 Migraine with aura

1.2.1 1.2.2 1.2.3 1.2.4 1.2.5 1.2.6

Typical aura with migraine headache 1.2 Migraine with aura Typical aura with non-migraine headache Typical aura without headache Familial hemiplegic migraine (FHM) Sporadic hemiplegic migraine Basilar-type migraine

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

1.2 Migraine with aura

A. At least 2 attacks fulfilling criterion B

B. Migraine aura fulfilling criteria B and C for one of the subforms 1.2.1-1.2.6 C. Not attributed to another disorder

1.2 Migraine with aura

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

1.2 Migraine with aura
Subtypes new to classification
1.2.1 Typical aura with migraine headache ?

Subtypes new to classification fulfilling criteria for 1.1 Migraine without aura

1.2 Migraine with aura most migraine auras are associated with headache

1.2.2 Typical aura with non-migraine headache 1.2.3 Typical aura without headache ? migraine aura is sometimes associated with a headache that does not fulfil these criteria ? or occurs without headache
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

1.2.1 Typical aura with migraine headache
A. At least 2 attacks fulfilling criteria B–D 1.2.1 Typical aura B. Aura consisting of ≥1 of the following, but no motor weakness: migraine headache with 1. fully reversible visual symptoms including positive and/or negative features 2. fully reversible sensory symptoms including positive and/or negative features 3. fully reversible dysphasic speech disturbance

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

1.2.1 Typical aura with migraine headache
C. At least two of the following: 1. homonymous visual symptoms and/or unilateral sensory symptoms 1.2.1 Typical aura 2.withone aura symptom develops gradually over at least migraine headache ≥5 min and/or different aura symptoms occur in succession over ≥5 min 3. each symptom lasts ≥5 and ≤60 min D. Headache fulfilling criteria B-D for 1.1 Migraine without aura begins during the aura or follows aura within 60 min E. Not attributed to another disorder
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

1.2.2 Typical aura with non-migraine headache 1.2.2 Typical aura As 1.2.1 except: D. Headache that does not fulfil criteria B-D for with non-migraine headache 1.1 Migraine without aura begins during the aura or follows aura within 60 min

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

1.2.3 Typical aura without headache 1.2.3 Typical aura As 1.2.1 except: D. Headache does not occur during aura nor follow aura without headache within 60 min

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

1.2.4 Familial hemiplegic migraine (FHM)
A. At least 2 attacks fulfilling criteria B and C 1.2.4 Familial hemiplegic B. Aura consisting of fully reversible motor weakness and ≥1 of: migraine (FHM) 1. fully reversible visual symptoms including positive and/or negative features 2. fully reversible sensory symptoms including positive and/or negative features 3. fully reversible dysphasic speech disturbance

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

1.2.4 Familial hemiplegic migraine (FHM)
C. At least two of the following: 1. at least one aura symptom develops gradually over 1.2.4 Familialaura symptoms occur in ≥5 min and/or different hemiplegic succession over ≥5 min (FHM) migraine 2. each aura symptom lasts ≥5 min and <24 h 3. headache fulfilling criteria B-D for 1.1 Migraine without aura begins during the aura or follows onset of aura within 60 min D. At least one 1st- or 2nd-degree relative fulfils these criteria E. Not attributed to another disorder
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

1.2.6 Basilar-type migraine
As 1.2.1 except: B. Aura consisting of ≥2 of the following fully reversible symptoms, but no motor weakness:
1. dysarthria; 2. vertigo; 3. tinnitus; 1.2.6 Basilar-type 4. hypacusia; both migraine 5. diplopia; 6. visual symptoms simultaneously in temporal and nasal fields of both eyes; 7. ataxia; 8. decreased level of consciousness; 9. simultaneously bilateral paraesthesias

C. At least one of the following:
1. at least one one aura symptom develops gradually over ≥5 min and/or different aura symptoms occur in succession over ≥5 min 2. each aura symptom lasts ≥5 and ≤60 min
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

1.2.6 Basilar-type migraine
Terminology change 1988-2004

? 1.2.6 Basilar-type migraine 1.2.6 Basilar-type migraine was previously classified asTerminology change 1988-2004 1.2.4 Basilar migraine ? Terminology has been changed because there is little evidence that the basilar artery or, necessarily, basilar-artery territory is involved

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

1.3 Childhood periodic syndromes that are commonly precursors of migraine 1.3 Childhood periodic syndromes that are commonly 1.3.1 Cyclical vomiting 1.3.2 precursors of migraine Abdominal migraine
1.3.3 Benign paroxysmal vertigo of childhood

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

1.3.2 Abdominal migraine
A. At least 5 attacks fulfilling criteria B-D B. Attacks of abdominal pain lasting 1-72 h C. Abdominal pain has all of the following 1.3.2 Abdominal migraine characteristics: 1. midline location, periumbilical or poorly localised 2. dull or “just sore” quality 3. moderate or severe intensity D. During abdominal pain ≥2 of the following: 1. anorexia; 2. nausea; 3. vomiting; 4. pallor E. Not attributed to another disorder
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

1.5 Complications of migraine

1.5.1 1.5.2 1.5.3 1.5.4 1.5.5

Chronic Complications of 1.5 migraine Status migrainosus migraine Persistent aura without infarction Migrainous infarction Migraine-triggered seizures

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

1.5 Complications of migraine
Reclassification 1988-2004
1988 1.6.1 2004 1.5 Complications of 1.5.1 Chronic migraine migraine Status migrainosus 1.5.2 Status migrainosus

Reclassification 1988-2004 1.5.3 Persistent aura

1.6.2 Migrainous infarction

without infarction 1.5.4 Migrainous infarction 1.5.5 Migraine triggered seizure

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

1.5.1 Chronic migraine
New entrant to classification

1.5.1 Chronicand D for migraine A. Headache fulfilling criteria C
B. Not attributed to another disorder

New entrant to classification 1.1 Migraine without aura on ≥15 d/mo for >3 mo

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

1.5.1 Chronic migraine
Notes
? When medication overuse is present, this is the most likely cause of chronic symptoms 1.5.1 Chronic migraine – code according to antecedent migraine subtype + 1.6.5 Probable chronic migraine + Notes 8.2.7 Probable MOH ? Post-withdrawal, code as: – 1.5.1 Chronic migraine + antecedent migraine subtype if symptoms persist beyond 2 mo – 8.2 Medication-overuse headache + antecedent migraine subtype if, before 2 mo, improvement occurs and these criteria are no longer fulfilled
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

‘Chronic’
Notes
? In pain terminology, chronic denotes persistence over a period of more than 3 months ‘Chronic’ ? In headache terminology, it retains this meaning for Notes secondary headache disorders ? For primary headache disorders that are more usually episodic (eg, migraine), chronic is used whenever headache occurs on more days than not over more than 3 months – the trigeminal autonomic cephalalgias (qv) are an exception
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

1.6 Probable migraine

1.6.1 Probable migraine without aura 1.6 Probable migraine 1.6.2 Probable migraine with aura 1.6.5 Probable chronic migraine

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

1.6 Probable migraine
1.6.1 Probable migraine without aura
A. Attacks fulfilling all but one of criteria A-D for 1.1 Migraine without aura 1.6 Probable migraine B. Not attributed to another disorder

1.6.2 Probable migraine with aura
A. Attacks fulfilling all but one of criteria A-D for 1.2 Migraine with aura B. Not attributed to another disorder

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

1.6 Probable migraine
1.6.5 Probable chronic migraine
A. Headache fulfilling criteria C and D for 1.1 Migraine without aura on ≥15 d/mo for >3 mo 1.6 Probable migraine B. Not attributed to another disorder but there is, or has been within the last 2 mo, medication overuse fulfilling criterion B for any of the subforms of 8.2 Medication-overuse headache

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

2. Tension-type headache

2.1 Infrequent episodic tension-type headache 2. Tension-type headache 2.2 Frequent episodic tension-type headache 2.3 Chronic tension-type headache 2.4 Probable tension-type headache

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

Infrequent/frequent episodic TTH
New subdivision 1988-2004
Why this new subdivision? Infrequent/frequent

episodic

? Infrequent TTH has very little impact on the TTH individual and does not deserve much attention from New subdivision 1988-2004 the medical profession ? Frequent TTH sufferers can encounter considerable disability that sometimes warrants expensive drugs and prophylactic medication

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

2.1 Infrequent episodic TTH
A. At least 10 episodes occurring on <1 d/mo (<12 d/y) and fulfilling criteria B-D B. Headache lasting from 30 min to 7 d C. Headache has ≥2 of the following characteristics: 2.1 Infrequent episodic TTH 1. bilateral location 2. pressing/tightening (non-pulsating) quality 3. mild or moderate intensity 4. not aggravated by routine physical activity D. Both of the following: 1. no nausea or vomiting (anorexia may occur) 2. no more than one of photophobia or phonophobia E. Not attributed to another disorder
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

2.1 Infrequent episodic TTH
2.1.1 Infrequent episodic tension-type headache associated with pericranial tenderness A. Episodes fulfilling criteria A-E for 2.1 Infrequenttension-type headache episodic TTH 2.1 Infrequent episodic B. Increased pericranial tenderness on manual palpation 2.1.2 Infrequent episodic tension-type headache not associated with pericranial tenderness A. Episodes fulfilling criteria A-E for 2.1 Infrequent episodic tension-type headache B. No increased pericranial tenderness
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

2.2 Frequent episodic TTH
As 2.1 except: A. At least 10 episodes occurring on ≥1 but <15 d/mo for ≥3 mo (≥12 and <180 d/y) and fulfilling criteria B-D

2.2 Frequent episodic TTH

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

2.2 Frequent episodic TTH
2.2.1 Frequent episodic tension-type headache associated with pericranial tenderness A. Episodes fulfilling criteria A-E for 2.2Frequent episodic tension-type headache Frequent episodic TTH 2.2 B. Increased pericranial tenderness on manual palpation 2.2.2 Frequent episodic tension-type headache not associated with pericranial tenderness A. Episodes fulfilling criteria A-E for 2.2 Frequent episodic tension-type headache B. No increased pericranial tenderness
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

2.3 Chronic TTH
A. Headache occurring on ≥15 d/mo (≥180 d/y) for >3 mo and fulfilling criteria B-D B. Headache lasts hours or may be continuous C. Headache 2.3 of the following TTH has ≥2 Chronic characteristics: 1. bilateral location 2. pressing/tightening (non-pulsating) quality 3. mild or moderate intensity 4. not aggravated by routine physical activity D. Both of the following: 1. not >1 of photophobia, phonophobia, mild nausea 2. neither moderate or severe nausea nor vomiting E. Not attributed to another disorder
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

2.3 Chronic TTH
2.3.1 Chronic tension-type headache associated with pericranial tenderness A. Headache fulfilling criteria A-E for 2.3 Chronic TTH 2.3 Chronic tension-type headache B. Increased pericranial tenderness on manual palpation 2.3.2 Chronic tension-type headache not associated with pericranial tenderness A. Episodes fulfilling criteria A-E for 2.3 Chronic tension-type headache B. No increased pericranial tenderness
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

2.4 Probable TTH
2.4.1 Probable infrequent episodic TTH A. Episodes fulfilling all but one of criteria A-D for 2.1 Infrequent episodic tension-type headache B. Episodes do not fulfil criteria for 2.4 Probable TTH 1.1 Migraine without aura C. Not attributed to another disorder 2.4.2 Probable frequent episodic TTH A. Episodes fulfilling all but one of criteria A-D for 2.2 Frequent episodic tension-type headache B. Episodes do not fulfil criteria for 1.1 Migraine without aura C. Not attributed to another disorder
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

2.4.3 Probable chronic TTH

As 2.3 except: E. Not attributed to another disorder but there is, or has been within the last 2 mo, medication overuse fulfilling criterion B for any of the subforms of 8.2 Medication-overuse headache

2.4.3 Probable chronic TTH

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

3. Cluster headache and other trigeminal autonomic cephalalgias 3. Cluster headache and other trigeminal 3.1 Cluster headache autonomic 3.2 Paroxysmal hemicrania cephalalgias
3.3 Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) 3.4 Probable trigeminal autonomic cephalalgia
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

3.1 Cluster headache
A. At least 5 attacks fulfilling criteria B-D B. Severe or very severe unilateral orbital, supraorbital and/or temporal pain lasting 15-180 min if untreated C. Headache is accompanied by ≥1 of the following: 3.1 conjunctival headache 1. ipsilateralClusterinjection and/or lacrimation 2. ipsilateral nasal congestion and/or rhinorrhoea 3. ipsilateral eyelid oedema 4. ipsilateral forehead and facial sweating 5. ipsilateral miosis and/or ptosis 6. a sense of restlessness or agitation D. Attacks have a frequency from 1/2 d to 8/d E. Not attributed to another disorder
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

3.1 Cluster headache
3.1.1 Episodic cluster headache
A. Attacks fulfilling criteria A-E for 3.1 Cluster headache 3.1 Cluster headache B. At least two cluster periods lasting 7-365 d and separated by pain-free remission periods of ≥1 mo

3.1.2 Chronic cluster headache
A. Attacks fulfilling criteria A-E for 3.1 Cluster headache B. Attacks recur over >1 y without remission periods or with remission periods lasting <1 mo
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

‘Chronic’
Notes
? In pain terminology, chronic denotes persistence over a period of more than 3 months ‘Chronic’ are more usually ? For primary headache disorders that Notes episodic, chronic is used whenever headache occurs on more days than not over more than 3 months ? The trigeminal autonomic cephalalgias are an exception: – in these disorders, chronic is not used until the condition has been unremitting for more than 1 year
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

Episodic/chronic cluster headache
Reclassification 1988-2004
1988 2004 3.1.1 Episodic/chronic cluster Cluster headache periodicity headache undetermined Reclassification 1988-2004 3.1.2 Episodic cluster 3.1.1 Episodic cluster headache headache 3.1.3 Chronic cluster 3.1.2 Chronic cluster headache headache Default diagnosis until periodicity is determined or 1 y is 3.1.1 Episodic cluster headache
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

Episodic/chronic cluster headache
Definition change 1988-2004

?

3.1.1 Episodic cluster headache from Definition change 3.1.2 Chronic cluster headache 1988-2004

Episodic/chronic cluster The definition ofheadachedistinguishing remission period

is changed: duration increased from a minimum of 14 days to a minimum of 1 month

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

3.1.2 Chronic cluster headache
Abandoned subclassification 1988-2004

?

3.1.2 Chronic clusterheadache Patients may switch from 3.1.2 Chronic cluster headache to 3.1.1 Episodic cluster headache, and vice versa
Chronic cluster headache unremitting from onset and Chronic cluster headache evolved from episodic have been dropped

Abandoned subclassification ? Therefore the previously classified subforms 19882004

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

3.2 Paroxysmal hemicrania
A. At least 20 attacks fulfilling criteria B-D B. Attacks of severe unilateral orbital, supraorbital or temporal pain lasting 2-30 min C. Headache is accompanied by ≥1 of the following: 1. ipsilateral conjunctival injection and/or lacrimation 3.2 Paroxysmal hemicrania 2. ipsilateral nasal congestion and/or rhinorrhoea 3. ipsilateral eyelid oedema 4. ipsilateral forehead and facial sweating 5. ipsilateral miosis and/or ptosis D. Attacks have a frequency >5/d for > half of the time, although periods with lower frequency may occur E. Attacks are prevented completely by therapeutic doses of indomethacin F. Not attributed to another disorder
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

3.2 Paroxysmal hemicrania
New subdivision 1988-2004 3.2.1 Episodic paroxysmal hemicrania
A. Attacks fulfilling criteria A-F for 3.2 Paroxysmal 3.2 Paroxysmal hemicrania hemicrania New subdivision lasting 7-365 d B. At least two attack periods1988-2004and separated by pain-free remission periods of ≥1 mo

3.2.2 Chronic paroxysmal hemicrania
A. Attacks fulfilling criteria A-F for 3.2 Paroxysmal hemicrania B. Attacks recur over >1 y without remission periods or with remission periods lasting <1 mo
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

Episodic/chronic paroxysmal hemicrania
New subdivision 1988-2004

Episodic/chronic Why this new subdivision?

paroxysmal hemicrania ? Only chronic paroxysmal hemicrania was previously New subdivision 1988-2004 recognised and classified
? Sufficient clinical evidence for the episodic subtype has accumulated to subdivide paroxysmal hemicranias in a manner analogous to cluster headache

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

3.3 Short-lasting Unilateral Neuralgiform headache attacks with Conjunctival injection and Tearing 3.3 Short-lasting Unilateral New entrant to classification Neuralgiform headache attacks A.with Conjunctival injection and At least 20 attacks fulfilling criteria B-D Tearing B. Attacks of unilateral orbital, supraorbital or temporal
New pulsating pain classification stabbing or entrant tolasting 5-240 s C. Pain is accompanied by ipsilateral conjunctival injection and lacrimation D. Attacks occur with frequency 3-200/d E. Not attributed to another disorder
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

3.4 Probable TAC
3.4.1 Probable cluster headache 3.4.2 Probable paroxysmal hemicrania 3.4.3 Probable SUNCT 3.4 Probable TAC
A. Attacks fulfilling all but one of the specific criteria for 3.1 Cluster headache, 3.2 Paroxysmal hemicrania or 3.3 SUNCT B. Not attributed to another disorder

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

4. Other primary headaches
4.1 Primary stabbing headache 4.2 Primary cough headache 4.3 Primary exertional headache 4. Other primary headaches 4.4 Primary headache associated with sexual activity 4.5 Hypnic headache 4.6 Primary thunderclap headache 4.7 Hemicrania continua 4.8 New daily-persistent headache (NDPH)
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

4. Other primary headaches
Terminology change 1988-2004

4. Other primary headaches This section was previously
Terminology change 1988-2004
4. Miscellaneous headaches unassociated with structural lesion

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

4.4 Primary headache associated with sexual activity
4.4.1 Preorgasmic headache
A.Dull ache in the head and neck associated with 4.4 Primary headache awareness of neck and/or jaw muscle contraction and fulfilling criterion with sexual associated B B.Occurs during sexual activity and increases with activity sexual excitement C.Not attributed to another disorder

4.4.2 Orgasmic headache
A.Sudden severe (“explosive”) headache fulfilling criterion B B.Occurs at orgasm C.Not attributed to another disorder
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

4.5 Hypnic headache
New entrant to classification
A. Dull headache fulfilling criteria B-D B. Develops only during sleep,headache 4.5 Hypnic and awakens patient C. At least two entrant to classification New of the following characteristics: 1. occurs >15 times/mo 2. lasts ≥15 min after waking 3. first occurs after age of 50 y D. No autonomic symptoms and no more than one of nausea, photophobia or phonophobia E. Not attributed to another disorder
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

4.6 Primary thunderclap headache
A. Severe head pain fulfilling criteria B and C 4.6 Primary thunderclap B. Both of the following characteristics: headache 1. sudden onset, reaching maximum intensity in <1 min 2. lasting from 1 h to 10 d C. Does not recur regularly over subsequent weeks or months D. Not attributed to another disorder

ICHD-II. Cephalalgia 2004; 24 (Suppl 1)

?International Headache Society 2003/4

4.7 Hemicrania continua
New entrant to classification
A. Headache for >3 mo fulfilling criteria B-D B. All of the following characteristics: 1. 4.7 Hemicrania continua unilateral pain without side-shift 2. daily and continuous, without pain-free periods New intensity, to classification 3. moderateentrantwith exacerbations of severe pain C. At least one of the following autonomic features occurs during exacerbations, ipsilateral to the pain: 1. conjunctival injection and/or lacrimation 2. nasal congestion and/or rhinorrhoea 3. ptosis and/or miosis D. Complete response to therapeutic doses of indomethacin E. Not attributed to another disorder
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

4.8 New daily-persistent headache
New entrant to classification
A. Headache for >3 mo fulfilling criteria B-D B. Headache is daily and unremitting from onset or from 4.8 New <3 d from onset daily-persistent C. At least two of the following pain characteristics: headache 1. bilateral entrant to classification New location 2. pressing/tightening (non-pulsating) quality 3. mild or moderate intensity 4. not aggravated by routine physical activity D. Both of the following: 1. not >1 of photophobia, phonophobia or mild nausea 2. neither moderate or severe nausea nor vomiting E. Not attributed to another disorder
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4

4.8 New daily-persistent headache
Notes
? 4.8 New daily-persistent headache has many 4.8 New daily-persistent similarities to 2.3 Chronic tension-type headache ? It is unique in that headache is daily and unremitting headache from, or almost from, the moment of onset Notes ? A clear recall of such onset is necessary for the diagnosis ? If there is or has been within the last 2 mo medication overuse fulfilling criterion B for any of the subforms of 8.2 Medication-overuse headache, the diagnosis cannot be 4.8 New daily-persistent headache
ICHD-II. Cephalalgia 2004; 24 (Suppl 1) ?International Headache Society 2003/4


相关文章:
五年级英语下册Unit7IHaveaHeadache课件1陕旅版_图文.ppt
五年级英语下册Unit7IHaveaHeadache课件1陕旅版_英语_小学教育_教育专区。五年级英语下册Unit7IHaveaHeadache课件1陕旅版 Warming-up Head ,shoulders, knees and...
三年级英语上册Unit1Haveyougotaheadache课件3外研版(一起)_图文_....ppt
三年级英语上册Unit1Haveyougotaheadache课件3外研版(起)_英语_小学教育_教育专区。三年级英语上册Unit1Haveyougotaheadache课件3外研版(起),外研版三年级英语...
三年级英语上册Unit1Haveyougotaheadache课件外研版一起_图文_....ppt
三年级英语上册Unit1Haveyougotaheadache课件外研版起_英语_小学教育_教育专区。Have you got a headache? Pair work A:What have you got ? B:I have got...
三年级英语上册Unit1Haveyougotaheadache课件外研版一起_图文_....ppt
三年级英语上册Unit1Haveyougotaheadache课件外研版起_英语_小学教育_教育专区。三年级英语上册Unit1Haveyougotaheadache课件外研版起 ...
三年级英语上册Unit1Haveyougotaheadache课件2外研版一起_图文_....ppt
三年级英语上册Unit1Haveyougotaheadache课件2外研版起_
三年级英语上册Unit1Haveyougotaheadache课件(一起)_图文.ppt
三年级英语上册Unit1Haveyougotaheadache课件(起)_英语_小学教育_教育专区。三年级英语上册Unit1Haveyougotaheadache课件(起) Have you got a headache? Pair ...
陕旅版英语六上《Lesson 10 I have a headache》课件1_图文.ppt
陕旅版英语六上《Lesson 10 I have a headache》课件1_英语_初中教育_教育专区。I. 看图片,拼写出相对应的单词 have a headache 头痛 feel bad 感觉不舒服 ...
五年级下册英语课件-Unit 7 I Have a Headache Part A 1陕旅版_....ppt
五年级下册英语课件-Unit 7 I Have a Headache Part A 1陕旅版_高考_高中教育_教育专区。五年级下册英语课件-Unit 7 I Have a Headache Part A 1陕旅版 ...
五年级下册英语课件-Unit 7 I Have a Headache Part B 1陕旅版_....ppt
五年级下册英语课件-Unit 7 I Have a Headache Part B 1陕旅版_高考_高中教育_教育专区。五年级下册英语课件-Unit 7 I Have a Headache Part B 1陕旅版 ...
2012九年级二班家长会PT课件[1]_图文.ppt
2012九年级二班家长会PT课件[1] - 九年级 五班 家长会 班主任:刘宝波
陕旅版五年级英语下册 Unit 7 I Have a Headache Part B 1课件_....ppt
陕旅版五年级英语下册 Unit 7 I Have a Headache Part B 1课件_小学教育_教育专区。Unit 7 I Have A Headache Part B First: Words Learning: Words ...
新陕旅版五年级英语下册Unit7 I Have a Headache第1课时教学设计_....doc
课程展示活动和过程的设计建议(presentation) (1)新课展示 Part A Let’s learn 教师继续表现出身体不舒服的样子,用纸擤鼻涕并说:Oh! I feel even bad now. ...
陕旅版五年级英语下册 Unit 7 I Have a Headache Part A 1课件_....ppt
陕旅版五年级英语下册 Unit 7 I Have a Headache Part A 1课件_小学教育_教育专区。Unit 7 I Have A Headache Part A First: Words Learning: Words ...
泰比特儿童智能手表开咪PT01型产品介绍V1.2_图文.pdf
泰比特儿童智能手表开咪PT01型产品介绍V1.2_少儿英语_幼儿教育_教育专区。泰比特开咪,关怀无处不在 儿童智能手表介绍 Product Introduction PT01 CONTENTS 目录 ...
三年级英语上册Unit1Haveyougotaheadacheppt课件外研版(一起)_....ppt
三年级英语上册Unit1Haveyougotaheadacheppt课件外研版(起)_英语_小学教育_教育专区。Have you got a headache? Pair work A:What have you got ? B:I ...
2018陕旅版英语五年级下册 Unit 7 I Have a Headache Part B 1-....ppt
2018陕旅版英语五年级下册 Unit 7 I Have a Headache Part B 1-PPT课件_幼儿读物_幼儿教育_教育专区。2018 Unit 7 I Have A Headache 第二课时 First: ...
2018陕旅版英语五年级下册 Unit 7 I Have a Headache Part A 1-....ppt
2018陕旅版英语五年级下册 Unit 7 I Have a Headache Part A 1-PPT课件_幼儿读物_幼儿教育_教育专区。2018 Unit 7 I Have A Headache课时 First: ...
最新五年级下册英语(陕旅版) Unit 7 I Have a Headache Part A 1....ppt
最新五年级下册英语(陕旅版) Unit 7 I Have a Headache Part A 1课件_小学教育_教育专区。Unit 7 I Have A Headache Part A First: Words Learning: Words...
五年级英语下册 Unit 7 I Have a Headache课件1 陕旅版_图文.ppt
五年级英语下册 Unit 7 I Have a Headache课件1 陕旅版_幼儿读物_幼儿教育_教育专区。五年级英语下册 Unit 7 I Have a Headache课件1 陕旅版 ...
最新陕旅版英语五年级下册 Unit 7 I Have a Headache Part B 1....ppt
最新陕旅版英语五年级下册 Unit 7 I Have a Headache Part B 1课件_小学教育_教育专区。Unit 7 I Have A Headache Part B First: Words Learning: Words ...