Clinical Newswire Sept. 15, 2003 (ROME, Italy) - The International Headache Society has issued a new classification of headache disorders, 15 years after its first edition. The IHC, which was founded in l981 and is comprised of more than 1,200 members from over 60 countries, has finally issued “a classification that is easy to utilize and can be applied throughout the world, so that patients in different countries can be diagnosed in the same manner and correctly” said Jes Olsen, Professor of Neurology at the University of Copenhagen and Chairperson of the IHS Classification Subcommittee. The new edition of the classification was presented during the XI IHS Congress in Rome this week.
This new classification is the first to well characterize the condition ‘medication overuse headache’, the most common problem seen by the specialist in routine practice, affecting 1% to 4% of the general population.
“Diagnosis using specific criteria can now be reached”, adds Professor Giuseppe Nappi, scientific director of the Mondino Foundation in Pavia, Italy. “Taking aspirin 15 days a month or triptan/ergotamine for 10 days a month are enough to experience overuse headache, if this behaviour continues for 3 months. Recovering from this syndrome may require up to 6 months and even warrant admission to the hospital in the most severe cases”.
“New research tools to image the functional changes in the brain reveal that patients suffering from medication overuse show changes not only in parts of the brain related to acute and chronic pain, but also in other areas related to getting addicted to drugs,” says Dr. Schoenen, Professor of Neurology at the University of Liege. “This finding demonstrates that analgesic/ergotamine overuse is really responsible for the evolution of an occasional headache into a chronic problem”.
The new classification aims to be as clear and unambiguous as possible. Terms such as ‘sometimes’, ‘often’, and ‘usually’ are avoided. A better definition is provided for certain secondary headaches, and headache due to coronary artery disease and two forms of childhood syndromes, namely cyclical vomiting and the abdominal migraine, are now well recognized. A more precise diagnosis is proposed for tension type headache, a ‘featureless’ headache that is very difficult to diagnose.
The new International Classification of Headache Disorders also notes a link between cervical dystonia and headache. Diagnostic criteria for headache associated with craniocervical dystonia include pain which resolves within three months after successful treatment of the causative disorder.
“Today, more effective and better tolerated drugs are available to prevent headache before it starts. With the adoption of a correct lifestyle and the right medications, it is now possible for patients to plan their lives without the fear of headache attacks,” concluded Professor Virgilio Gallai, co-chair of the IHS congress scientific committee.
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