Migraine headache in adults

International classification of headache disorders, 3rd edition (ICHD-3)[3]Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211. https://www.ichd-3.org/wp-content/uploads/2018/01/The-International-Classification-of-Headache-Disorders-3rd-Edition-2018.pdf http://www.ncbi.nlm.nih.gov/pubmed/29368949?tool=bestpractice.com

1.1 Migraine without aura

• A. At least 5 attacks fulfilling criteria B to D

• B. Headache attacks lasting 4 to 72 hours (when untreated or unsuccessfully treated)

• C. Headache has at least 2 of the following 4 characteristics:

  1. Unilateral location

  2. Pulsating quality

  3. Moderate or severe pain intensity

  4. Aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs)

• D. During headache at least one of the following:

  1. Nausea and/or vomiting

  2. Photophobia and phonophobia

• E. Not better accounted for by another ICHD-3 diagnosis.

1.2 Migraine with aura

• A. At least 2 attacks fulfilling criteria B and C

• B. One or more of the following fully reversible aura symptoms:

  1. Visual

  2. Sensory

  3. Speech and/or language

  4. Motor

  5. Brainstem

  6. Retinal

• C. At least 3 of the following 6 characteristics:

  1. At least one aura symptom spreads gradually over 5 minutes

  2. Two or more aura symptoms occur in succession

  3. Each individual aura symptom lasts 5 to 60 minutes

  4. At least one aura symptom is unilateral

  5. At least one aura symptom is positive

  6. The aura is accompanied, or followed within 60 minutes, by headache

• D. Not better accounted for by another ICHD-3 diagnosis.

1.3 Chronic migraine

• A. Headache (migraine-like or tension-type-like) on 15 days/month for >3 months, and fulfilling criteria B and C

• B. Occurring in a patient who has had at least 5 attacks fulfilling criteria B to D for 1.1 Migraine without aura and/or criteria B and C for 1.2 Migraine with aura

• C. On 8 days/month for >3 months, fulfilling any of the following:

  1. Criteria C and D for 1.1 Migraine without aura

  2. Criteria B and C for 1.2 Migraine with aura

  3. Believed by the patient to be migraine at onset and relieved by a triptan or ergot derivative

• D. Not better accounted for by another ICHD-3 diagnosis.

1.4 Complications of migraine

• A. A headache attack fulfilling criteria B and C

• B. Occurring in a patient with 1.1 Migraine without aura and/or 1.2 Migraine with aura, and typical of previous attacks except for its duration and severity

• C. Both of the following characteristics:

  1. Unremitting for >72 hours

  2. Pain and/or associated symptoms are debilitating

• D. Not better accounted for by another ICHD-3 diagnosis.

1.5 Probable migraine

• A. Attacks fulfilling all but one of criteria A to D for 1.1 Migraine without aura, or all but one of criteria A to C for 1.2 Migraine with aura

• B. Not fulfilling ICHD-3 criteria for any other headache disorder

• C. Not better accounted for by another ICHD-3 diagnosis.