A Negro

GC Manzoni

Guzyal Tabeeva

H-C Diener

J Olesen

ME Bigal

NT Mathew

SD Silberstein

Tatiana Voznesenskaya

Vera Osipova

Journal of Headache and Pain

English

PubMed

Springer - Publisher Connector

COMMENTARY
Chronic migraine classification: one more attempt of optimization
and criteria revision
Vera Osipova • Guzyal Tabeeva •
Tatiana Voznesenskaya
Received: 1 February 2012 / Accepted: 16 February 2012 / Published online: 7 April 2012
 The Author(s) 2012. This article is published with open access at Springerlink.com
First of all we would like to thank Manzoni et al. for the
deep and thoughtful discussion on chronic migraine (CM)
classification [1]. All of us who deal with CM patients feel
sharp need in universal and complete classification of this
complicated and ambiguous disorder, especially taking into
account the problem of medication overuse [2, 3]. Below,
we present our opinion on the latest revision of the ICHD-2
for migraine suggested by the Italian team and propose new
revision of CM diagnostic criteria for ICHD-3.
Proposed revision of the ICHD-2 for migraine [1]
1.1 Migraine without aura
1.1.1 Infrequent migraine
1.1.2 Frequent migraine
1.1.3 Chronic migraine
1.1.3.1 With medication overuse
1.1.3.2 Without medication overuse
1.5 Complications of migraine
1.5.1 Transformed migraine
1.5.1.1 With medication overuse
1.5.1.2 Without medication overuse
The term ‘‘transformation’’ is known to mean the period
when the usual course of migraine has begun to change (the
main feature—gradual increase in attack frequency and the
loss of typical migraine signs), but the patient did not yet
reach the degree of ‘‘chronic M’’ (CM), i.e., does not
comply with the new proposed diagnostic criteria of CM
(ICHD-2R, 2006) [4, 5]. If we consider that the term
‘‘transformed M’’ (TM) is important and really has inde-
pendent clinical and diagnostic value, we can keep it in the
text of ICHD as the pre-stage of CM (with the diagnostic
criteria proposed by Silberstein et al. or somehow modi-
fied) [6] (Option 1).
Option 1
1.1 Migraine without aura
1.1.1 Infrequent episodic migraine
1.1.2 Frequent episodic migraine (without division below or with it)
1.1.2.1 With medication overuse
1.1.2.2 Without medication overuse
1.2 Migraine with aura
…
1.5 Complications of migraine
1.5.1 Transformed migraine
1.5.1.1 With medication overuse
1.5.1.2 Without medication overuse
1.5.2 Chronic migraine
1.5.2.1 With medication overuse
1.5.2.2 Without medication overuse
1.5.3 Status migrainosus
If we consider that the terms ‘‘transformed’’ and
‘‘chronic’’ reflect, to a considerable degree, similar if not
the same course of M evolution they could be used as
synonyms (since chronification is a terminal stage of
transformation) [7]. In this case, the term ‘‘chronic’’ reads
more literate and could be used in the text of the ICHD
instead of the term TM.
On behalf of the Russian Headache Research Society.
V. Osipova (&)  G. Tabeeva  T. Voznesenskaya
Department of Neurology and Clinical Neurophysiology,
First Sechenov Moscow State Medical University,
Ul.Rossolimo, 11, 119021 Moscow, Russia
e-mail: osipova_v@mail.ru
123
J Headache Pain (2012) 13:277–278
DOI 10.1007/s10194-012-0429-6
In this case it is important to note: since the term CM
‘‘absorbs’’ the term TM, diagnostic criteria of CM should
also ‘‘absorb’’ all or some of the most prominent diagnostic
criteria of TM [6]. Below we present our version of such
combined criteria.
Chronic migraine (ICHD-3) Osipova, Tabeeva, Vozne-
senskaya (2012) [5, 6]
Diagnostic criteria
A. History of episodic migraine meeting criteria for migraine
without (with?) aura (possibly) relieved by triptan(s) or ergots
B. History of headache transformation with increasing headache
frequency and decreasing migrainous features severity
C. For [3 latest month headache is present [ 15 d/month with
following characteristics
1. [ 5 attacks/month, fulfilling criteria for migraine without
(with?) aura
2. On [8 days/month patient has continuous mild to moderate
headache with MO-like, TTH-like or mixed characteristics not
completely fulfilling criteria for MO and TTHa
D. With or without medication overuse (triptans/ergots/complex
analgesics)
E. Headache is not attributed to another disorder
a We see an inaccuracy in the third criteria of CM in the latest ICHD-
2R version: ‘‘On [ 8 d/month for [ 3 month, headache fulfills cri-
teria for MO and/or treated and relieved by triptan(s) or ergot’’.
Clinical experience shows that in the majority of CM patients these
‘‘background’’ interim headaches are far from fulfilling MO criteria.
Moreover, the patients can use not only triptans/ergots but also
complex analgesics to relieve headache
It is also reasonable that the possibility of chronification
as the main variant of migraine evolution/complications
could be mentioned in ICHD only once, either under 1 or
under 1.5 (Options 2 and 3).
Any of these options could be chosen (we consider
Option 3 the most appropriate) but the diagnostic criteria of
TM should by all means be taken into account and added to
CM criteria as proposed above. Although from our point of
view the proposed criteria completely reflect the clinical
essence and nature of CM, the contribution of the native
English speaker in terms of linguistic editing could be
needed. We believe that each brick in a stone-work serves
to speed up the construction of the ICHD-3.
Conflict of interest None.
Open Access This article is distributed under the terms of the
Creative Commons Attribution License which permits any use, dis-
tribution, and reproduction in any medium, provided the original
author(s) and the source are credited.
References
1. Manzoni GC, Bonavita V, Bussone G, Cortelli P, Narbone MC,
Cevoli S, D’Amico D, De Simone R, Torelli P (2011) Chronic
migraine classification: current knowledge and future perspectives.
J Headache Pain 12:585–592
2. Negro A, Martelletti P (2011) Chronic migraine plus medication
overuse headache: two entities or not? J Headache Pain 12:593–601
3. Diener H-C, Limmroth V (2004) Medication-overuse headache: a
worldwide problem. Lancet Neurol 3:475–483
4. Mathew NT (1993) Transformed migraine. Cephalalgia 13(suppl
12):78–83
5. Olesen J, Bousser MG, Diener HC, Dodick D, First M, Goadsby
PJ, Goebel H, Lainez MJA, Lance JW, Lipton RB, Nappi G, Sakai
F, Schoenen J, Silberstein SD, Steiner TJ (2006) New appendix
criteria open for a broader concept of chronic migraine. Cepha-
lalgia 26:742–746
6. Silberstein SD, Lipton RB, Solomon S, Mathew NT (1994)
Classification of daily and near-daily headaches: proposed revi-
sions to the IHS criteria. Headache 34:1–7
7. Bigal ME, Rapoport AM, Sheftell FD, Tepper SJ, Lipton RB
(2005) Chronic migraine is an earlier stage of transformed
migraine in adults. Neurology 65:1556–1661
Option 2
1.1. Migraine without aura
1.1.1. Episodic migraine (without division below or with it)
1.1.1.1. Infrequent episodic migraine
1.1.1.2. Frequent episodic migraine (without division below or
with it)
1.1.1.2.1. With medication overuse
1.1.1.2.2. Without medication overuse
1.1.2 Chronic migraine
1.1.2.1. With medication overuse
1.1.2.2. Without medication overuse
1.5 Complications of migraine
1.5.1 Status migrainosus, etc
Option 3
1.1 Migraine without aura
1.1.1. Infrequent episodic migraine
1.1.2. Frequent episodic migraine (without division below
or with it)
1.1.2.1. With medication overuse
1.1.2.2. Without medication overuse
1.2. Migraine with aura
…
1.5. Complications of migraine
1.5.1 Chronic migraine (with new diagnostic criteria combining
both CM and TM features)
1.5.1.1 With medication overuse
1.5.1.2 Without medication overuse
1.5.2. Status migrainosus
278 J Headache Pain (2012) 13:277–278
123


Chronic migraine classification: one more attempt of optimization and criteria revision

Crossref

The Journal of Headache and Pain

5.1 Status migrainosus, etc

Chronic migraine classiﬁcation: current knowledge and future perspectives.

Chronic migraine is an earlier stage of transformed migraine in adults.

Chronic migraine plus medication overuse headache: two entities or not?

Classiﬁcation of daily and near-daily headaches: proposed revisions to the IHS criteria.

Episodic migraine (without division below or with it)

Frequent episodic migraine (without division below or with it)

Infrequent episodic migraine

Medication-overuse headache: a worldwide problem.

New appendix criteria open for a broader concept of chronic migraine.

Status migrainosus 278 J Headache Pain

Transformed migraine.

Without medication overuse

file:///data/remote/core/dit/data/Springer-OA/pdf/d70/aHR0cDovL2xpbmsuc3ByaW5nZXIuY29tLzEwLjEwMDcvczEwMTk0LTAxMi0wNDI5LTYucGRm.pdf

Chronic migraine classification: one more attempt of optimization and criteria revision

Abstract

Similar works

Full text

Available Versions

Springer - Publisher Connector

Crossref

Springer - Publisher Connector