TABLE 18-2. IHS CRITERIA FOR COMMON HEADACHE SYNDROMES

Part of the criteria for all benign headaches is ruling out serious underlying organic disease causing headache (see text).

  1. Common migraine
    1. Must have headache with at least two of the following:
      1. Unilateral (one side) location
      2. Pulsing/pounding quality
      3. Nausea
      4. Light and sound sensitivity
    2. History of similar headaches in the past
  2. Classic migraine
    1. Must meet criteria for common migraine but with warning symptoms before HA (usually 5 to 30 minutes)
      1. Spots in front of eyes (often colored spots)
      2. Fortification spectra
      3. Wavy lines in vision
      4. Flashing lights
      5. Paresthesia
      6. Weakness
      7. Aphasia
    2. History of similar headaches in the past
  3. Cluster headache
    1. Severe unilateral orbital, supraorbital and/or temporal pain
    2. Pain lasts 15-180 minutes
    3. At least one of the following on the side of headache:
      1. Conjunctival injection
      2. Facial sweating
      3. Lacrimation
      4. Miosis
      5. Nasal congestion
      6. Ptosis
      7. Rhinorrhea
      8. Eyelid edema
    4. History of similar headaches in the past
  4. Tension-type headaches
    1. Headache pain accompanied by two of the following characteristics:
      1. Pressing/tightening (nonpulsing) quality
      2. Bilateral location
      3. Not aggravated by routine physical activity
    2. Headache should be lacking:
      1. Nausea or vomiting
      2. Photophobia and phonophobia (one or the other may be present)
    3. Episodic tension-type headache should be present less than 15 days per month and chronic tension-type headache is present more than 15 days per month.
    4. History of similar headaches in the past
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