BACKGROUND: The International Classification of Headache Disorders, an essential tool in the diagnosis of headache disorders, has been revised as its 3rd edition, beta (ICHD-IIIbeta). The clinical application in practice is needed to test the feasibility and usefulness of the Korean version of ICHD-IIIbeta. METHODS: Neurologists enrolled consecutive first-visit headache patients from February to March 2014. The classification of headache disorder was done by each investigator according to ICHD-IIIbeta based on the initial structured questionnaire, clinical evaluation, and neuroimaging studies, if needed. A consensus meeting dealt with the cases that were difficult to diagnose. The feasibility and usefulness of this version was assessed by the proportion of unclassified headache disorders using ICHD-IIIbeta compared to the previous version. RESULTS: A total of 207 patients were enrolled: the mean age was 41 years (16-87 years) and women constituted 63.3%. Primary headache disorders were diagnosed in 167 patients (80.7%): 82 migraines, 37 tension-type headaches, 3 cluster headaches, and 45 other primary headache disorders. Thirty-five patients (16.9%) had secondary headache disorders or painful cranial neuropathies/other facial pain and 5 patients (2.4%) could not be classified by ICHD-IIIbeta. The diagnoses differed as compared to the previous version in 32 patients (15.5%): 14.5% differed due to the mitigation of the previous strict criteria and 1% differed due to the introduction of a new diagnostic category. CONCLUSIONS: Classifications by ICHD-IIIbeta are possible in more than 97% of the first-visit headache patients and ICHD-IIIbeta has proved to be more useful than its previous version.
Classification* ; Cluster Headache ; Consensus ; Diagnosis ; Facial Pain ; Female ; Headache ; Headache Disorders* ; Headache Disorders, Primary ; Headache Disorders, Secondary ; Humans ; Migraine Disorders ; Neuroimaging ; Surveys and Questionnaires ; Research Personnel ; Tension-Type Headache

Headache disorders, one of most common disease in general population, have been developed according to many versions of international classifications. The primary headaches are those in which no consistently identified organic cause can be determined. It is divided into the following categories: (1) migraine, (2) tension-type headache, (3) cluster headache and other trigeminal autonomic cephalalgias, (4) other primary headaches. This review described a diagnosis of primary headache disorders based on International Classification of Headache Disorders (ICHD)-3 beta criteria.
Classification ; Cluster Headache ; Dental Clinics* ; Diagnosis* ; Headache Disorders ; Headache Disorders, Primary ; Headache* ; Migraine Disorders ; Temporomandibular Joint Disorders ; Tension-Type Headache ; Trigeminal Autonomic Cephalalgias

Headache is one of the most common physical symptoms which almost everyone experience at least once during a life. Headache is often associated with disability, but rarely with secondary headache which could result in a serious life-threatening illness, i.e. brain tumor. However, in most cases, headache is a benign illness which comprises a primary headache, i.e. migraine or tension-type headache. The accurate diagnosis of headache is critical for clinicians and it begins with history taking and physical examination since there are no diagnostic tests for primary headaches. Nowadays, there are a wide variety of pharmacological treatments according to each headache disorder. The specific purposes of this review are introducing history of classification of headache disorder and presenting diagnostic process of headache disorder. Then, we discuss the effective pharmacological treatment strategies of each headache disorder.
Brain Neoplasms ; Classification ; Diagnosis ; Diagnostic Tests, Routine ; Headache Disorders ; Headache* ; Migraine Disorders ; Physical Examination ; Tension-Type Headache

BACKGROUND AND PURPOSE: Chronic daily headache (CDH) is defined as a headache disorder in which headaches occur on a daily or near-daily basis (at least 15 days/month) for more than 3 months. Chronic migraine (CM) and medication overuse headache (MOH) are very disabling headaches that remain underdiagnosed. The aim of this study was to establish the frequency of CDH and its various subtypes, and examine the associations with MOH among first-visit headache patients presenting at neurology outpatient clinics in Korea. METHODS: Eleven neurologists enrolled first-visit patients with complaints of headaches into outpatient clinics for further assessment. Headache disorders were classified according to the International Classification of Headache Disorder (third edition beta version) by each investigator. RESULTS: Primary CDH was present in 248 (15.2%) of the 1,627 included patients, comprising CM (143, 8.8%), chronic tension-type headache (CTTH) (98, 6%), and definite new daily persistent headache (NDPH) (7, 0.4%). MOH was associated with headache in 81 patients (5%). The association with MOH was stronger among CM patients (34.5%) than patients with CTTH (13.3%) or NDPH (14.3%) (p=0.001). The frequency of CDH did not differ between secondary and tertiary referral hospitals. CONCLUSIONS: The frequencies of CDH and MOH diagnoses were 15.2% and 5%, respectively in first-visit headache patients presented at secondary or tertiary referral hospitals in Korea. CM was the most common subtype of CDH and was most frequently associated with MOH.
Ambulatory Care Facilities ; Classification ; Diagnosis ; Epidemiology ; Headache Disorders* ; Headache Disorders, Secondary* ; Headache* ; Humans ; Korea* ; Migraine Disorders ; Neurology ; Prescription Drug Overuse* ; Research Personnel ; Tension-Type Headache ; Tertiary Care Centers

PURPOSE: The purpose of this study is to help diagnosis migraine and tension-type headache in children with chronic recurrent headache by comparing clinical characteristics of migraine and tension-type headache. METHODS: We performed a clinical analysis of 89 children diagnosed as migraine and/or tension-type headache by using international headache society classification with the aid of Prenky's criteria of migraine and Jay's category of tension-type headache. RESULTS: The diagnosed group consisted of 39 children with migraine, 40 tension-type headache cases and coexisting migraine and tension-type headache in 10 cases. In the location of the headache, the incidence of temporal area was significantly higher in the migraine than in tension-type headache(P<0.001) and the incidence of occipital area was significantly higher in the tension-type headache than in migraine(P<0.01). In migraine, 27 cases(69.2%) had pulsating headache which was significantly higher than in the tension-type headache(P<0.001). In tension-type headache, 18 cases(45.0%) had dull headaches which were significantly higher than in migraine(P<0.01). Nausea, vomiting, dizziness, relief of headache after sleep, photophobia, and visual disturbance among associated symptoms with headache were significantly higher in migraine than tension-type headache(P<0.05). The incidence of family history of headache in migraine(71.8 %) was higher than in the tension-type headache(40.0%)(P<0.01). CONCLUSION: Diagnostic criteria are significant in diagnosis of migraine and tension-type headache. The characteristics of headache are overlapped in both headache types and there are differences of expression for headache in children, so there is a problem in diagnosing of headache type. The international Headache Society Classifications are useful for children, but there are problems that diagnostic criteria are too strictly applied to children.
Child* ; Classification ; Diagnosis ; Dizziness ; Headache ; Humans ; Incidence ; Migraine Disorders* ; Nausea ; Photophobia ; Tension-Type Headache* ; Vomiting

Rhinogenic headache may be defined as a headache directly caused by pathology within the nose or paranasal sinuses. Rhinogenic headache is a controversial, but distinct type of headache that has received an increased amount of attention in the literature over the past twenty years. The International Classification of Headache Disorders, 3rd edition has been released by the 'International Headache Society' in May 2013. As this version is based on a large body of research on headache, in contrast to previous editions that were mostly based on opinion of experts, it is being considered as a major step forward in the diagnosis and management of headache. The International Headache Society presented the diagnostic criteria of rhinogenic headache divided into three types: Headache Attributed to Acute Rhinosinusitis, Headache Attributed to Chronic or Recurring Rhinosinusitis, Headache Attributed to Disorder of the Nasal Mucosa, Turbinates or Septum. We herein present the salient features of the new classification, which are likely to be of interest to the rhinologist. In addition, I review the evidence that intranasal mucosal contact points cause facial pain or headache and present the important points to consider in diagnosis and treatment of mucosal contact point headache.
Classification* ; Diagnosis ; Facial Pain ; Headache Disorders* ; Headache* ; Nasal Mucosa ; Nose ; Paranasal Sinuses ; Pathology ; Turbinates

BACKGROUND AND PURPOSE: New-onset headache in elderly patients is generally suggestive of a high probability of secondary headache, and the subtypes of primary headache diagnoses are still unclear in the elderly. This study investigated the characteristics of headache with an older age at onset (≥65 years) and compared the characteristics between younger and older age groups. METHODS: We prospectively collected demographic and clinical data of 1,627 patients who first visited 11 tertiary hospitals in Korea due to headache between August 2014 and February 2015. Headache subtype was categorized according to the International Classification of Headache Disorders, Third Edition Beta Version. RESULTS: In total, 152 patients (9.3%, 106 women and 46 men) experienced headache that began from 65 years of age [elderly-onset group (EOG)], while the remaining 1,475 patients who first experienced headache before the age of 65 years were classified as the younger-age-at-onset group (YOG). Among the primary headache types, tension-type headache (55.6% vs. 28.8%) and other primary headache disorders (OPH, 31.0% vs. 17.3%) were more common in the EOG than in the YOG, while migraine was less frequent (13.5% vs. 52.2%) (p=0.001) in the EOG. Among OPH, primary stabbing headache (87.2%) was more frequent in the EOG than in the YOG (p=0.032). The pain was significantly less severe (p=0.026) and the frequency of medication overuse headache was higher in EOG than in YOG (23.5% vs. 7.6%, p=0.040). CONCLUSIONS: Tension-type headache and OPH headaches, primarily stabbing headache, were more common in EOG patients than in YOG patients. The pain intensity, distribution of headache diagnoses, and frequency of medication overuse differed according to the age at headache onset.
Age of Onset ; Aged ; Classification* ; Diagnosis ; Electrooculography ; Female ; Headache Disorders* ; Headache Disorders, Primary ; Headache Disorders, Secondary ; Headache* ; Humans ; Korea ; Migraine Disorders ; Prescription Drug Overuse ; Prospective Studies ; Tension-Type Headache ; Tertiary Care Centers

PURPOSE: Headache is a common problem in children and adolescents, and they experience severe pain and disabilities from headache. But there had not been an appropriate system for the diagnosis and the classification for headache in children and adolescents before the international classification of headache disorders(ICHD-II) was developed. But family history was not included in this classification's criteria. So we evaluated the effects of family history on the diagnosis of children with recurrent headaches. METHODS: 217 patients with recurrent headaches younger than fifteen years old were selected. To diagnose the patients' headache, we utilized headache questionnaires, headache diaries, and studied the family history of headache on the patients' maternal and paternal lines. Final diagnosis was based on the ICHD-II. RESULTS: In the migrainous patients, 78.1% had positive family history of headache on the maternal lines, and 16.2% on the paternal lines. In the patients with tension-type headache, 56.8% had positive family history of headache on the maternal lines. When the mother of a patient suffered from recurrent headaches, migraine occurred 2.94 times as frequently as tension-type headache(Mantel-Haenszel odds ratio, 2.94; P<0.01; 95% confidence interval, 1.36-6.38). And if a patient had parents with recurrent headaches, migraine occurred 3.22 times as frequently as tension-type headache(odds ratio, 3.22; P<0.005; 95% confidence interval, 1.48-7.02). CONCLUSION: We can consider migraine rather than tension-type headache when a patient has family history of recurrent headaches. In our study, we were able to validate that positive family history of headache was important in diagnosing the headache of children.
Adolescent ; Child ; Classification ; Diagnosis* ; Headache ; Humans ; Migraine Disorders* ; Mothers ; Odds Ratio ; Parents ; Surveys and Questionnaires ; Tension-Type Headache

To diagnosis Tolosa-Hunt syndrome (TSH) used to be difficult because some other diseases like tumors, sarcoids, vasculitises or other inflammatory masses simulate the clinical manifestations, including steroid responsiveness and radiologic findings. According to the international classification of headache disorders 2nd edition, the diagnosis of THS requires demonstration of granuloma by MRI or biopsy. We performed MRI 4 times during 6 months in a patient who seemed to have THS. Initial MRI was normal but the second MRI showed granuloma which decreased gradually in size with steroid treatment.
Biopsy ; Classification ; Diagnosis ; Granuloma ; Headache Disorders ; Humans ; Magnetic Resonance Imaging* ; Tolosa-Hunt Syndrome* ; Vasculitis

To diagnosis Tolosa-Hunt syndrome (TSH) used to be difficult because some other diseases like tumors, sarcoids, vasculitises or other inflammatory masses simulate the clinical manifestations, including steroid responsiveness and radiologic findings. According to the international classification of headache disorders 2nd edition, the diagnosis of THS requires demonstration of granuloma by MRI or biopsy. We performed MRI 4 times during 6 months in a patient who seemed to have THS. Initial MRI was normal but the second MRI showed granuloma which decreased gradually in size with steroid treatment.
Biopsy ; Classification ; Diagnosis ; Granuloma ; Headache Disorders ; Humans ; Magnetic Resonance Imaging* ; Tolosa-Hunt Syndrome* ; Vasculitis