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- headache disorders are classified by the ICHD-III as (1)
- primary headache disorders:
- tension type headache
- cluster headache and other trigeminal autonomic cephalagias
- other primary headache disorders
- secondary headache disorders
- these include a new headache occurring with another lesion capable of causing it.( e.g., headache attributed to intracranial tumour)
- migraine is a common disabling primary headache disorder
- migraine is the second most prevalent neurologic disorder (after tension-type
headache), with a female-to-male ratio of 3:1 and an estimated 1-year prevalence
of approximately 15% in the general population (4)
- prevalence peaks between
the ages of 35 and 39 years, and about 75% of affected persons report the onset
of migraine before the age of 35 years (4)
- since the disorder tends to remit with
older age, an onset of migraine after the age of 50 years should arouse suspicion
of a secondary headache disorder (4)
- migraine is a syndrome characterised by:
- periodic headaches with complete resolution between attacks
- an attack may be composed of the following stages:
- the frequency of attacks is variable:
- as high as several per week
- as low as several per lifetime
- a prodrome is a vague change in mood or appetite
- an aura is a clear neurological symptom:
- visual disturbance
- motor or sensory disturbance
children, migraine is a diagnosis of exclusion (3).
- (1)Headache Classification Committee of
the International Headache Society (IHS).
The international classification of headache
disorders, 3rd edition. Cephalalgia
2018; 38: 1-211
- (2) Drug
and Therapeutics Bulletin (1998); 36(6):41-4.
- (3) Drug and Therapeutics Bulletin
(2004); 42 (4): 25-8.
- (4) Ashina M. Migraine. N Engl J Med 2020;383:1866-76.
Last edited 11/2020 and last reviewed 11/2020