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Unifying Concepts

ICHD-II Diagnostic Criteria for Migraine

Migraine without aura

A. At least 5 attacks fulfilling criteria B-D

B. Headache attacks lasting 4-72 hours (untreated or unsuccessfully treated)

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

  1. Unilateral location
  2. Pulsating quality
  3. Moderate or severe pain intensity
  4. Aggravation by or causing avoidance of routine physical activity (eg, walking or climbing stairs)

D. During headache at least 1 of the following:

  1. Nausea and/or vomiting
  2. Photophobia and phonophobia

E. Not attributed to another disorder

Migraine with aura

A. At least 2 attacks fulfilling criterion B

B. Migraine aura fulfilling criteria B-C for one of the subforms (typical aura with migraine headache, typical aura with non-migraine headache, typical aura without headache, familial hemiplegic migraine, sporadic hemiplegic migraine, or basilar-type migraine)

C. Not attributed to another disorder

Typical aura with migraine headache

A. At least 2 attacks fulfilling criteria B-D

B. Aura consisting of at least 1 of the following, but no motor weakness:

  1. Fully reversible visual symptoms including positive features (eg, flickering lights, spots or lines) and/or negative features (ie, loss of vision)
  2. Fully reversible sensory symptoms including positive features (ie, pins and needles) and/or negative features (ie, numbness)
  3. Fully reversible dysphasic speech disturbance

C. At least two of the following:

  1. Homonymous visual symptoms and/or unilateral sensory symptoms
  2. At least one aura symptom develops gradually over >/=5 minutes and/or different aura symptoms occur in succession over >/=5 minutes
  3. Each symptom lasts >/=5 and </=60 minutes

D. Headache fulfilling criteria B-D for “Migraine without aura” begins during the aura or follows aura within 60 minutes

E. Not attributed to another disorder

Typical aura without headache

As “Typical aura with migraine headache” except:

B. Aura consisting of at least 1 of the following, with or without speech disturbance but no motor weakness:

  1. Fully reversible visual symptoms including positive features (eg, flickering lights, spots or lines) and/or negative features (ie, loss of vision)
  2. Fully reversible sensory symptoms including positive features (ie, pins and needles) and/or negative features (ie, numbness)

D. Headache does not occur during aura nor follow aura within 60 minutes

References:

  1. International Headache Society. The International Classification of Headache Disorders, 2nd Edition. Cephalalgia 2004; 24 (suppl 1): 1-160 (www.i-h-s.org)

This material was taken from the International Classification of Headache Disorders. It is intended for educational purposes only.

 

Created: Jun 13, 2005

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