Migraine classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Classification

Migraines have been classified by the International Headache Society which periodically revises their classification.

Defining Severity of Pain

In addition to classifying the type of headache, the International Headache Society defines intensity of pain on a verbal 4 point scale:

• 0 no pain
• 1 mild pain 'does not interfere with usual activities'
• 2 moderate pain 'inhibits, but does not wholly prevent usual activities'
• 3 severe pain 'prevents all activities'

Migraine Without Aura

Aslo known as common migraine or hemicrania simplex is a recurrent headache that lasts 4-72 hours. It is characterized by unilateral location, pulsating quality, moderate to severe intensity, worsens with physical activity and can be associated to nauseas, vomiting and photophobia. In order to diagnose migraine without aura, there must have been at least five attacks not attributable to another cause that fulfill the following criteria

1. Headache attacks lasting 4-72 hours

2. At least two of the following characteristics

• Unilateral location
• Pulsating quality
• Moderate or severe pain intensity
• Aggravation by or causing avoidance of routine physical activity

3. During the headache there must be at least one of the following associated symptom clusters

• Nausea and/or vomiting
• Photophobia and phonophobia

When these criteria are not fully met, the problem may be classified as "probable migraine without aura" but other diagnoses such as "episodic tension type headache" must also be excluded.