The International Headache Society’s (IHS) International Classification of Headache Disorders, 2nd Edition (ICHD-II), is considered the gold standard for defining and assessing headaches. They revised the ICHD-II with this criteria for chronic Migraine:
- Headache (tension-type and/or migraine) on ≥15 days per month for at least 3 months*
- Occurring in a patient who has had at least five attacks fulfilling criteria for 1.1 Migraine without aura
- On ≥8 days per month for at least 3 months headache has fulfilled C1 and/or C2 below, that is, has fulfilled criteria for pain and associated symptoms of migraine without aura
1) Has at least two of a-d
a) unilateral location
b) pulsating quality
c) moderate or severe pain intensity
d) aggravation by or causing avoidance of routine physical activity
(e.g. walking or climbing stairs)
and at least one of a or b
a) nausea and/or vomiting
b) photophobia and phonophobia
2) Treated and relieved by triptan(s) or ergot before the expected development of C1 above- No medication overuse† and not attributed to another causative disorder‡
Aside from the other important tidbits and notes that are on the definitions page, the website itself is a great resource for any patient or practitioner looking to better understand headaches or specific ways to classify them.
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