比较第2版头痛疾病国际分类和选择性诊断标准对青少年慢性每日头痛分类的差异

作     者：Bigal M.E. Rapoport A.M. Tepper S.J. 袁海峰 

作者机构：New England Cent er for Headache 778 Long Ridge Road Stamford CT 06902 United States Dr. 

出 版 物：《世界核心医学期刊文摘（神经病学分册）》 (Digest of the World Core Medical Journals:Clinical Neurology)

年 卷 期：2005年第1卷第10期

页      面：20-21页

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

主　　题：慢性每日头痛 国际分类 诊断标准 慢性紧张型头痛 持续状态 持续头痛 操作标准 转换型 标化 诊断系统 

摘      要：Objectives.- To compare the second edition of the International Classificati on of Headache Disorders (ICHD- 2) and the Silberstein- Lipton (S- L) criteri a in the classification of adolescents with chronic daily headache (CDH). Method s.- We reviewed the clinical records and the headache diaries of 170 adolescent s (13 to 17 years) seen between 1998 and 2003 at a headache center. Relevant inf ormation was transferred to a standardized form that included operational criter ia for the ICHD- 2. CDH subtypes were classified according the criteria propose d by S- L into transformed migraine (TM) with (TM+ ) and without medication ov eruse (TM- ), chronic tension- type headache (C- TTH), new daily persistent h eadache (NDPH), and he micrania continua (HC). Results.- From the 69 patients with TM- according t he S- L criteria, most (71% ) could be classified as chronic migraine (CM), wh ile a minority of patients required a combination of diagnosis, mainly migraine and CTTH (14.4% ). Of the patients with TM+ , just 39.6% met the criteria fo r probable CM (PCM) with probable medication overuse (PMO). If instead of 15 mig raine days per month, we considered 15 or more days of migraine or probable migr aine, 84% of the subjects with TM- and 68.7% of those with TM+ could be classified. Of the 27 subjects classified as NDPH without medication overuse acc ording to the S- L system, the majority (51.2% ) were also classified as NDPH according the ICHD- 2. Interestingly, three (11.1% of the subjects with NDPH without medication overuse) were classified as CM in the ICHD- 2 because these patients had an abrupt onset of 15 or more days of migraine per month. All patie nts with NDPH with medication overuse according to the S- L criteria required a combination of diagnoses in the ICHD- 2. All subjects with CTTH received a sin gle diagnosis in both classification systems. Conclusions.- (i) Among adolescen ts with TM, the majority (58.1% ) could be classified as CM, according to the I C