Clinical Application of Korean Version of the International Classification of Headache Disorders, 3rd Edition, Beta Version

ABSTRACT

BACKGROUND: The International Classification of Headache Disorders, an essential tool in the diagnosis of headache disorders, has been revised as its 3rd edition, beta (ICHD-IIIbeta). The clinical application in practice is needed to test the feasibility and usefulness of the Korean version of ICHD-IIIbeta. METHODS: Neurologists enrolled consecutive first-visit headache patients from February to March 2014. The classification of headache disorder was done by each investigator according to ICHD-IIIbeta based on the initial structured questionnaire, clinical evaluation, and neuroimaging studies, if needed. A consensus meeting dealt with the cases that were difficult to diagnose. The feasibility and usefulness of this version was assessed by the proportion of unclassified headache disorders using ICHD-IIIbeta compared to the previous version. RESULTS: A total of 207 patients were enrolled the mean age was 41 years (16-87 years) and women constituted 63.3%. Primary headache disorders were diagnosed in 167 patients (80.7%) 82 migraines, 37 tension-type headaches, 3 cluster headaches, and 45 other primary headache disorders. Thirty-five patients (16.9%) had secondary headache disorders or painful cranial neuropathies/other facial pain and 5 patients (2.4%) could not be classified by ICHD-IIIbeta. The diagnoses differed as compared to the previous version in 32 patients (15.5%) 14.5% differed due to the mitigation of the previous strict criteria and 1% differed due to the introduction of a new diagnostic category. CONCLUSIONS: Classifications by ICHD-IIIbeta are possible in more than 97% of the first-visit headache patients and ICHD-IIIbeta has proved to be more useful than its previous version.