What changes were made to the International Classification of Headache Disorders for migraine headache in 2018?

Updated: Oct 21, 2019
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Helmi L Lutsep, MD  more...
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In January 2018, the International Classification of Headache Disorders, Third Edition was published.

Changes from the previous edition include the following: [7]

  • The addition of chronic migraines: Those that occur on at least 15 days of the month for more than 3 months

  • For a diagnosis of migraine with aura, the following criteria must be met: One or more visual, sensory, speech, motor, brainstem, or retinal symptoms, as well as at least 2 of the following 4 criteria: (1) at least 1 aura symptom spreading gradually over 5 or more minutes and/or 2 or more symptoms occurring in succession; (2) each aura symptom lasting 5–60 minutes; (3) at least 1 aura symptom being unilateral; and (4) the aura being accompanied by or followed shortly by headache

  • Under headaches associated with sexual activity, the subtypes of preorgasmic and orgasmic headache have been eliminated

  • For thunderclap headaches, the headache must last at least 5 minutes, but the criterion of not recurring regularly during subsequent weeks or months has been discarded

  • Hypnic headaches no longer have to first occur after age 50 years

  • A number of pain characteristics under the new daily persistent headaches section have been eliminated

  • For secondary headaches, it is not required that the causative agent be removed before a diagnosis

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