ICHD classification of migraine

The classification of all headaches, including migraines, is organized by the International Headache Society, and published in the International Classification of Headache Disorders (ICHD). The current version, the ICHD-3 beta, was published in 2013.

The first category within the ICHD is Migraine. Migraines in general are considered to be a neurological syndrome. It is estimated that 11% (303 million) of the global population, including 43 million Europeans and 28 million Americans, experience migraines.

The ICHD-3 beta classification includes 6 main subtypes of migraine (ICHD-1: 7 main subtypes, ICHD-2: 6 main subtypes), most of which are further subdivided. Overall ICHD-3 beta distinguishes 29 migraine subtypes. The following table outlines the main subtypes and their ICHD-1, -2, -3 beta and ICD-10 codes.

Diagnostic criteria for migraine without aura:
A. At least five attacks fulfilling criteria B-D
B. Headache attacks lasting 4-72 hours [when untreated in adults]
C. Headache has at least two of the following characteristics:

D. During the headache, at least one of the following [is present]:

E. Not attributable to another disorder

Migraine without aura also referred to as a common migraine, (previously known as hemicrania simplex) is a specific neurological disorder characterized by recurrent, headaches that often affect one side of the head (i.e., it is ), are of at least intensity, and may cause nausea, phonophobia or photophobia. One defining characteristic of the common migraine is a lack of the visual disturbances known as an aura. The exact International Classification of Headache Disorders diagnostic criteria appear to the right.

Because migraine without aura can be hard to distinguish from an infrequent tension-type headache, 5 attacks must have been experienced to meet the diagnosis. When migraine without aura is likely, but 5 attacks have not occurred, a diagnosis of probable migraine without aura (ICHD-2: 1.6.1) is warranted.

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