한국판 국제두통질환분류 3판 베타판의 임상적용

Abstract

Background: The International Classification of Headache Disorders, an essential tool in the diagnosis of headachedisorders, has been revised as its 3rd edition, beta (ICHD-Ⅲβ). The clinical application in practice is needed to test thefeasibility and usefulness of the Korean version of ICHD-Ⅲβ. Methods: Neurologists enrolled consecutive first-visit headache patients from February to March 2014. The classificationof headache disorder was done by each investigator according to ICHD-Ⅲβ based on the initial structured questionnaire,clinical evaluation, and neuroimaging studies, if needed. A consensus meeting dealt with the cases that were difficult todiagnose. The feasibility and usefulness of this version was assessed by the proportion of unclassified headachedisorders using ICHD-Ⅲβ 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 clusterheadaches, and 45 other primary headache disorders. Thirty-five patients (16.9%) had secondary headache disorders orpainful cranial neuropathies/other facial pain and 5 patients (2.4%) could not be classified by ICHD-Ⅲβ. The diagnosesdiffered as compared to the previous version in 32 patients (15.5%): 14.5% differed due to the mitigation of the previousstrict criteria and 1% differed due to the introduction of a new diagnostic category. Conclusions: Classifications by ICHD-Ⅲβ are possible in more than 97% of the first-visit headache patients and ICHD-Ⅲβ has proved to be more useful than its previous version.