Criteria for Tension Type Headache and Migraine

ICDH 3 Beta Criteria for Tension Type Headache and Migraine

Tension Type Headache has the following criteria:

A) At least 10 episodes fulfilling the criteria B-D.

B) Headache lasting from 30 minutes to 7 days.

C) Headache has at least two of the following characteristics:

    1. Bilateral location

    2. Pressing/tightening (non-pulsating) quality

    3. Mild or moderate intensity

    4. Not aggravated by routine physical activity such as walking or climbing stairs

D) Headache has both of the following:

    No nausea or vomiting (anorexia may occur)

    No more than one episode of photophobia or phonophobia

Migraine without aura is diagnosed by a headache pattern fulfilling the following criteria:

A) At least five attacks fulfilling B-D.

B) Attacks lasting 4-72 hours (untreated or unsuccessfully treated).

C) At least two of the following characteristics:

    1. Unilateral (one sided) location.

    2. Pulsating (throbbing) quality.

    3. Moderate or severe intensity (inhibits or prohibits daily activities).

    4. Aggravation by walking stairs or similar routine activity.

 D) At least one of the following:

     1. Nausea and/or vomiting.

     2. Photophobia (sensitivity to light) and phonophobia (sensitivity to sound).

Tension type headache is the most prevalent type of primary headache and about 70% of all headaches.  It is found with the anxiety disorders.  Migraine is about 30% of all headaches.  Migraine without aura used to be called “common” migraine because it is the most prevalent type of migraine, consisting of about 70% of all attacks.  Primary headache means no organic cause for the headache can be determined.  With migraine typically the patient has one sided headache (migraine comes from the Latin word meaning half of head or hemicrania), nausea and vomiting, photophobia (fear of light), sonophobia (fear of sounds), and goes to sleep in a quiet, dark room.  This is often called sick headache, sinus headache, heat or sun headache, menstrual headache, letdown headache (a headache that comes during a weekend, vacation, or holiday), cold front or weather change headache (from a drop in the barometric pressure), or nocturnal headache (middle of the night, end of a dream headache.)  The patient may not know he has migraine but comes for treatment and diagnosis of headache.