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J Headache Pain. Aug 2004; 5(2): 131–136.
PMCID: PMC3451616
Decreasing the minimal duration of the attack to 1 hour: is this sufficient to increase the sensitivity of the ICHD-II diagnostic criteria for migraine in childhood?
Marco A. Arruda,corresponding author Carlos A. Bordini, Marcelo C. Ciciarelli, and José G. Speciali
Department of Neurology, Ribeirão Preto Medical School, São Paulo, Brazil
Marco A. Arruda, brheadache/at/netsite.com.br.
corresponding authorCorresponding author.
Received December 18, 2003; Accepted March 12, 2004.
Abstract
We applied the second edition of the International Classification of Headache Disorders (ICHD-II) in 417 children (age range, 2–12 years) with chronic headaches attending a pediatric headache clinic. The initial diagnosis was made according to the ICHD-II while the final diagnosis was, based on the longitudinal intuitive clinical diagnosis (LICD), deemed to be the gold standard. The diagnosis of migraine without aura had a sensitivity of 52%, a specificity of 100% and a positive predictive value of 100%; for the diagnosis of migraine (at the one-digit level) these values were 87%, 100% and 100%, respectively. The ICHD-II criteria for migraine without aura have high specificity but low sensitivity in childhood, even considering the minimal duration of the attacks to be 1 hour. Other factors, such as the existence of subgroup 2.4 (probable tension-type headache), are responsible for the low sensitivity of ICHD-II criteria for the diagnosis of migraine without aura in patients of this age group.
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