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Critical analysis of the international classification of headache disorders diagnostic criteria (ICHD I-1988) and (ICHD II-2004), for migraine in children and adolescents

Authors

  • MMF Lima,

    Corresponding author
    1. Headache Outpatient Ward for Children and Adolescents, General Hospital Medical School (GHMS),
    2. Discipline of Paediatric Neurology, Department of Neurology and Psychiatry,
      Prof Dr Márcia Maria Ferreira Lima, Headache Outpatient Ward for Children and Adolescents, General Hospital, Medical School (UNESP), Discipline of Paediatric Neurology, Department of Neurology and Psychiatry, Medical School – UNESP- Botucatu-SP –Brazil, Postal Box 539-Botucatu-São Paulo-Brazil CEP:18618–000. Tel. +55 14 38116260, fax +55 14 38155965, e-mail marcialimabtu@yahoo.com.br
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  • NAMR Padula,

    1. Discipline of Paediatric Neurology, Department of Neurology and Psychiatry,
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  • LCA Santos,

    1. Discipline of Paediatric Neurology, Department of Neurology and Psychiatry,
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  • LDB Oliveira,

    1. Discipline of Paediatric Neurology, Department of Neurology and Psychiatry,
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  • S Agapejev,

    1. Discipline of Neurology, Department of Neurology and Psychiatry and
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  • C Padovani

    1. Bioscience Intitute, Statistics, State University (UNESP), Botucatu, Brazil
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Prof Dr Márcia Maria Ferreira Lima, Headache Outpatient Ward for Children and Adolescents, General Hospital, Medical School (UNESP), Discipline of Paediatric Neurology, Department of Neurology and Psychiatry, Medical School – UNESP- Botucatu-SP –Brazil, Postal Box 539-Botucatu-São Paulo-Brazil CEP:18618–000. Tel. +55 14 38116260, fax +55 14 38155965, e-mail marcialimabtu@yahoo.com.br

Abstract

The present study analyzed the (ICHD I-1988) and (ICHD II-2004) diagnostic criteria in children and adolescents. Our population consisted of 496 patients of the Headache Outpatient Ward for Children and Adolescents retrospectively studied from 1992 to 2002. Individuals were classified according to three diagnostic groups: Intuitive Clinical Diagnosis (Gold Standard), ICHD I-1988 and ICHD II-2004. They were statistically compared using the variables: Sensitivity (S), Specificity (Sp), Positive Predictive Value (PPV), Negative Predictive Value (NPV). When ICHD I-1988 was used, the sensitivity of migraine without and with aura was 21% and 27%, respectively, whereas in ICHD II-2004 it changed to 53% and 71% without affecting specificity. As a conclusion, the current classification criteria (ICHD II-2004) showed greater sensitivity and high specificity for migraine than ICHD I-1988, although it improved migraine diagnosis in children and adolescents, the sensitivity remains poor.  

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