THE IHS CLASSIFICATION CRITERIA FOR MIGRAINE HEADACHES IN ADOLESCENTSNEED MINOR MODIFICATIONS

The operational and diagnostic criteria for migraine and all other hea dache disorders released in 1988 by the International Headache Society are universally considered reliable and exhaustive. These criteria, h owever, cannot be considered as satisfactory for population-based stud ies on migraine prevalence, especially if adolescents are the subjects of the study. Using these diagnostic criteria, we conducted an epidem iological study in order to assess the prevalence of migraine headache in a student population aged 11 to 14 years. Our survey made it possi ble to code IHS 1.1 (migraine without aura) in 2.35%, IHS 1.2 (migrain e with aura) in 0.62%, IHS 1.7 (migrainous disorders not fulfilling mi graine criteria) in 1.52%, and IHS 13 (headache not classifiable) in 1 .38% of the examined pupils. In adolescents, the low prevalence estima tes of migraine headache coded IHS 1.1 and the relatively high prevale nce estimates of headaches coded IHS 1.7 and IHS 13 have appeared to b e a consequence of the rigidity of some operational diagnostic criteri a of the recent IHS classification rather than of the geographical, en vironmental, or socioeconomical pecularities of the cohort. Therefore, in order to improve the reliability and the exhaustiveness of the IHS classification by increasing its sensitivity, we believe that minor m odifications of the diagnostic criteria are necessary. Within these re vised criteria, the subitem ''moderate or severe intensity'' of pain h eadache should become mandatory, whereas the lower limit of the criter ion ''duration of pain'' should be reduced to 1 hour.