High-density assessment of the IHS classification criteria for migraine without aura: a prospective study

Fifty-six adult female patients with the clinical diagnosis of MwoA kept a diary 6 times per day for 10 consecutive weeks to record the occurrence, pa in characteristics, and accompanying symptoms of headache. In order to avoi d bias due to retrospection or expectancy the diary was programmed into pal mtop computers which signaled the patients with a beep to enter the diary w ith a random-fixed time schedule: two signals occurred in, respectively, th e morning, the afternoon, and the evening, but at different times for each day. The palmtop computers also warranted flawless data storage and automat ic computations of response delay and missing values. Of the 339 attacks, 7 5% had a duration of 4-72 h and 94% confirmed the International Headache So ciety classification criteria for MwoA concerning pain characteristics and accompanying symptoms. Our results obtained for attacks in treated patients are highly comparable with the results of Rasmussen, Jensen, and Olesen (1 991) obtained in the general population with unknown treatment of headache. Together, both studies support the MS classification criteria for MwoA. Th e electronic Experience Sampling Method also allowed for an unbiased descri ption of the course of treated MwoA attacks: 67% subsided in the first day. In the 16 attacks the characteristics and accompanying symptoms were prese nt in 60-80% of the attacks at the first assessment (9.30 a.m.) with the ex ception of moderate to severe pain intensity (37%) and nausea or vomiting ( 31%). A waxing and waning of characteristics and symptoms over the day rema ined in about 30-40% of the attacks with a tendency towards increases in th e evening (7.30 p.m. and 10 p.m.). The method is there for a replication of this study in untreated MwoA patients. square Computer diary, IHS classifi cation of headache, migraine without aura.