11 General introduction 1 Table 1. Diagnostic criteria for several migraine subtypes according to the ICHD-3. Pure menstrual migraine and menstrually-related migraine are now still part of the ICHD-3 appendix as they had not been sufficiently validated. Migraine without aura (MO) A. At least five attacks fulfilling criteria B-D B. Headache attacks lasting 4-72 hours (untreated or unsuccessfully treated) C. Headache has at least two of the following four characteristics: 1. unilateral location 3. moderate or severe pain intensity 2. pulsating quality 4. aggravation by or causing avoidance of routine physical activity D. During headache at least one of the following: 1. nausea and/or vomiting 2. photophobia and phonophobia E. Not better accounted for by another ICHD-3 diagnosis. Migraine with aura (MA) A. At least two attacks fulfilling criteria B and C B. One or more of the following fully reversible aura symptoms: 1. visual 4. motor 2. speech and/or language 5. brainstem 3. sensory 6. retinal C. At least three of the following six characteristics: 1. at least one aura symptom spreads gradually over ≥5 minutes 2. two or more aura symptoms occur in succession 3. each individual aura symptom lasts 5-60 minutes 4. at least one aura symptom is unilateral 5. at least one aura symptom is positive 6. the aura is accompanied, or followed within 60 minutes, by headache D. Not better accounted for by another ICHD-3 diagnosis. Chronic migraine (CM) A. Headache (migraine-like or tension-type-like) on ≥15 days/month for >3 months, and fulfilling criteria B and C B. Occurring in a patient who has had at least five attacks fulfilling criteria B-D for Migraine without aura and/or criteria B and C for Migraine with aura C. On ≥8 days/month for >3 months, fulfilling any of the following: 1. criteria C and D for Migraine without aura 2. criteria B and C for Migraine with aura 3. believed by the patient to be migraine at onset and relieved by a triptan or ergot derivative D. Not better accounted for by another ICHD-3 diagnosis. Pure menstrual migraine (ICHD-3 appendix) A. Attacks, in a menstruating woman, fulfilling criteria for Migraine without aura or Migraine with aura and criterion B B. Occurring exclusively on day 1 ± 2 (i.e., days −2 to +3) of menstruation in at least two out of three menstrual cycles and at no other times of the cycle. Menstrually-related migraine (ICHD-3 appendix) A. Attacks, in a menstruating woman, fulfilling criteria for Migraine without aura or Migraine with aura and criterion B B. Occurring on day 1 ± 2 (i.e., days −2 to +3) of menstruation in at least two out of three menstrual cycles, and additionally at other times of the cycle.
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