头痛分类的国际标准(ICHD-III)概述:头痛分为三大组:原发性头痛;继发性头痛;脑神经痛、中枢和原发性颜面痛及其他头痛。每一种原发性头痛均视为一种独立的疾病;继发性头痛一般只是某种无先兆偏头痛的诊断标准:A:符合B-D特征,至少发作5次发作B:头痛(未经治疗)发作持续4-72小时C:至少有以下特征中的2项单侧性、搏动性、中重度痛、日常活动会加重D:至少以下一项伴随症状:恶心和/或呕吐、畏光和畏声先兆性偏头痛的诊断标准:E:不能归因于其他A:符合B-C特征,至少发作2次发作B:完全可逆以下症状的1项或多项视觉、感觉、语言障碍(典型先兆)肢体无力症状(偏瘫型偏头痛)脑干症状(基底型偏头痛)视网膜症状(视网膜型偏头痛)C:至少有以下特征中的2项至少1个先兆逐渐发展的过程>5min,和/或TheinternationalClassificationofHeadachedisorders,3rdEditon疾病的一种症状,该头痛称为“缘于”此种疾病的头痛三大组头痛共分为14类:一、原发性头痛(theprimaryheadaches)1.偏头痛(Migraine)Migrainewithoutaura无先兆偏头痛Migrainewithaura有先兆偏头痛MigrainewithtypicalauraTypicalaurawithheadacheTypicalaurawithoutheadacheMigrainewithbrainstemauraHemiplegicmigraine偏瘫型偏头痛Familialhemiplegicmigraine(FHM)一家族性Familialhemiplegicmigrainetype1(FHM1)Familialhemiplegicmigrainetype2(FHM2)Familialhemiplegicmigrainetype3(FHM3)Familialhemiplegicmigraine,otherlociSporadichemiplegicmigraine一散发性RetinalmigraineChronicmigraine慢性偏头痛Complicationsofmigraine偏头痛并发症Statusmigrainosus偏头痛持续状态Persistentaurawithoutinfarctionvomitingsyndrome周期性呕吐慢性偏头痛:偏头痛发作每月>15天,连续3个月Abdominalmigrain偏头痛持续状态:单次发作持续72小时以A:至少符合B-D的5次以上的发B:单侧、眼眶、上眼眶及/或颞部重度或极重度疼Migrainousinfarction偏头痛脑梗死Migraineaura-triggeredseizureProbablemigraine很可能的偏头痛ProbablemigrainewithoutauraProbablemigrainewithauraEpisodicsyndromesthatmaybeassociatedwithmigraine可能与偏头痛有关的发作性综合征RecurrentgastrointestinaldisturbaneeBenignparoxysmalvertigo良性发作性眩晕Benignparoxysmaltorticollis良性发作性斜颈2.紧张型头痛(Tension-typeheadache)每次发作持续30min-7d,慢性者可持续不缓解Infrequentepisodictension-typeheadache偶发性vid/月,至少10次以上(v12d/年)Infrequentepisodictension-typeheadacheassociatedwithpericranialtendernessInfrequentepisodictension-typeheadachenotassociatedwithpericranialtendernessFrequentepisodictension-typeheadache频发性±1d/月,但<15d,至少发作10次以上(±12d/年但<180d)Frequentepisodictension-typeheadacheassociatedwithpericranialtendernessFrequentepisodictension-typeheadachenotassociatedwithpericranialtendernessChronictension-typeheadache慢性紧张型头痛每月发作±15d,3个月以上Chronictension-typeheadacheassociatedwithpericranialtendernessChronictension-typeheadachenotassociatedwithpericranialtendernessProbabletension-typeheadache很可能的紧张型头痛丛集性头痛的诊断标准:Probableinfrequentepisodictension-typeheadacheProbablefrequentepisodictension-typeheadacheProbablechronictension-typeheadache如不治疗持续15min-180min;3.三叉自主神经性头痛(Trigeminalautonomiccephalalgias)Clusterheadache丛集性头痛Episodicclusterheadache发作性丛集性头痛Chronicclusterheadache慢性丛集性头痛(复发作大于1年无缓解期,或缓解期<1个月)ParoxysmalhemicraniaEpisodicparoxysmalhemicraniaChronicparoxysmalhemicraniaShort-lastingunilateralneuralgiformheadacheattacksShort-lastingunilateralneuralgiformheadacheattackswithconjunctvalinjectionandtearing(SUNCT)EpisodicSUNCTChronicSUNCTShort-lastingunilateralneuralgiformheadach...