Response to Seshia S et al.: The classification of chronic headache: room for further improvement? Chronic headache classification.

摘要

Dr Seshia and colleagues raise a number of important issues regarding headache classification in their paper. They recommend the introduction of a diagnosis called chronic daily headache, but at the same time realize that this is not an actual diagnosis but a collective description of headaches that occur very frequently. Even the fathers of the term, Stephen Silberstein and Richard Lipton, acknowledge that chronic daily headache is not a medical diagnosis. Seshia etal. point out that the word 'chronic' is used with three different meanings in the Headache Classification. The first meaning is in migraine and tension-type headache, where chronic actually means frequent; the second meaning is in cluster headache, where chronic means unremitting; and the third meaning is in the secondary headaches, where chronic means that the headache has persisted for > 3 months.