High diagnostic stability of confirmed migraine and confirmed tension-type headache according to the ICHD-3 beta in adolescents

Background: Stable headache diagnosis classification is a
prerequisite for identification of headache type specific risk
factors. Does the stability of a headache diagnosis over time vary
between migraine and tension-type headache (TTH)? Are there
differences in diagnosis stability between a probable and a
definite headache diagnosis? Findings: In a sample of 783 students
(ages 12 to 18 years) participating in a headache intervention
study in greater Munich, the stability of headache classification
according to the International Classification of Headache Disorder
- third edition (beta version) (ICHD-3 beta) after a follow-up of 7
months was examined. Differences in stability of probable or
definite migraine and probable or definite TTH were assessed. The
stability of the headache diagnosis was assessed as predictive
value of headache diagnosis with regard to confirmation of the
headache type using the same diagnostic instrument 7 months later.
Predictive values with 95% confidence intervals (CI) are reported.
Of students with initial migraine, a diagnosis of migraine was
confirmed in 65.71% of students after 7 months (95%-CI
{[}59.40-71.64]). A clear distinction between probable (44.71%,
95%-CI {[}33.91-53.89]) and confirmed diagnosis (76.88% 95%-CI
{[}69.56-83.17]) of migraine was observed. For TTH the predictive
value was 62.66% (95%-CI {[}57.07-68.01]) overall with a lower
stability for probable (46.10%, 95%-CI {[}37.68-54.69]) compared to
the confirmed diagnosis (69.71%, 95%-CI {[}23.58-37.67]).
Conclusion: While confirmed migraine and confirmed TTH diagnoses
seem stable over time, stability of a probable diagnosis for either
headache type was lower.