头痛的国际分类(第三版)中文

1TheinternationalClassificationofHeadachedisorders,3rdEditon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）1.1Migrainewithoutaura无先兆偏头痛1.2Migrainewithaura有先兆偏头痛1.2.1Migrainewithtypicalaura1.2.1.1Typicalaurawithheadache1.2.1.2Typicalaurawithoutheadache1.2.2Migrainewithbrainstemaura1.2.3Hemiplegicmigraine偏瘫型偏头痛1.2.3.1Familialhemiplegicmigraine(FHM)—家族性1.2.3.1.1Familialhemiplegicmigrainetype1(FHM1)1.2.3.1.2Familialhemiplegicmigrainetype2(FHM2)1.2.3.1.3Familialhemiplegicmigrainetype3(FHM3)1.2.3.1.4Familialhemiplegicmigraine,otherloci1.2.3.2Sporadichemiplegicmigraine—散发性1.2.4Retinalmigraine1.3Chronicmigraine慢性偏头痛1.4Complicationsofmigraine偏头痛并发症1.4.1Statusmigrainosus偏头痛持续状态1.4.2Persistentaurawithoutinfarction1.4.3Migrainousinfarction偏头痛脑梗死1.4.4Migraineaura-triggeredseizure1.5Probablemigraine很可能的偏头痛1.5.1Probablemigrainewithoutaura1.5.2Probablemigrainewithaura1.6Episodicsyndromesthatmaybeassociatedwithmigraine可能与偏头痛有关的发作性综合征1.6.1Recurrentgastrointestinaldisturbance1.6.1.1Cyclicalvomitingsyndrome周期性呕吐1.6.1.2Abdominalmigraine腹型偏头痛1.6.2Benignparoxysmalvertigo良性发作性眩晕1.6.3Benignparoxysmaltorticollis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2.1Infrequentepisodictension-typeheadache偶发性1d/月，至少10次以上（12d/年）2.1.1Infrequentepisodictension-typeheadacheassociatedwithpericranialtenderness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E：不能归因于其他先兆性偏头痛的诊断标准：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/或不同先兆接连发生过程5min每个先兆症状持续时间5-60min至少一个先兆症状为单侧性先兆发生同时或之后内60min出现符合偏头痛D：不能归因于其他肢体无力症状可以持续至72h，部分患者肢体无力感可持续数周；若患者先兆持续1周以上，称为无梗死的持续先兆一般先兆症状多为双侧，可持续数月或数年若先兆持续60min至1周以内，则称为propablemigrainewithaura若出现影像学梗死灶，则称为偏头痛性脑梗死（年轻女性，后循环比较常见）慢性偏头痛：偏头痛发作每月15天，连续3个月以上偏头痛持续状态：单次发作持续72小时以上22.1.2Infrequentepisodictension-typeheadachenotassociatedwithpericranialtenderness2.2Frequentepisodictension-typeheadache频发性≥1d/月，但15d，至少发作10次以上（≥12d/年但180d）2.2.1Frequentepisodictension-typeheadacheassociatedwithpericranialtenderness2.2.2Frequentepisodictension-typeheadachenotassociatedwithpericranialtenderness2.3Chronictension-typeheadache慢性紧张型头痛每月发作≥15d，3个月以上2.3.1Chronictension-typeheadacheassociatedwithpericranialtenderness2.3.2Chronictension-typeheadachenotassociatedwithpericranialtenderness2.4Probabletension-typeheadache很可能的紧张型头痛2.4.1Probableinfrequentepisodictension-typeheadache2.4.2Probablefrequentepisodictension-typeheadache2.4.3Probablechronictension-typeheadache3.三叉自主神经性头痛（Trigeminalautonomiccephalalgias）3.1Clusterheadache丛集性头痛3.1.1Episodicclusterheadache发作性丛集性头痛3.1.2Chronicclusterheadache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）3.2Paroxysmalhemicrania3.2.1Episodicparoxysmalhemicrania3.2.2Chronicparoxysmalhemicrania3.3Short-lastingunilateralneuralgiformheadacheattacks3.3.1Short-lastingunilateralneuralgiformheadacheattackswithconjunctivalinjectionandtearing(SUNCT)3.3.1.1EpisodicSUNCT3.3.1.2ChronicSUNCT3.3.2Short-lastingunilateralneuralgiformheadacheattackswithcranialautonomicsymptoms(SUNA)3.3.2.1EpisodicSUNA3.3.2.2ChronicSUNA3.4Hemicraniacontinua3.5Probabletrigeminalautonomiccephalalgia3.5.1Probableclusterheadache3.5.2Probableparoxysmalhemicrania3.5.3Probableshort-lastingunilateralneuralgiformheadacheattacks3.5.4Probablehemicraniacontinua4.其它的原发性头痛Otherprimaryheadachedisorders）4.1Primarycoughheadache原发性咳嗽头痛4.1.1Probableprimarycoughheadache4.2Primaryexerciseheadache原发性运动性头痛4.2.1Probableprimaryexerciseheadache4.3Primaryheadacheassociatedwithsexualactivity原发性性活动伴随的头痛4.3.1Probableprimaryheadacheassociatedwithsexualactivity4.4Primarythunderclapheadache原发性霹雳头痛丛集性头痛的诊断标准：A：至少符合B-D的5次以上的发作B：单侧、眼眶、上眼眶及/或颞部重度或极重度疼痛，如不治疗持续15min-180min；C：伴随至少以上一项症状同侧结膜充血/流泪同侧鼻腔充血/流鼻水同侧眼皮水肿同侧前额及脸部出汗同侧瞳孔缩小/眼睑下垂不安的症状或躁动D：发作频率隔日1至8次/日E：除外其他疾患34.5Cold-stimulusheadache冷刺激性头痛4.5.1Headacheattributedtoexternalapplicationofacoldstimulus4.5.2Headacheattributedtoingestionorinhalationofacoldstimulus4.5.3Probablecold-stimulusheadache4.5.3.1Headacheprobablyattributedtoexternalapplicationofacoldstimulus4.5.3.2Headacheprobablyattributedtoingestionorinhalationofacoldstimulus4.6External-pressureheadache4.6.1External-compressionheadache4.6.2External-tractionheadache4.6.3Probableexternal-pressureheadache4.6.3.1Probableexternal-compressionheadache4.6.3.2Probableexternal-tractionheadache4.7Primarystabbingheadache4.7.1Probableprimarystabbingheadache4.8Nummularheadache4.8.1Probablenummularheadache4.9Hypnicheadache4.9.1Probablehypnicheadache4.10Newdailypersistentheadache(NDPH)新症每日持续性头痛4.10.1Probablenewdailypersistentheadach二、继发性头痛（thesecondaryheadaches）5.缘于头、颈部外伤的头痛（Headacheattributedtotraumaorinjurytotheheadand/orneck）5.1Acuteheadacheattributedtotraumaticinjurytothehead5.1.1Acuteheadacheattributedtomoderateorseveretraumaticinjurytothehead5.1.2Acuteheadacheattributedtomildtraumaticinjurytothehead5.2Persistentheadacheattributedtotraumaticin