Chronic Migraine – ICHD-3 Definition — SCE Neurology MCQ

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EasyHeadache & Facial PainChronic Migraine – ICHD-3 DefinitionSCE Neurology

A 55-year-old woman with chronic headache is evaluated. She has headaches on 18 days per month, of which 10 meet criteria for migraine (with aura). Her headaches have been present for >3 months. She uses simple analgesics on <10 days per month. What diagnosis does she meet criteria for?

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Correct answer: A — Chronic migraine — defined as headache on ≥15 days/month for >3 months, of which ≥8 days have migraine features

ICHD-3 defines chronic migraine as headache on ≥15 days/month for >3 months, of which at least 8 days meet criteria for migraine or respond to migraine-specific treatment (triptans). Not all 15+ headache days need to be migraine — the non-migraine days may have tension-type features. This patient has 18 headache days/month (≥15) with 10 migraine days (≥8), meeting criteria. Her analgesic use is below MOH thresholds (she uses <10 days/month). A: Episodic migraine is <15 days/month. C: She has migraine features. D: Analgesic use is below MOH thresholds. E: Different presentation.

Reference: ICHD-3 (2018); NICE TA260 Chronic Migraine