• Paola Sarchielli.
• Department of Neuroscience, University of Perugia, Perugia, Italy. headache@unipg.it
• Expert Opin Pharmacother. 2004 Apr 1;5(4):959-75.

AbstractThe XI Congress of the International Headache Society (IHC) provided useful feedback for a wide range of disciplines for all scientists involved in basic and applied research concerning headaches. The major topics of the Congress included comorbidity, paediatric headache, phenotypic markers, genetics, migraine therapy, trigeminal neuralgia and paroxysmal facial pain with autonomic signs. The most recent advances were presented and discussed and all efforts were made to transfer these new understandings of pathogenesis, clinical features and treatments, to clinical practice, in an attempt to gain a better understanding of patient problems and requests. The Presidential Symposium, which anticipated the scientific sessions, provided the most updated knowledge regarding neuroimaging, neurophysiological and potential clinical implications of the activation of brainstem structures as well as the dependency of cortical events on this activation during migraine attacks. The results of the strenuous work carried out from autumn 1999 to 2003 of an International Committee of headache experts, presided by J. Olesen, reached its peak with the presentation of the new International Headache Classification ICHD-II. There are many relevant changes in the new classification, even though the basic structure and the most important criteria, such as those for migraine without aura and tension-type headache, have been maintained. Several new entities have been added including chronic migraine for patients having migraine >or= 15 days/month. New rules separate primary and secondary headaches and a new chapter now presents headaches attributed to psychiatric disorders. Headaches due to disturbance of homeostasis has been brought together in a new chapter and the diagnostic criteria for secondary headaches are now more systematically constructed. All these changes will hopefully promote research, especially for the novel entities reported in the appendix, which have not been sufficiently validated or for which sufficient evidence still has not been published.

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