The international Classification of Headache disorders, 3rd Editon
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（the primary headaches）
1.偏头痛（Migraine）
1.1 Migraine without aura无先兆偏头痛
1.2 Migraine with aura有先兆偏头痛
1.2.1 Migraine with typical aura
1.2.1.1 Typical aura with headache
1.2.1.2 Typical aura without headache
1.2.2 Migraine with brainstem aura
1.2.3 Hemiplegic migraine偏瘫型偏头痛
1.2.3.1 Familial hemiplegic migraine (FHM)—家族性
1.2.3.1.1 Familial hemiplegic migraine type 1 (FHM1)
1.2.3.1.2 Familial hemiplegic migraine type 2 (FHM2)
1.2.3.1.3 Familial hemiplegic migraine type 3 (FHM3)
1.2.3.1.4 Familial hemiplegic migraine, other loci
1.2.3.2 Sporadic hemiplegic migraine—散发性
1.2.4 Retinal migraine
1.3 Chronic migraine慢性偏头痛
1.4 Complications of migraine偏头痛并发症
1.4.1 Status migrainosus偏头痛持续状态
1.4.2 Persistent aura without infarction
1.4.3 Migrainous infarction偏头痛脑梗死
1.4.4 Migraine aura-triggered izure
1.5 Probable migraine很可能的偏头痛
1.5.1 Probable migraine without aura
1.5.2 Probable migraine with aura
1.6 Episodic syndromes that may be associated with migraine可能与偏头痛有关的发作性综合征
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
1.6.1 Recurrent gastrointestinal disturbance1.6.1.1Cyclical vomiting syndrome周期性呕吐
1.6.1.2 Abdominal migraine腹型偏头痛
1.6.2 Benign paroxysmal vertigo良性发作性眩晕
1.6.3 Benign paroxysmal torticollis良性发作性斜颈
2.紧张型头痛（Tension-type headache）每次发作持续30min-7d，慢性者可持续不缓解
2.1 Infrequent episodic tension-type headache偶发性 <1d/月，至少10次以上（<12d/年）
2.1.1 Infrequent episodic tension-type headache associated with pericranial tenderness
2.1.2 Infrequent episodic tension-type headache not associated with pericranial tenderness
2.2 Frequent episodic tension-type headache频发性≥1d/月，但<15d，至少发作10次以上（≥12d/年但<180d）
2.2.1 Frequent episodic tension-type headache associated with pericranial tenderness
2.2.2 Frequent episodic tension-type headache not associated with pericranial tenderness
2.3 Chronic tension-type headache慢性紧张型头痛 每月发作≥15d，3个月以上
2.3.1 Chronic tension-type headache associated with pericranial tenderness
2.3.2 Chronic tension-type headache not associated with pericranial tenderness
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
2.4 Probable tension-type headache很可能的紧张型头痛2.4.1 Probable infrequent episodic tension-type headache
2.4.2 Probable frequent episodic tension-type headache
2.4.3 Probable chronic tension-type headache
3.三叉自主神经性头痛（Trigeminal autonomic cephalalgias）
3.1 Cluster headache丛集性头痛
3.1.1 Episodic cluster headache发作性丛集性头痛
3.1.2 Chronic cluster headache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）
3.2 Paroxysmal hemicrania
3.2.1 Episodic paroxysmal hemicrania
3.2.2 Chronic paroxysmal hemicrania
3.3 Short-lasting unilateral neuralgiform headache attacks
3.3.1 Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)
3.3.1.1 Episodic SUNCT
3.3.1.2 Chronic SUNCT
3.3.2 Short-lasting unilateral neuralgiform headache attacks with cranial autonomic sympt
oms (SUNA)
3.3.2.1 Episodic SUNA
3.3.2.2 Chronic SUNA
3.4 Hemicrania continua
3.5 Probable trigeminal autonomic cephalalgia
3.5.1 Probable cluster headache
3.5.2 Probable paroxysmal hemicrania
3.5.3 Probable short-lasting unilateral neuralgiform headache attacks
3.5.4 Probable hemicrania continua
4.其它的原发性头痛 Other primary headache disorders ）
4.1 Primary cough headache原发性咳嗽头痛
4.1.1 Probable primary cough headache
4.2 Primary exerci headache原发性运动性头痛
4.2.1 Probable primary exerci headache
4.3 Primary headache associated with xual activity原发性性活动伴随的头痛
4.3.1 Probable primary headache associated with xual activity
4.4 Primary thunderclap headache原发性霹雳头痛
4.5 Cold-stimulus headache冷刺激性头痛
4.5.1 Headache attributed to external application of a cold stimulus
4.5.2 Headache attributed to ingestion or inhalation of a cold stimulus
4.5.3 Probable cold-stimulus headache
4.5.3.1 Headache probably attributed to external application of a cold stimulus
4.5.3.2 Headache probably attributed to ingestion or inhalation of a cold stimulus
NDPH诊断标准：
A：持续性头痛，符合B-C的标准
B：Distinct and clearly remembered ont, with pain becoming continuous and unremitting within 24 hours
C：Prent for>3 months
D：除外其他疾患
慢性头痛，起病急，可清晰回忆发病时间为哪一天
疼痛缺乏特点，可以为偏头痛，可以为紧张性，亦可两者混合
若患者符合慢性偏头痛或慢性紧张型头痛的标准，则不诊断NDPH
若患者为药物过度使用性头痛，且符合NDPH的标准，
则可两者均可作为诊断
4.6 External-pressure headache
