Abstract
New Edition of the International Headache Classification ICHD-3 Beta
After 3 years of work the International Headache Classification Committee had its last meeting in September 2012. All chapters for a revised 3rd Edition of the Classification are now ready for desk editing. The plan is to publish an International Classification of Headache Disorders 3rd edition Beta (ICHD-3 Beta) version on the IHS website in January and in Cephalalgia in March 2013. To publish a beta version is a new initiative because the former two editions were published as definitive. This time we want to allow for broad input from the Headache Community and allow time for field testing of important parts of the classification. After a period of 2 years of field testing, the Committee will then convene again and make whatever changes necessary in order to arrive at the final version of ICHD-3, which is expected to appear in 2016.
How should the Beta version be used? We encourage everybody to immediately start using the ICHD-3 Beta. It is much improved compared to ICHD-II and contains much new material. Therefore, it should be used immediately, not only for field testing but also in clinical use and especially for scientific studies of all sorts. There are changes throughout the entire classification, but most changes are in the section on secondary headaches. A new set of diagnostic criteria has been developed for all secondary headaches. They allow the diagnosis of a secondary headache while it is still present and not, as previously, only after treatment or spontaneous remission. Many new entities have been added. The appendix is much improved and expanded, often with material that needs field testing.
I hope that ICHD-3 Beta will elicit great interest, comments and debate, and that it will immediately be put to use.
Jes Olesen
Department of Neurology, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark. Email:
Working with the IHS on multiple fronts to advance headache medicine
I have come relatively recently to the field of headache, having focused earlier in my career on basic cellular neurophysiology and pharmacology. This has had both disadvantages and some advantages. On the downside, I've had a lot of catching up to do regarding basic and clinical headache medicine, and I continue to be humbled by how little I know and how inexperienced I am relative to most of my colleagues in the IHS. On the positive side, I can take advantage of my newcomer status to ask naïve questions that challenge conventional wisdom in the field, and to evaluate key questions with a fresh perspective.
As a Professor of Neurology at UCLA and director of our headache programme here, I am fortunate to be in a position to approach the problem of headache from a variety of angles. Our laboratory uses cellular and in vivo imaging, and electrophysiological recording approaches in combination with behavioural studies to investigate fundamental mechanisms of migraine and potential migraine therapies. We have recently expanded our scope to include more clinical research, including imaging studies and therapeutic trials. We have an active headache fellowship programme that has produced some outstanding headache scientists and clinicians, and we are increasing our efforts to educate medical students, residents, and colleagues regarding headache. Finally, we have an active clinical practice in headache that does its best to provide quality care to a seemingly endless number of headache patients. As I'm sure is true for many of you, our clinic is a source of both great reward and great frustration, and both drive us to do better for our patients with headache disorders.
An effective approach to a problem of such enormous magnitude as headache requires international collaboration and a worldwide effort. The work of the IHS serves to strengthen the research, education, and clinical facets of headache medicine by promoting and providing resources for each individually, as well as by enabling critical connections between them.
I feel lucky to be a part of such an important organisation, and I look forward to continuing to do all that I can as a member of the Board of Trustees to ensure its ongoing success and future productivity.
Andrew Charles
UCLA Neurology, Los Angeles, CA, USA. Email: