Introduction
The International Classification of Headache Disorders (ICHD) II and III beta defines menstrual migraine as attacks of migraine without aura occurring on day 1±2 of the menstrual cycle in ≥2/3 menstruations. According to the ICHD III beta, a three month prospective headache diary is required in order to establish the diagnosis of MM.
Aims
To compare the diagnosis of MM from a clinical interview based on the ICHD II-criteria for MM, with prospective headache diaries in a population-based study.
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Methods
237 women with self-reported migraine in at least half of menstruations were interviewed by a neurologist about headache and diagnosed according to ICHD II. Additionally, the MM-criteria were expanded to include other types of migraine related to menstruation. Subsequently, all women were asked to complete three month prospective headache diaries.
Results
A total of 123 (52%) women completed both clinical interview and diaries. Thirty-eight women were excluded from the analyses; two had incomplete diaries and 36 women recorded £1 menstruation, leaving 85 diaries eligible for analysis. Sensitivity, specificity, positive and negative predictive value and Kappa for the diagnosis of MM in clinical interview vs. headache diary were 82%, 83%, 90%, 71% and 0.62 (95% CI 0.46-0.80). Using a broader definition of MM, Kappa was 0.64 (95% CI 0.47-0.83).
Conclusion
A thorough clinical interview is valid for the diagnosis of MM. When this is undertaken, prospective headache diaries should not be mandatory to diagnose MM but may be necessary to exclude a chance association.
No conflict of interest.
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