Only probable forms were diagnosed in 13.46% (as single probable diagnosis in 8.73% of cases or multiple diagnoses of probable forms in the remaining ones). A certain diagnosis of one chronic form plus that of a probable form was obtained in 50.8% of cases (26.9% represented by probable medication–overuse headache). The percentage of certain diagnoses mainly in the chronic headache group (28.4%), and to a lesser extent tension–type headache (6.5%), were obtained in 34.9% of cases. Only probable forms were diagnosed in the remaining 7.3% (as single probable diagnosis in 5.8% of cases or multiple diagnoses of probable forms in the remaining ones). A certain diagnosis of primary headache plus that of a probable form was obtained in 24.4% of cases (12.7% represented by chronic migraine (CM) or chronic tension–type headache (CTTH)+probable medicationoveruse headache). A diagnosis of one of the primary headache forms was obtained in 67.9% of cases. We tested the computerised, structured medical record by entering and analysing the consecutive clinical sheets of primary headaches in the episodic forms (200) and chronic headache (200) and the corresponding output diagnoses of patients attending our Headache Centre. For the purposes of ICHD-3, all non-opioid analgesics are regarded as a single class therefore, a patient who uses more than one non-opioid analgesic cumulatively, but not any single drug, on 15 or more days/month is coded 8.2.3 Non-opioid analgesic-overuse headache (with the individual drugs specified in parenthesis) and not 8.2.6 Medication-overuse headache attributed to multiple drug classes not individually overused. Many patients use more than one non-opioid analgesic: a common example is paracetamol (acetaminophen) and a non-steroidal anti-inflammatory drug (NSAID). Comments:Ī patient who fulfils criteria for more than one of the subforms of 8.2.3 Non-opioid analgesic-overuse headache should be given all applicable codes. It usually, but not invariably, resolves after the overuse is stopped. Headache occurring on 15 or more days/month in a patient with a pre-existing primary headache and developing as a consequence of regular use of one or more non-opioid analgesics on 15 or more days/month for more than 3 months.
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