The characteristics of head pain in response to an experimental cold stimulus to the palate: An observational study of 414 volunteers.
OBJECTIVE
The objective of this article is to study the characteristics of headaches following an experimental cold stimulus and evaluate whether the ICHD-II criteria for headache attributed to ingestion or inhalation of a cold stimulus (HICS) are adequate for the diagnosis of the headache induced by ice on the palate area (ice-induced headache (IH)).


RESULTS
One hundred and fifty-three out of 414 (37.0%) individuals tested had IH, but only 77/153 (50.3%) satisfied the ICHD-II criteria. The frontal (60.8%) and temporal (48.4%) areas were the most affected ones, with bilateral (77.1%) predominance, often of the pulsatile type (41.2%). One hundred and forty-seven out of 379 (38.8%) individuals who presented with a previous history of primary headache presented with IH, while only six out of 35 (17.1%) who had no history of previous headache reported pain in the test (OR 3.063, 95% CI 1.241-7.557). The ice-induced headache test was positive in 115/240 (47.9%) of the migraine sufferers and in 32/139 (23%) of the tension-type headache sufferers (OR 3.076, 95% CI 1.924-4.918).


CONCLUSIONS
IH is predominantly frontotemporal, bilateral and throbbing, most commonly affecting migraine sufferers, and the ICHD-II criteria are insufficient for classifying all individuals. We should, however, recommend caution regarding such a generalization from our findings with experimentally provoked cold stimulus headache to cold stimulus headache in general (i.e. HICS, ICHD-II).
Neurology and Neurosurgery Unit, Department of Neuropsychiatry, Federal University of Pernambuco, Brazil.
Daniella A
DA
de Oliveira
Marcelo M
MM
Valença
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002648:Child; D003080:Cold Temperature; D005260:Female; D006261:Headache / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D007053:Ice; D008297:Male; D008875:Middle Aged; D010159:Palate / Q000503:physiopathology*; D010812:Physical Stimulation; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
D007053:Ice