{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T18:48:58Z","timestamp":1757616538959,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Fam Plann Reprod Health Care"],"published-print":{"date-parts":[[2007,4]]},"DOI":"10.1783\/147118907780254097","type":"journal-article","created":{"date-parts":[[2007,3,21]],"date-time":"2007-03-21T18:50:28Z","timestamp":1174503028000},"page":"134.1-134","source":"Crossref","is-referenced-by-count":0,"title":["Conflicting terminology in the context of migraine"],"prefix":"10.1136","volume":"33","author":[{"given":"Antje","family":"Ischebeck","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2007,4,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1783\/147118907779399684","article-title":"Menstrual migraine: a clinical review","volume":"33","author":"MacGregor, E.A.","year":"2007","unstructured":"MacGregor EA. Menstrual migraine: a clinical review. J Fam Plann Reprod Health Care 2007: 33: 36\u201347.","journal-title":"J Fam Plann Reprod Health Care"},{"key":"ref_2","article-title":"Faculty of Family Planning and Reproductive Health Care (FFPRHC). UK Medical Eligibility Criteria for Contraceptive Use","author":"[2 February 2007].","year":"2005","unstructured":"Faculty of Family Planning and Reproductive Health Care (FFPRHC). UK Medical Eligibility Criteria for Contraceptive Use (UKMEC 2005\/2006). 2006. http:\/\/www.ffprhc.org.uk\/admin\/uploads\/298_UKMEC_200506.pdf [Accessed 2 February 2007]."},{"key":"ref_3","unstructured":"Menstrual migraine Thank you for the excellent article on menstrual migraine.1 I note some discrepancies between the International Headache Society classification of migraine in the article and information on migraine in the FFPRHC Guidance on \u2018First prescription of combined oral contraception\u2019. The Guidance tells us: \u201cSymptoms of aura include... unilateral weakness\u201d; however, the classification states that motor weakness is not a feature of aura (Box 1). Again, the CEU Guidance says: \u201cFlashing lights do not constitute aura\u201d and yet the classification talks of flickering lights being an example of a positive visual symptom in aura. Can you explain these differences?","article-title":"Menstrual migraine Thank you for the excellent article on menstrual migraine.1 I note some discrepancies between the International Headache Society classification of migraine in the article and information on migraine in the FFPRHC Guidance on \u2018First prescription of combined oral contraception\u2019. The Guidance tells us: \u201cSymptoms of aura include... unilateral weakness\u201d; however, the classification states that motor weakness is not a feature of aura (Box 1). Again, the CEU Guidance says: \u201cFlashing lights do not constitute aura\u201d and yet the classification talks of flickering lights being an example of a positive visual symptom in aura. Can you explain these differences?"},{"key":"ref_4","first-page":"36","article-title":"Plann Reprod","volume":"33","author":"Fam, J.","year":"2007","unstructured":"J Fam Plann Reprod Health Care 2007: 33: 36\u201347.","journal-title":"Health Care"},{"key":"ref_5","unstructured":"Dr Ischebeck notes that the International Headache Society (IHS) diagnostic criteria for migraine with aura includes \u2018flickering lights\u2019, which conflicts with the UK Medical Eligibility Criteria for Contraceptive Use (UKMEC) and the FFPRHC Clinical Effectiveness Unit Guidance on \u2018First prescription of combined oral contraception\u2019 statement that \u2018flashing lights are not classified as aura\u2019.1\u20133 The reference quoted by UKMEC refers to the risk of stroke associated with migraine aura and exogenous steroids and does not clarify the symptoms of aura.4","article-title":"Dr Ischebeck notes that the International Headache Society (IHS) diagnostic criteria for migraine with aura includes \u2018flickering lights\u2019, which conflicts with the UK Medical Eligibility Criteria for Contraceptive Use (UKMEC) and the FFPRHC Clinical Effectiveness Unit Guidance on \u2018First prescription of combined oral contraception\u2019 statement that \u2018flashing lights are not classified as aura\u2019.1\u20133 The reference quoted by UKMEC refers to the risk of stroke associated with migraine aura and exogenous steroids and does not clarify the symptoms of aura.4"},{"key":"ref_6","unstructured":"In the FACT Review on \u2018Hormonal contraception and migraine\u2019 that was published in the Journal in 2001, I wrote: \u201c... not all visual disturbances reported by migraine sufferers are aura. A migrainous scotoma is typically a bright spot, which may gradually increase in size to the shape of a letter \u2018C\u2019, developing scintillating edges that appear as \u2018zig-zags\u2019 (fortification spectra). The aura usually starts at or near the centre of fixation gradually spreading laterally, increasing in size over a period of 5\u201360 minutes. Generalised \u2018spots before the eyes\u2019, \u2018flashing lights\u2019, blurring of vision, or photophobia of variable duration before or with headache often occur during migraine and are not suggestive of focal ischaemia.\u201d5","article-title":"In the FACT Review on \u2018Hormonal contraception and migraine\u2019 that was published in the Journal in 2001, I wrote: \u201c... not all visual disturbances reported by migraine sufferers are aura. A migrainous scotoma is typically a bright spot, which may gradually increase in size to the shape of a letter \u2018C\u2019, developing scintillating edges that appear as \u2018zig-zags\u2019 (fortification spectra). The aura usually starts at or near the centre of fixation gradually spreading laterally, increasing in size over a period of 5\u201360 minutes. Generalised \u2018spots before the eyes\u2019, \u2018flashing lights\u2019, blurring of vision, or photophobia of variable duration before or with headache often occur during migraine and are not suggestive of focal ischaemia.\u201d5"},{"key":"ref_7","unstructured":"As UKMEC recommends, new onset of migraine aura during CHC use should remain an absolute contraindication to continuing this method but I am unclear why it is UKMEC 3 for continuing progestogen-only methods. I refer to my letter published in the Journal in response to the National Institute for Health and Clinical Excellence (NICE) guidelines on longacting reversible contraception (LARC), in which I noted that in contrast to CHCs there is evidence that use of progestogen-only methods is not associated with increased risk of ischaemic stroke.9 Hence, there is no reason why these methods should not be continued if they remain appropriate methods of contraception.","article-title":"As UKMEC recommends, new onset of migraine aura during CHC use should remain an absolute contraindication to continuing this method but I am unclear why it is UKMEC 3 for continuing progestogen-only methods. I refer to my letter published in the Journal in response to the National Institute for Health and Clinical Excellence (NICE) guidelines on longacting reversible contraception (LARC), in which I noted that in contrast to CHCs there is evidence that use of progestogen-only methods is not associated with increased risk of ischaemic stroke.9 Hence, there is no reason why these methods should not be continued if they remain appropriate methods of contraception"},{"key":"ref_8","article-title":"Faculty of Family Planning and Reproductive Health Care (FFPRHC). UK Medical Eligibility Criteria for Contraceptive Use","author":"[2 February 2007].","year":"2005","unstructured":"Faculty of Family Planning and Reproductive Health Care (FFPRHC). UK Medical Eligibility Criteria for Contraceptive Use (UKMEC 2005\/2006). 2006. http:\/\/www.ffprhc.org.uk\/admin\/uploads\/298_UKMEC_200506.pdf [Accessed 2 February 2007]."},{"key":"ref_9","article-title":"Faculty of Family Planning and Reproductive Health Care (FFPRHC) Clinical Effectiveness Unit","volume-title":"First Prescription of Combined Oral Contraception (updated","author":"FirstPrescCombOralContJan06.pdf [22 February 2007].","year":"2006","unstructured":"Faculty of Family Planning and Reproductive Health Care (FFPRHC) Clinical Effectiveness Unit. FFPRHC Guidance (July 2006). First Prescription of Combined Oral Contraception (updated January 2007). http:\/\/www.ffprhc.org.uk\/admin\/uploads\/538_ FirstPrescCombOralContJan06.pdf [Accessed 22 February 2007]."},{"key":"ref_10","first-page":"1","article-title":"Headache Classification Subcommittee of the International Headache Society (IHS). The International Classification of Headache Disorders","volume":"24","year":"2004","unstructured":"Headache Classification Subcommittee of the International Headache Society (IHS). The International Classification of Headache Disorders (2nd edition). Cephalalgia 2004; 24(Suppl. 1): 1\u2013160.","edition":"2","journal-title":"Cephalalgia"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1046\/j.1468-2982.2000.00035.x","article-title":"Recommendations on the risk of ischaemic stroke associated with use of combined oral contraceptives and hormone replacement therapy in women with migraine","volume":"20","author":"Bousser, M.G.; Conard, J.; Kittner, S.; de Lignieres, B.; MacGregor, E.A.; Massiou, H.","year":"2000","unstructured":"Bousser MG, Conard J, Kittner S, de Lignieres B, MacGregor EA, Massiou H, et al. Recommendations on the risk of ischaemic stroke associated with use of combined oral contraceptives and hormone replacement therapy in women with migraine. Cephalalgia 2000; 20: 155\u2013156.","journal-title":"Cephalalgia"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1783\/147118901101194912","article-title":"Hormonal contraception and migraine (FACT Review)","volume":"27","author":"MacGregor, E.A.","year":"2001","unstructured":"MacGregor EA. Hormonal contraception and migraine (FACT Review). J Fam Plann Reprod Health Care 2001; 27: 49\u201352.","journal-title":"J Fam Plann Reprod Health Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1046\/j.1468-2982.1998.1806342.x","article-title":"Screening for migraine in the general population: validation of a simple questionnaire","volume":"18","author":"Gervil, M.; Ulrich, V.; Olesen, J.; Russell, M.","year":"1998","unstructured":"Gervil M, Ulrich V, Olesen J, Russell M. Screening for migraine in the general population: validation of a simple questionnaire. Cephalalgia 1998; 18: 342\u2013348.","journal-title":"Cephalalgia"},{"key":"ref_14","first-page":"13","article-title":"and the World Health Organization Collaboration Study of Cardiovascular Disease and Steroid Hormone Contraception. Migraine and stroke in young women: case-control study","volume":"318","author":"Chang, C.; Donaghy, M.; Poulter, N.","year":"1999","unstructured":"Chang C, Donaghy M, Poulter N, and the World Health Organization Collaboration Study of Cardiovascular Disease and Steroid Hormone Contraception. Migraine and stroke in young women: case-control study. BMJ 1999; 318: 13\u201318.","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1136\/jnnp.73.6.747","article-title":"on behalf of the European Collaborators of the World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Duration, frequency, recency, and type of migraine and risk of ischaemic stroke in women of childbearing age","volume":"73","author":"Donaghy, M.; Chang, C.L.; Poulter, N.","year":"2002","unstructured":"Donaghy M, Chang CL, Poulter N, on behalf of the European Collaborators of the World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Duration, frequency, recency, and type of migraine and risk of ischaemic stroke in women of childbearing age. J Neurol Neurosurg Psychiatr 2002; 73: 747\u2013750.","journal-title":"J Neurol Neurosurg Psychiatr"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1783\/147118906775275280","article-title":"NICE Guidance on LARC (Letter)","volume":"32","author":"MacGregor, E.A.","year":"2006","unstructured":"MacGregor EA. NICE Guidance on LARC (Letter). 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