8.1.5 Headache induced by food and/or additive

Previously used term:
Dietary headache.

Coded elsewhere:
An episode of migraine triggered by a specific food or additive is coded as the appropriate subtype of 1. Migraine.

Description:
Headache caused by ingestion of a food or an additive containing one or more specific substances, which may not be identified, to which the patient is sensitive.

Diagnostic criteria:
A. Any headache fulfilling criterion C
B. A food or an additive containing one or more specific substances, not necessarily identified but capable of causing headache in sensitive subjects, has been ingested
C. Evidence of causation demonstrated by all of the following:

    1. headache has developed within 12 hr of ingestion of the food or additive
    2. headache has resolved within 72 hr after ingestion of the food or additive
    3. headache has at least one of the following four characteristics:

      a) bilateral
      b) mild to moderate intensity
      c) pulsating quality
      d) aggravated by physical activity

D. Not better accounted for by another ICHD-3 diagnosis.

Comment:
Monosodium glutamate, which is a well-established cause of headache, therefore has a separate subcoding below. Phenylethylamine, tyramine and aspartame have been incriminated, but without conclusive evidence.