Intrauterine SARS-CoV-2 Exposure and Infant Neurodevelopment through 18 Months of Age: Findings from the Researching COVID to Enhance Recovery (RECOVER) Pregnancy Study.

Exploring the Interictal Neuropsychological Burden of Pediatric Migraine.

A corpus-based study of cultural content in integrated course 1–4 <i>New Advanced College English</i> (3rd Edition)

Language development delay is a prevalent developmental concern in preschool children, with significant implications for cognitive, emotional, and social functioning. Parental communication patterns are central to early language acquisition. A family-centered nursing approach emphasizes collaboration with parents to detect delays early. This study aims to examine the relationship between parental communication patterns and language development in preschool children using a family-centered framework. A cross-sectional study was conducted with 126 preschool children aged 36–60 months and their parents in XX Subdistrict, Jombang, East Java. The population consisted of 420 children. Sample size was calculated using the Lemeshow formula for proportions, resulting in 126 respondents with a 10% margin of error and 95% confidence level. Simple random sampling was applied. Data were collected using the Parental Communication Pattern Scale (PCPS) and the Ages &amp; Stages Questionnaires, 3rd Edition (ASQ-3). Validity and reliability tests were performed (r-value &gt; 0.3, Cronbach’s α = 0.88–0.92). Data were analyzed using descriptive statistics, Pearson correlation, and multiple linear regression. A significant positive correlation was found between parental communication patterns and language development (r = 0.642, p &lt; 0.001). Children with responsive and open communication styles had significantly higher ASQ-3 scores (p = 0.003). Regression analysis showed that PCPS accounted for 41.2% of the variance in language scores. Parental communication patterns significantly influence language development. A family-centered nursing approach integrating PCPS and ASQ-3 can enhance early detection and intervention.

Introduction Headache is one of the most frequent neurological symptoms in SLE; however, its definition and relationship with the disease remain unclear. Distinguishing whether a headache is attributable to lupus or represents a primary headache disorder can be challenging. This preliminary study aimed to investigate the prevalence, frequency, and associated clinical factors of primary headaches in juvenile-onset SLE (jSLE) compared to healthy peers. Methods This cross-sectional case-control study included 32 children with jSLE and 38 age- and sex-matched healthy controls, who were evaluated between July and September 2025. Headache characteristics were assessed using a standardized questionnaire and classified according to the International Classification of Headache Disorders, 3rd edition (ICHD-3). All participants underwent neurological and fundoscopic examinations. Clinical, laboratory, and treatment-related parameters including disease activity (SLEDAI-2K), cumulative dose of systemic corticosteroids, and autoantibody profiles were compared between jSLE patients with and without primary headache. Results Primary headache was observed in 31.3% of jSLE patients (10/32) and 10.5% of controls (4/38) ( p = 0.03). Among jSLE patients with headache, migraine without aura (60%) and tension-type headache (40%) were the predominant subtypes. Compared with those without headache, patients with headache had higher BMI z-scores ( p = 0.03), shorter sleep duration ( p = 0.03), more frequent antiphospholipid antibody positivity ( p = 0.04), and higher cumulative corticosteroid doses ( p = 0.02). Disease activity and duration did not differ significantly. Conclusion Primary headaches, particularly migraine, are more frequent in pediatric lupus compared to healthy controls. Their associations with BMI, sleep, antiphospholipid antibodies, and corticosteroid exposure suggest multifactorial origins rather than direct links to disease activity. These findings highlight the need for larger, prospective studies to clarify underlying mechanisms.

This study was conducted to provide a clinically oriented, mechanism-based framework for interpreting neuroimaging across disorders of cerebrospinal fluid (CSF) pressure, with particular emphasis on patients who fall between classic diagnostic categories of spontaneous intracranial hypotension (SIH) and idiopathic intracranial hypertension (IIH). Headache specialists are increasingly asked to evaluate patients whose symptoms, imaging, and opening pressures do not fit neatly within International Classification of Headache Disorders, 3rd edition criteria. At the same time, modern work in SIH, IIH, CSF-venous fistulas (CVFs) and rebound intracranial hypertension (RIH) has highlighted that these entities are better understood as dynamic expressions of a shared craniospinal physiology rather than isolated syndromes. This narrative review synthesizes contemporary literature on SIH, IIH, CVF, and RIH together with the authors' experience in a tertiary CSF disorder program. We focus on imaging markers of buoyancy loss and venous adaptation, the Bern score and its extensions, adjunctive MRI features that refine pretest probability when the brain MRI is normal, evolving myelographic techniques including photon-counting computed tomography, modern MRI phenotyping in IIH, and recent data on opening pressures in SIH and CVF. These data are organized around a unifying physiologic model rather than by individual disease labels. In SIH, the shift from a binary to a probability-based imaging paradigm-anchored by the Bern score-has been complemented by additional markers such as meningeal diverticula, optic nerve sheath narrowing, and imaging findings suggestive of migraine that further inform decisions about advanced myelography even when the brain MRI is formally normal. Recognition of lateral dural tears with small herniated arachnoid pouches mimicking meningeal diverticula and CVFs detectable with only advanced myelographic techniques underscores that absence of a localized leak does not exclude SIH. Most patients with imaging-proven SIH have normal or even elevated opening pressures, challenging current diagnostic criteria and suggesting that some leaks may arise in the setting of chronically increased craniospinal pressure. In IIH, only a subset of MRI features meaningfully discriminates true IIH from mimics, and venous sinus behavior emerges as a dynamic marker of compliance rather than a simple anatomic lesion. RIH after leak closure and "popping the balloon" in patients with established IIH who develop spinal leaks both illustrate how modest shifts in CSF volume and venous capacitance can drive rapid transitions between high- and low-pressure states. Disorders of CSF pressure are best conceptualized as points along an interconnected physiologic continuum in which buoyancy, venous compliance, leak morphology, and CSF-venous communication interact to produce the observed clinical and imaging phenotypes. For patients with mixed or subtle findings, applying this mechanism-oriented framework can improve interpretation of MRI and myelography, prevent premature exclusion of SIH or IIH on the basis of normal opening pressure or "negative" imaging, and support more nuanced, individualized treatment decisions in clinical practice.

Until 1995, patients with newly diagnosed germinoma received 40-60 Gy of radiation to the primary site with or without chemotherapy (regimen A). After 2000, treatment shifted to chemotherapy followed by 24 Gy of whole-ventricle radiation therapy (WVRT) (regimen B). This study compares long-term intelligence outcomes between the two treatment regimens. This retrospective analysis included 151 patients diagnosed with germinoma between 1983 and 2021. Intelligence was assessed using the Wechsler Adult Intelligence Scale (revised or 3rd edition) and the Wechsler Intelligence Scale for Children (3rd edition). Patient backgrounds were also collected. A total of 55 and 69 patients were treated with regimens A and B, respectively. The number of patients who underwent at least one longitudinal neurocognitive assessment was 35 and 29 for regimen A and 53 and 22 for regimen B, respectively. The median interval from initial treatment to the last neurocognitive assessment was 120 months. In the longitudinal intelligence assessments, the median intervals were 58 months from treatment to the first evaluation and 83 months from the first to the final assessment. Full-Scale Intelligence Quotient (FSIQ) scores declined in regimen A but were maintained in regimen B according to analysis of covariates and generalized linear mixed model analysis. Chemotherapy followed by 24 Gy of WVRT appears to be associated with a smaller decline in FSIQ over a long-term follow-up.

Advancing Forensic Nursing Through Inclusive and Global Standards: Development of the Forensic Nursing Scope and Standards of Practice, 3rd Edition.

Proceedings of the 3rd edition of the International e-Health Forum 2024

To critically evaluate the current International Classification of Headache Disorders, 3rd edition (ICHD-3) definition of status migrainosus (SM) and assess how well it meets clinical and research needs. The review will also explore additional attack dimensions that could support a more patient-centric and clinically actionable definition. ICHD-3 defines SM as a debilitating migraine attack lasting more than 72 h. This 72-h threshold is historically derived rather than empirically validated, and limited evidence is available to guide treatment. We posit that a primarily duration-based definition restricts both the clinical utility of SM and its usefulness as a construct in acute treatment trials. This narrative review was structured around five key questions: (Q1) Do we need specific diagnostic criteria for SM; (Q2) Should time be used within the definition; (Q3) Should attack severity and disability be included; (Q4) Should treatment response be included; and (Q5) Should migraine attack phases be considered. Targeted PubMed searches (inception-mid-2025) were performed for questions 2-5. One reviewer was assigned to each of these questions and independently conducted title/abstract screening, full-text review, and data extraction. Searches yielded 36 publications from 504 screened for question 2, 12 from 322 for question 3, 61 from 171 for question 4, and 13 from 1708 for question 5. Q1: Although SM remains clinically useful, the current criteria do not capture the heterogeneity of prolonged attacks and provide limited guidance for treatment escalation. Q2: Attack duration varies widely across migraine phenotypes, and the 72-h cutoff lacks clear justification and is misaligned with real-world practice, where escalation occurs well before 72 h. Q3: "Debilitating" is undefined, and pain severity alone insufficiently reflects functional impact; disability may offer a more meaningful indicator for clinical decision-making. Q4: Treatment refractoriness is central to how prolonged attacks are managed but is not incorporated into current criteria, and standardized definitions of acute treatment failure are lacking. Q5: Prodrome, aura, and postdrome can meaningfully contribute to attack burden, yet SM criteria do not specify whether nonheadache phases count toward attack duration. A revised definition of SM should move beyond a rigid 72-h threshold and give greater weight to functional impairment, treatment response, and more explicit definitions of attack duration that clarify how nonheadache phases are handled.

Triptans are highly effective acute treatments for migraine attacks, yet population-level data suggest persistent underuse. Updated real-world data on triptan use and overuse in Austria are lacking. This nationwide, retrospective claims-based study analysed triptan use and overuse in Austria in 2023. Adults (≥ 18 years) with at least one dispensed triptan were identified. Triptan overuse was defined as the dispensing of ≥ 30 defined daily doses (DDDs) in at least one quarter, consistent with the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria. Data on demographics, preventive migraine therapies, antidepressant use, sick leave, and hospital admissions were assessed and compared with data from 2007 using identical methodology. Among 7.75 million insured adults, 63,729 individuals (0.82%) fulfilled the inclusion criteria and used triptans, representing a 46% increase since 2007. However, this corresponds to an estimated number of approximately 8% of individuals with migraine. Triptan overuse more than doubled compared with 2007 (12.5% vs. 5.9%) and was associated with older age, with the largest proportion of overusers being 51–65 years old. Overusers showed substantially higher use of preventive therapies, including anti-calcitonin-gene-related-peptide (CGRP) antibodies (21.8% vs. 9.7%), and antidepressants (24.8% vs. 19.9%) (all p < 0.001). Hospital admissions were slightly more frequent among overusers, whereas sick-leave days were less frequent in this group. Women were more likely than men to use triptans, anti-CGRP antibodies, and antidepressants. Despite increased triptan use over the past 15 years, overall utilization in Austria remains low, while the percentage of patients with triptan overuse has more than doubled. Preventive migraine therapies remain infrequently prescribed. Higher rates of hospital admissions and concomitant antidepressant use may indicate a greater overall disease burden among triptan overusers.

Migraine chronification is associated with increased clinical burden, yet structural neuroimaging findings remain inconsistent. We compared global and regional brain volumes among patients with episodic migraine (EM), chronic migraine (CM), and healthy controls (HC) using an automated whole-brain volumetric approach. This retrospective study included 58 CM patients, 55 EM patients, and 60 age- and sex-matched HC. Diagnoses were established according to the International Classification of Headache Disorders, 3rd edition (ICHD-3). Structural MRI data acquired on a 1.5-T scanner were processed using the automated volBrain pipeline. Regional brain volumes were compared using one-way ANOVA. To address multiple testing across 220 regions, family-wise error rate (FWER) was controlled with Holm–Bonferroni and false discovery rate (FDR) with Benjamini–Hochberg. Cohen’s d values were calculated as exploratory effect sizes. Monthly attack frequency was significantly higher in CM than EM (p < 0.001), while disease duration was similar. No significant differences were observed among EM, CM, and HC in global or regional brain volumes after FWER and FDR correction. Regions showing nominal uncorrected differences demonstrated small and inconsistent effect sizes. With rigorous whole-brain correction, automated volumetry did not reveal robust structural differences between episodic and chronic migraine. If present, migraine-related morphometric alterations are likely subtle and methodologically sensitive. Larger longitudinal studies using higher-resolution imaging are needed.

To assess long-term safety of antiseizure medication (ASM) discontinuation after resolution of acute provoked neonatal seizures and prior to hospital discharge. Prospective, observational, comparative effectiveness cohort study of neonates with acute provoked seizures born from July 2015 to March 2018, and followed until September 2024, at nine U.S. Neonatal Seizure Registry centers with Level IV neonatal intensive care units and Level IV pediatric epilepsy programs. Duration of ASM treatment was quantified as (1) discontinuation before discharge from the neonatal seizure admission or (2) maintenance at the time of hospital discharge. Outcomes were adjusted for propensity to receive ASM at discharge. Propensity for ASM maintenance was defined among enrolled participants by a logistic regression model including seizure etiology, gestational age, therapeutic hypothermia, worst electroencephalography (EEG) background, days of EEG seizures, and discharge neurological exam (all p ≤ .1 in a joint model, except etiology, which was included for face validity). The primary outcome was non-inferiority of cognition (Wechsler Preschool and Primary Scale of Intelligence assessed at age 5-6 years). Secondary outcomes were non-inferiority of functional development (Vineland Adaptive Behavior Scale, 3rd Edition, assessed at 3-8 years) and post-neonatal epilepsy (assessed at 1-8 years). Among 284 children with at least one follow-up, outcomes were similar in the discontinued vs maintained ASM groups for full-scale IQ at age 5 years (adjusted difference +10 points), functional development at ages 3-8 years (adjusted difference 0 points), and post-neonatal epilepsy at ages 1-8 years (adjusted hazard ratio .93, 95% confidence interval [CI] .48-1.80). Prolonged administration of ASM for several months after resolution of acute provoked neonatal seizures may expose infants to unnecessary medications. These results provide additional evidence for safety of discontinuing ASM for most neonates soon after the resolution of acute provoked seizures-a practice that is recommended in the International League Against Epilepsy (ILAE) guideline for neonatal seizure management.

To investigate the prevalence of migraine features among patients with sudden sensorineural hearing loss (SSNHL) and evaluate potential clinical associations. Retrospective survey-based study. Single institution tertiary care center. 168 adult patients with SSNHL were recruited. Migraine diagnosis was determined using International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria. Patient demographics, migraine-related features, and SSNHL characteristics were analyzed using univariate and multivariate logistic regression. Of 168 SSNHL patients, 77 (46%) met full ICHD-3 migraine criteria, which is higher than the general population. An additional 23% met the majority of the migraine criteria. Multivariate analysis revealed that aural fullness preceding hearing loss (P < .001), concordant laterality of hearing loss and headache (P < .001), hyperacusis (P = .006), otalgia (P = .01), and motion sickness (P = .03) were independently associated with migraine. Interestingly, 89% of patients with migraine headache and SSNHL had their SSNHL on the same side as their headaches. These findings reveal a high prevalence of migraine headache among patients with SSNHL. Clinical features, including aural fullness and concordant laterality (dominant headaches on the same side as SSNHL), were predictive of migraine in SSNHL patients. These findings support the hypothesis that migraine and SSNHL may share overlapping vascular and neurogenic mechanisms, highlighting the importance of identifying migraine features in SSNHL to optimize management and explore potential therapeutic strategies.

Rationale:Retinal migraine is a rare cause of transient monocular visual loss that presents a significant diagnostic challenge and necessitates the careful exclusion of alternative etiologies. This case report describes the 6-year clinical course of a rare, headache-free variant of retinal migraine.Patient concerns:A 42-year-old male experienced recurrent transient monocular visual loss episodes 2 to 3 times per year, affecting either eye, without any associated headache. Each episode involved stereotypical visual symptoms starting with photopsia, followed by an expanding altitudinal visual field defect.Diagnoses:Extensive investigations, including neuroimaging, vascular studies, blood work, and ophthalmological examinations, returned normal results. After years of investigations and excluding other etiologies, a diagnosis of retinal migraine was established based on the International Classification of Headache Disorders 3rd edition criteria.Interventions:The patient opted for low-dose aspirin to decrease the risk of permanent visual loss.Outcomes:The patient continued to experience similar visual episodes without any change in frequency, severity, or characteristics.Lessons:Retinal migraine may occur without headache, consistent with current International Classification of Headache Disorders 3rd edition criteria. Careful history-taking remains a cornerstone of accurate diagnosis, and time can serve as an invaluable diagnostic tool. Finally, a patient-centered approach is essential, particularly when evidence-based management options are limited.

In contrast to the extensive research on the effects of high-altitude exposure on adult neurological function, fetal and pediatric neurodevelopment in high-altitude environments has received relatively little attention. This study aimed to determine whether exposure to high-altitude exposure during gestation and infancy could influence neurodevelopmental outcomes compared with low-altitude infants. A total of 50 high-altitude-born and 100 low-altitude-born infants were studied. Parents were followed longitudinally and instructed to complete the Ages and Stages Questionnaire, 3rd edition (ASQ-3), when their infants reached 6, 12, and 18 months of age. The primary outcome measures included neurodevelopmental scores and the proportion of infants classified as failing in the five ASQ-3 domains. High-altitude infants had lower gross motor scores and higher failure rates. Subgroup analysis revealed no significant differences attributable to confounding factors. Regression analysis identified high-altitude exposure as the only significant predictor of gross motor delay. Prenatal and postnatal exposure to high-altitude exposure was found to be associated with an increased risk of gross motor neurodevelopmental delay in infants. This is the first prospective cohort study to compare the neurodevelopmental outcomes of high-altitude born/raised infants with those of low-altitude controls. Infants born and raised at high-altitude exhibited lower neurodevelopmental scores and a higher likelihood of failing in the gross motor domain of ASQ-3. High-altitude exposure had no negative influence on infants' physical growth and other neurodevelopmental domains assessed by the ASQ-3.

This study aimed to evaluate the comparative effectiveness of propranolol therapy and structured behavioral interventions in reducing headache severity in pediatric patients and to identify predictors of treatment response. In this prospective, single-center study, 178 pediatric patients diagnosed with migraine based on the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria were enrolled. Participants were allocated into two groups according to baseline Pediatric Migraine Disability Assessment Scale (PedMIDAS) scores: Group 1 (PedMIDAS <15, n = 88) received standardized behavioral therapy, while Group 2 (PedMIDAS ≥15, n = 90) received propranolol (1-3 mg/kg/day) for 12 weeks. Primary outcomes were predefined as changes in monthly migraine attack frequency, PedMIDAS scores, and Visual Analog Scale (VAS)-measured headache intensity. Vitamin D deficiency and vitamin B12 deficiency were evaluated as biochemical predictors, and adherence was monitored bi-weekly. Both groups showed significant improvement at week 12. Monthly migraine attacks declined from 3.5 ± 1.6 to 2.1 ± 1.2 in Group 1 and from 6.4 ± 2.1 to 3.1 ± 1.7 in Group 2. PedMIDAS scores decreased from 8.60 ± 3.25 to 5.75 ± 2.52 and 24.40 ± 9.65 to 16.11 ± 7.72, respectively (p < 0.001 both). VAS scores also improved in both groups with no significant between-group difference in percentage reduction. A ≥50% reduction in attack frequency plus ≥1-grade PedMIDAS improvement defined treatment response. In the propranolol group, response was independently associated with benign paroxysmal vertigo and essential tremor, while vitamin D and vitamin B12 deficiency predicted poorer outcomes. Both propranolol and structured behavioral therapy effectively reduce migraine-related disability and pain in pediatric patients, yielding comparable proportional improvements. The identification of key clinical and biochemical predictors supports a personalized treatment approach, integrating comorbidity screening and nutritional assessment to optimize outcomes. ClinicalTrials.gov/NCT07180043, retrospectively registered.

Colorectal cancer lung metastases (CRCLM) significantly influence treatment planning and prognosis in colorectal cancer (CRC). This study aimed to develop and validate machine learning-based models to support individualized risk stratification for chest computed tomography (CT) utilization during baseline evaluation by predicting synchronous CRCLM at diagnosis. Patients with primary CRC diagnosed between 2010 and 2015 were identified from the Surveillance, Epidemiology, and End Results (SEER) database using International Classification of Diseases for Oncology, 3rd edition (ICD-O-3) codes. Synchronous CRCLM was defined by the variable "CS Mets at DX-Lung". Predictors included age, sex, race, primary tumor site, grade, histologic type, tumor stage (T stage), node stage (N stage), tumor size, carcinoembryonic antigen (CEA) level, tumor deposits, and perineural invasion. The cohort was randomly divided into training (70%) and validation (30%) sets. eXtreme gradient boosting (XGB), random forest (RF), decision tree (DT), and logistic regression (LR) models were developed and evaluated mainly by receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). Model interpretability was assessed using SHapley Additive exPlanation (SHAP). Among 51,553 patients, 1,329 (2.6%) had synchronous CRCLM. In the validation cohort, the area under the curve was 0.81 for XGB, 0.81 for RF, 0.79 for DT, and 0.73 for LR after hyperparameter optimization. Calibration curves indicated high consistency between predictions and observations. DCA revealed substantial clinical utility for all models. SHAP analysis highlighted CEA and N stage as the strongest predictors in the RF model, while CEA and T stage were most influential in the XGB model. Machine learning models, particularly XGB and RF, demonstrated robust performance in predicting synchronous CRCLM. CEA was consistently identified as the most important risk factor, supporting personalized chest CT utilization during initial CRC staging.

AimSeveral studies have reported a higher prevalence of migraine in patients with multiple sclerosis (MS) than in healthy controls (HCs). The aim of this study was to elucidate the headache prevalence in patients with MS or other neuroimmunological disorders, as well as to investigate the associations between headache characteristics and disease activity.MethodsIn this multicenter study in Japan, a headache questionnaire was distributed to patients with MS (n = 338), aquaporin-4 IgG-positive neuromyelitis optica spectrum disorder (NMOSD; n = 106), myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD; n = 51) or acetylcholine receptor antibody-positive myasthenia gravis (MG; n = 104), and healthy controls (HCs; n = 407). We included only participants aged 18-65 years in this study. The questionnaire responses were classified according to the International Classification of Headache Disorders, 3rd edition. The questionnaire was designed to systematically capture headache characteristics based on established diagnostic criteria.ResultsIn total, any type of headache was found for 54.1% in MS, 63.2% in NMOSD, 43.1% in MOGAD, 43.3% in MG and 43.5% in HCs. After Holm-Bonferroni correction for comparisons among the five groups, the MS (p = 0.015) and NMOSD (p < 0.001) groups had significantly higher odds of any headache compared to the HC group. No difference was observed for migraine (MS 16.0%, NMOSD 16.0%, MOGAD 9.8%, MG 12.5%, HCs 17.0%). In contrast, patients with MS (24.0%) and NMOSD (37.7%) showed a significantly higher frequency of tension-type headache (TTH) than HCs (16.7%) even after adjusting for age and sex. Neither disease activity nor disease-modifying therapy displayed any association with headache severity in patients with MS, NMOSD, or MOGAD.ConclusionsOur study showed no increased prevalence of migraine in MS and other neuroimmunological disorders, whereas TTH comorbidity was higher in MS and NMOSD than in controls.

Purpose: The International Classification of Headache Disorders, 3rd edition (ICHD-3), defines headache diagnoses based on combinations of clinical symptoms. Diagnostic overlap is common, and symptom variability complicates diagnostic classification. We evaluated natural classes of headache disorders using a statistical approach and compared these classes with ICHD-3 diagnostic categories.Methods: Data from a nationwide, population-based web survey on headache and sleep conducted in South Korea (n=3,030) were analyzed. Participants who reported headache within the past year (n=1,938) were included. Latent class analysis was performed using categorical ICHD-3 diagnostic criteria to identify distinct classes. The characteristics of each class and the distribution of ICHD-3 primary headache diagnoses were examined.Results: Nine classes were identified, comprising 626, 54, 248, 148, 187, 143, 79, 61, and 392 individuals. Three classes were tension-type headache (TTH)–like: Class 1 was male-dominant mild bilateral TTH, Class 8 represented classic, severe TTH, and Class 9 was mild unilateral TTH. Class 4 showed a typical migraine phenotype and contained most migraine cases. Classes 5 and 6 were dominated by probable migraine (PM) and differed mainly in sensory sensitivity and disability, which were higher in Class 6. Classes 2, 3, and 7 were categorized as “other headache.” Class 2 had the highest prevalence of medication-overuse headache (MOH), whereas Class 3 was characterized by mild headache with nausea. Class 7 showed a mixed-type profile with prominent photophobia. Severity and central sensitization markers were key classifiers.Conclusion: Latent class analysis identified nine clinically distinct headache classes. PM was clearly distinct from both TTH and migraine. One subtype within the “other headache” class showed the highest MOH burden.