Migraine and tension-type headache triggers in a Greek population

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Vasilios Constantinides

2015-08-01

Full Text Available Migraine and tension type headache are the two most common primary headaches. The purpose of this study was to detect differences in clinical characteristics and headache triggers and in a Greek cohort of 51 migraineurs and 12 patients with tension-type headache. (TTH Migraine patients had a significantly lower age at headache onset and frequency, higher mean visual analogue scale (VAS and greater maximum duration of headache episodes compared to TTH patients. They did not differ from (TTH patients in quality of headache, laterality of pain, way of headache installation and progression and temporal pattern of headaches. Nausea, vomiting and phonophobia were more frequent in migraine. Triggering of headaches by dietary factors was associated with migraine, whereas there was no difference between the two groups in any of the other headache triggers. Stress, both physical and psychological, were particularly common in both patient groups.

Manual therapy in adults with tension-type headache: A systematic review.

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Cumplido-Trasmonte, C; Fernández-González, P; Alguacil-Diego, I M; Molina-Rueda, F

2018-03-07

Tension-type headache is the most common primary headache, with a high prevalence and a considerable socioeconomic impact. Manual physical therapy techniques are widely used in the clinical field to treat the symptoms associated with tension-type headache. This systematic review aims to determine the effectiveness of manual and non-invasive therapies in the treatment of patients with tension-type headache. We conducted a systematic review of randomised controlled trials in the following databases: Brain, PubMed, Web of Science, PEDro, Scopus, CINAHL, and Science Direct. Ten randomised controlled trials were included for analysis. According to these studies, manual therapy improves symptoms, increasing patients' well-being and improving the outcome measures analysed. Manual therapy has positive effects on pain intensity, pain frequency, disability, overall impact, quality of life, and craniocervical range of motion in adults with tension-type headache. None of the techniques was found to be superior to the others; combining different techniques seems to be the most effective approach. Copyright © 2018 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Primary Headache Disorders- Part 2: Tension-type headache and medication overuse headache.

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Jay, Gary W; Barkin, Robert L

2017-12-01

In Part 2 of Primary Headache disorders, we discuss the fourth Primary Headache Disorder, Tension-Type Headache (TTHA). We are again using the ICHD-III (Beta) definitions of such headaches, taking into consideration episodic and chronic TTHA, as well as the presence or absence of pericranial muscle tenderness. We discuss the pathophysiology and pharmacotherapeutic treatment of TTHA, and the aspects of the Myofascial Pain Syndrome that enhance and help the development of TTHA. We then discuss Medication Overuse Headache (MOH), itself a Secondary headache disorder, but one that is extremely important as it assists with the chronification of both migraine and TTHA. Finally we discuss how to manage and treat those patients with MOH. Chronic migraine, which is TTHA, Migraine as well as, in many patients, MOH, is discussed along with the treatment of this multifaceted disorder. Copyright © 2017 Elsevier Inc. All rights reserved.

Tension-Type Headache - The Normal and Most Prevalent Headache.

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Jensen, Rigmor Højland

2018-02-01

Tension-type headache (TTH) is the most prevalent form of primary headache in the general population but paradoxically the least studied headache. In this article, the epidemiology and diagnostic challenges of TTH are presented and discussed. The typical features and differential diagnosis of TTH are highlighted and the situations more likely to raise doubts are discussed. A structured approach to the patient and a better comprehension of the very frequent coexistence of migraine and medication overuse headache in the clinical population are emphasized. According to the IHS classification, several diagnoses should be applied but still some clinicians prefer to apply a single combined diagnosis in the severely affected patients, namely chronic migraine. Such uneven practice may complicate the diagnostic comparability and the entire management of TTH. The present treatment strategies for TTH are summarized and hopefully an increased awareness of TTH can translate into better quality of care and a more specific diagnosis and treatment for the numerous TTH sufferers. © 2017 American Headache Society.

Neuroticism, depression and pain perception in migraine and tension-type headache

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Ashina, S; Bendtsen, L; Buse, D C

2017-01-01

OBJECTIVES: People with migraine and tension-type headache (TTH) have psychiatric comorbidities. We aimed to test differences in mental health constructs by type and frequency of primary headache and associated pain sensitivity. MATERIALS AND METHODS: Data on headache features, neuroticism (Eysen...

Precipitating and relieving factors of migraine versus tension type headache

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Haque Badrul

2012-08-01

Full Text Available Abstract Background To determine the differences of precipitating and relieving factors between migraine and tension type headache. Methods This is a cross sectional study. We retrospectively reviewed the records of 250 migraine patients and 250 patients diagnosed as tension type headache from the specialized headache clinic in Dept. of Neurology, Dhaka Medical College Hospital. Data were collected through a predesigned questionnaire containing information on age, sex, social status and a predetermined list of precipitating and relieving factors. Results In this study, the female patients predominated (67%. Most of the patients were within 21–30 years age group (58.6%. About 58% of them belonged to middle class families. The common precipitating factors like stress, anxiety, activity, journey, reading, cold and warm were well distributed among both the migraine and tension type headache (TTH patients. But significant difference was demonstrated for fatigue (p  Conclusion The most frequent precipitating factors for headache appear to be identical for both migraine and TTH patients. Even though some factors like fatigue, sleep deprivation, sunlight and food significantly precipitate migraine and drug, massage are effective maneuver for relieving pain among migrianeurs.

Considerations in the treatment of tension-type headache in the elderly.

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Wrobel Goldberg, Stephanie; Silberstein, Stephen; Grosberg, Brian M

2014-11-01

Tension-type headache (TTH) is the most prevalent headache type in all age groups worldwide, including patients with advanced age. Because of its high prevalence and possible association with medical and psychiatric co-morbidities, TTH has a major socioeconomic impact. The lifetime prevalence of TTH ranges between 30 and 78 %, and the 1-year prevalence in individuals over the age of 55 years is 35.8 % (27.8 % in men, 42.4 % in women). Since the prevalence of secondary headache disorders increases in the elderly, the initial evaluation of this group of patients with a new-onset headache or a change in a pre-existing headache pattern should be directed towards their exclusion. This article reviews the diagnostic and treatment dilemmas encountered in elderly patients with tension-type headaches, highlighting both pharmacological and non-pharmacological interventions.

Psychological issues in the evaluation and treatment of tension-type headache.

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Rosen, Noah L

2012-12-01

Tension-type headache is the most common headache disorder, affecting approximately 40 % of Americans within a one-year span. Although the most common form, episodic tension-type headache, is rarely impairing, more frequent tension-type headache can occur with significant disability and psychological comorbidity. Appreciating the psychological impact, assessing the associated biopsychosocial issues, and understanding patients' coping styles are important in forming an appropriate treatment plan and maximizing treatment outcomes. A range of psychological therapies including relaxation training, cognitive behavioral therapy, biofeedback and mindfulness have demonstrated utility in treating chronic pain conditions and reducing the associated disability. This may be particularly applicable to special populations, including pediatric patients, pregnant patients and geriatric. Psychological assessment and treatment may be done conjointly with medication management and expands treatment options. There is great need to continue researching the effects of psychological treatments, standardizing interventions and making them available to the wider population.

Pain perception studies in tension-type headache.

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Bezov, David; Ashina, Sait; Jensen, Rigmor; Bendtsen, Lars

2011-02-01

Tension-type headache (TTH) is a disorder with high prevalence and significant impact on society. Understanding of pathophysiology of TTH is paramount for development of effective treatments and prevention of chronification of TTH. Our aim was to review the findings from pain perception studies of pathophysiology of TTH as well as to review the research of pathophysiology of TTH. Pain perception studies such as measurement of muscle tenderness, pain detection thresholds, pain tolerance thresholds, pain response to suprathreshold stimulation, temporal summation and diffuse noxious inhibitory control (DNIC) have played a central role in elucidating the pathophysiology of TTH. It has been demonstrated that continuous nociceptive input from peripheral myofascial structures may induce central sensitization and thereby chronification of the headache. Measurements of pain tolerance thresholds and suprathreshold stimulation have shown presence of generalized hyperalgesia in chronic tension-type headache (CTTH) patients, while DNIC function has been shown to be reduced in CTTH. One imaging study showed loss of gray matter structures involved in pain processing in CTTH patients. Future studies should aim to integrate pain perception and imaging to confirm this finding. Pharmacological studies have shown that drugs like tricyclic anti-depressant amitriptyline and nitric oxide synthase inhibitors can reverse central sensitization and the chronicity of headache. Finally, low frequency electrical stimulation has been shown to rapidly reverse central sensitization and may be a new modality in treatment of CTTH and other chronic pain disorders. © 2010 American Headache Society.

The prevalence of vestibular symptoms in migraine or tension-type headache.

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Akdal, Gülden; Ozge, Aynur; Ergör, Gül

2013-01-01

We assessed frequency of vestibular symptoms in Headache Clinic patients over 10 years. A descriptive study of 5111 consecutive patients with tension-type headache or migraine, analyzed for dizziness/ vertigo accompanying headache and for a lifetime history of motion-sickness, cyclic vomiting, recurrent abdominal pain or atopy. Migraine patients were re-grouped as those with vestibular symptoms (dizziness/vertigo or motion sickness) and those without and their data then re-analyzed. There were 1880 migraine patients and 3231 tension-type headache patients. Significantly more migraine patients than tension-type headache patients experienced vestibular symptoms (p< 0.0001). The migraine with vestibular symptoms group was significantly younger (p< 0.05) had more aura, more phonophobia with migraine attacks (p< 0.0001). Menstruation and reported sleep problems impacted on headaches. While past history of cyclical vomiting, recurrent abdominal pain or atopy was about twice as common in migraine with aura and it was also more common in migraine with vestibular symptoms than migraine without vestibular symptoms. Vestibular symptoms are common in migraine patients. Migraine with vestibular symptoms might constitute a special group, one more likely to have had cyclic vomiting, recurrent abdominal pain or atopy.

Temporomandibular disorders and tension-type headache.

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Mongini, Franco

2007-12-01

Pathologies currently defined as temporomandibular disorders may be different in nature. Temporomandibular joint (TMJ) disorders and craniofacial and cervical myogenous pain (MP) are distinct pathologies but may be superimposed and share some etiologic factors. Tension-type headache (TTH) may often be associated with craniofacial and cervical pain, and the same pharmacologic and nonpharmacologic treatment may be efficacious for both. Psychiatric comorbidity (depression and/or anxiety disorder) is less frequent in sheer TMJ disorders, compared with MP and TTH. A screening for the presence of an underlying psychiatric disorder should be part of the clinical evaluation in patients suffering from headache and facial pain.

[Possibilities of preventive therapy in frequent episodic tension-type headache].

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Tabeeva, G R; Fokina, N M

2016-01-01

To study the efficacy and safety of tenoten in the preventive treatment of frequent episodic tension-type headache (FETHA) compared to patients treated with pain relievers. A study included 60 patients with FETHA. Patients of the main group (n=30) received tenoten in addition to standard treatment. The study comprised 3 visits: beginning of treatment, after one month and after three months. All patients underwent physical and clinical/neurological examinations. In each visit, treatment efficacy was assessed according the following parameters: VAS scores (0-10) for assessment of pain and tension in pericranial muscles in 6 standard points, mean frequency and duration of the headache episode, quality of life indices, Beck depression scores, Spilberger trait and state anxiety, autonomic symptom severity, parameters of sleep disorders, frequency of adverse effects, CGI scores (0-7). Tenoten as a preventive medication reduced the frequency of headache episodes that allowed to diagnose patients with rare episodic tension-type headache in the end of treatment. At the same time, there was a significant reduction in headache intensity during the episode and decrease in amount of analgesics used by the patients.

MIGRAIN AND TENSION TYPE HEADACHE IN CHILDREN: THE APPROACH TO EFFECTIVE TREATMENT. PART 1

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A. V. Sergeev

2012-01-01

Full Text Available Headache is one of the most common complaints of children and adolescents. The most often causes of cephalgia in children are primary headaches (mainly migraine and tension-type headache. Recently there has been a significant increase in prevalence of primary headaches, which can be due to the changes of children’s way of life. The lack of the strict recommendations on symptomatic and preventive treatment of primary headaches in children in Russia often leads to erroneous indications. Inappropriate treatment can result in migraine and tension-type headache course aggravation with the formation of chronic daily headache, development of medicine-induced headache and other undesirable side-effects. The literature review covers the questions of therapy of the main forms of primary headaches in children: migraines and tension-type headaches. In the first part of the article the issues of diagnostics, algorithm of treatment and non-medicinal methods of treatment of headaches are discussed.

BIOFEEDBACK TRAINING AND TENSION-TYPE HEADACHE.

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Šecić, Ana; Cvjeticanin, Timon; Kes, Vanja Bašić

2016-03-01

Biofeedback is a training method, which connects physiological and psychological processes in a person for the purposes of improving his/her physical, emotional, mental and spiritual health. In biofeedback treatment, an active role of the patient is stressed for him/her to be able to actively control the physiological and emotional processes. The aim of biofeedback is to improve the conscious control of the individual's involuntary physiological activity. Research has shown that biofeedback, either applied alone or in combination with other behavioral therapies (techniques), is an effective treatment for various medical and psychological disorders, from headache and hypertension to temporomandibular and attention deficit disorders. More than 90% of adults experience headache once a year, which makes headache one of the most common symptoms and diagnoses in medicine. Tension-type headaches occur in at least 40% of the population and their impact on the health insurance costs and diminished productivity is significant. Studies have shown that clinical biofeedback training is effective in treating headaches. Moreover, the authors stress the need for additional research and further development of methodology for this kind of research.

Acute tension type headache, cognitive function and mood

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Andrew Paul Smith

2016-03-01

Full Text Available Background/Aims: Research has shown that migraine is often associated with memory problems. There have, however, been few studies of tension type headache (TTH and cognition. People who report frequent headaches often report high levels of negative affect. However, less is known about the acute effects of tension type headache on mood. To address these gaps in our knowledge, two studies examined the effects of acute TTH on cognitive performance and mood. Methods: Both studies involved one group of participants completing a battery of tasks when they had a TTH and when they had no headache. Another group (the control was headache free on both occasions. Duration of the headache was greater than 30 minutes and less than 4 hours. In the no headache condition the participants were headache free for at least 24 hours. In the first study 12 participants (6 with TTH, 6 controls completed a computerised battery measuring mood and aspects of cognition. In the second study 22 participants (7 TTH, 5 after TTH and10 controls completed paper and pencil mood and cognitive tasks.Results: In the first study having a headache was associated with an increase in negative affect both before and after the tasks. Three performance tasks showed impairments when the participants had headaches: logical reasoning was slower and less accurate; retrieval from semantic memory was slower; and reaction times in the categoric search task were slower. Results from the second study confirmed the global increase in negative affect when the person has a TTH. The results confirmed the impairments in the logical reasoning and semantic processing tasks and also showed that those with a TTH had greater psychomotor slowing and were more easily distracted. Effects did not continue after the headache had gone.Conclusions: Two small-scale studies have shown that TTH is associated with negative affect and impaired cognitive function. It is now of interest to determine whether OTC treatment

Pain Sensitivity Mediates The Relationship between Stress and Headache Intensity in Chronic Tension-Type Headache

OpenAIRE

Stuart Cathcart; Navjot Bhullar; Maarten Immink; Chris Della Vedova; John Hayball

2012-01-01

BACKGROUND: A central model for chronic tension-type headache (CTH) posits that stress contributes to headache, in part, by aggravating existing hyperalgesia in CTH sufferers. The prediction from this model that pain sensitivity mediates the relationship between stress and headache activity has not yet been examined.OBJECTIVE: To determine whether pain sensitivity mediates the relationship between stress and prospective headache activity in CTH sufferers.METHOD: Self-reported stress, pain sen...

Treating Chronic Tension-type Headache Not Responding to Amitriptyline Hydrochloride With Paroxetine Hydrochloride: A Pilot Evaluation

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Holroyd, Kenneth A.; Labus, Jennifer S.; O'Donnell, Francis J.; Cordingley, Gary E.

2007-01-01

Context In some individuals, chronic tension-type headache fails to respond to tricyclic antidepressant medications that often serve as first-line therapy. Objective To evaluate the clinical efficacy of paroxetine hydrochloride for chronic tension-type headache not responding to amitriptyline hydrochloride. Design and Setting Open-label trial of paroxetine conducted at 2 outpatient sites in Ohio. Participants and Intervention Thirty-one adults (mean age, 37 years; 20 women) with chronic tension-type headache (mean, 25 headache days per month) who had failed to respond (less than 30% improvement) to treatment with either amitriptyline (n = 13) or matched placebo (n = 18). All participants were treated with paroxetine (up to 40 mg per day) in a 9-month protocol. Outcome Measures Monthly headache index calculated as the mean of pain ratings (0 to 10 scale) recorded by participants in a diary 4 times per day, number of days per month with at least moderate pain (pain rating of 5 or greater), and analgesic medication use. Results In patients who had not responded to amitriptyline, paroxetine failed to reduce chronic tension-type headaches or analgesic medication use. In patients who had not responded to placebo, paroxetine produced modest reductions in chronic tension-type headaches and analgesic use. Conclusions We found no evidence that chronic tension-type headaches that failed to respond to tricyclic antidepressant therapy with amitriptyline improved when subsequently treated with paroxetine. More support was found for the efficacy of paroxetine in patients with chronic tension-type headaches who had failed to respond to placebo. PMID:14511278

Evidence for efficacy of acute treatment of episodic tension-type headache

DEFF Research Database (Denmark)

Moore, R Andrew; Derry, Sheena; Wiffen, Philip J

2014-01-01

The International Headache Society (IHS) provides guidance on the conduct of trials for acute treatment of episodic tension-type headache (TTH), a common disorder with considerable disability. Electronic and other searches identified randomised, double-blind trials of oral drugs treating episodic...

Association between tension-type headache and migraine with sleep bruxism: a systematic review.

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De Luca Canto, Graziela; Singh, Vandana; Bigal, Marcelo E; Major, Paul W; Flores-Mir, Carlos

2014-10-01

To evaluate the association between tension-type headache and migraine with sleep bruxism (SB). The association between SB and headaches has been discussed in both children and adults. Although several studies suggested a possible association, no systematic analysis of the available published studies exists to evaluate the quantity, quality, and risk of bias among those studies. A systematic review was undertaken, including articles that classified the headaches according to the International Classification of Headache Disorders and SB according to the criteria of the American Association of Sleep Medicine. Only articles in which the objective was to investigate the association between primary headaches (tension-type and migraine) and SB were selected. Detailed individual search strategies for The Cochrane Library, MEDLINE, EMBASE, PubMed, and LILACS were developed. The reference lists from selected articles were also checked. A partial grey literature search was taken by using Google Scholar. The methodology of selected studies was evaluated using the quality in prognosis studies tool. Of 449 identified citations, only 2 studies, both studying adults, fulfilled the inclusion criteria. The presence of SB significantly increased the odds (study 1: odds ratio [OR] 3.12 [1.25-7.7] and study 2: OR 3.8; 1.83-7.84) for headaches, although studies reported different headache type. There is not enough scientific evidence to either support or refute the association between tension-type headache and migraine with SB in children. Adults with SB appear to be more likely to have headache. © 2014 American Headache Society.

Disseminated neurocysticercosis presenting as affective mood disorder with chronic tension type headache

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Krishnarpan Chatterjee

2013-01-01

Full Text Available Neurocysticercosis is a common parasitic infection in India presenting usually with seizues, headache, focal neurological deficits. Neurocysticercosis presenting as a psychiatric illness is rare. Disseminated cysticercosis with involvement of central nervous system and head and neck muscles is rare even in endemic areas. We present a case of disseminated cysticercosis, which presented with chronic tension type headache and affective mood disorder. Treatment with cysticidal drugs led to complete remission of psychiatric complaints. In endemic areas history suggestive of mood disorder should not be used as supportive evidence of a primary headache syndome like tension type headche without ruling out secondary causes. Making an early diagnosis can prevent morbidity.

Migraine and tension-type headache treated with stromal vascular fraction: a case series.

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Bright, Ralph; Bright, Matthew; Bright, Pelin; Hayne, Shannon; Thomas, Wayne D

2014-06-30

Chronic migraines and tension-type headaches are debilitating diseases affecting 1.4 to 2.2% of the population with both quality of life and economic implications. To date, the pain associated with migraine and tension-type headaches has been controlled with a range of medications, with varying levels of success. In addition, the side-effect profile of these medications, as well as their potential for addiction, has been a cause for concern for both patients and physicians. Four women with long histories of migraine or frequent tension-type headache that meet the International Classification of Headache Disorders criteria for Chronic Migraine or Tension-type Headaches were given a systemic treatment(s) of autologous stromal vascular fraction or autologous 'StroMed' isolated from lipoaspirate. StroMed is stromal vascular fraction cells prepared by ultrasonic cavitation. Two of the four patients, both of whom are Arab women aged 40 and 36 years, ceased having migraines after 1 month, for a period of 12 to 18 months. The third patient, a Slavic woman aged 43 years, had a significant decrease in the frequency and severity of migraines with only seven migraines over 18 months. The fourth patient, an Asian woman aged 44 years, obtained a temporary decrease for a period of a month and was retreated 18 months later and has been free of migraines to date for 1 month. Pain medication was typically reduced from prescribed opioid analgesia to non-steroidal anti-inflammatory drugs and paracetamol. This case series is the first to provide evidence of the efficacy of autologous StroMed and stromal vascular fraction in the treatment of migraine and tension-type headache. The treatment of this disease by stromal vascular fraction adds a new dimension to its clinical applicability and suggests a relatively simple treatment that may help address the symptoms of the disease. Given what is known about the components of the stromal vascular fraction and how they act, the information

Acupuncture for the Prevention of Tension-Type Headache (2016).

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Nielsen, Arya

Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of tension-type headache.Cochrane Database Syst Rev2016, Issue 48. Art No.: CD007587. DOI: 10.1002/14651858.CD007587.pub2. Acupuncture is often used for prevention of tension-type headache but its effectiveness is still controversial. This is an update of our Cochrane review originally published in Issue 1, 2009 of The Cochrane Library. To investigate whether acupuncture is (a) more effective than no prophylactic treatment/routine care only; (b) more effective than "sham" (placebo) acupuncture; and (c) as effective as other interventions in reducing headache frequency in adults with episodic or chronic tension-type headache. We searched CENTRAL, MEDLINE, EMBASE, and AMED to 19 January 2016. We searched the World Health Organization (WHO) International Clinical Trials Registry Platform to 10 February 2016 for ongoing and unpublished trials. We included randomized trials with a post-randomization observation period of at least eight weeks, which compared the clinical effects of an acupuncture intervention with a control (treatment of acute headaches only or routine care), a sham acupuncture intervention or another prophylactic intervention in adults with episodic or chronic tension-type headache. Two review authors checked eligibility; extracted information on participants, interventions, methods and results; and assessed study risk of bias and the quality of the acupuncture intervention. The main efficacy outcome measure was response (at least 50% reduction of headache frequency) after completion of treatment (three to four months after randomization). To assess safety/acceptability we extracted the number of participants dropping out due to adverse effects and the number of participants reporting adverse effects. We assessed the quality of the evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Twelve trials (11 included in the previous version and one newly

Central and peripheral mechanisms in chronic tension-type headache

OpenAIRE

Lipchik, Gay L.; Holroyd, Kenneth A.; France, Christopher R.; Kvaal, Steven A.; Segal, David; Cordingley, Gary E.; Rokicki, Lori A.; McCool, Heidi R.

1996-01-01

The second exteroceptive suppression of masseter muscle activity (ES2) and tenderness in pericranial muscles were evaluated in 112 young adults who met IHS criteria in the following diagnostic classifications: 31 chronic tension headache, 31 episodic tension headache, 33 migraine without aura and 17 migraine with aura. An additional 31 subjects served as controls. Pericranial muscle tenderness better distinguished diagnostic subgroups and better distinguished recurrent headache sufferers from...

MIGRAINE AND TENSION-TYPE HEADACHE IN CHILDREN: THE APPROACH TO EFFECTIVE TREATMENT. PART 2

Directory of Open Access Journals (Sweden)

A. V. Sergeev

2012-01-01

Full Text Available Pediatric neurologists often have to prescribe drugs off-label in children, according to individual approach to every patient and weighing possible benefits and risk of side-effects. Multidisciplinary approach to migraine and tension-type headache treatment in children, including correction of comorbid psychiatric and somatic disorders, is a critical point in decrease of frequency and severity of headaches and normalization of everyday children’s activity. In the second part of the article the authors discuss the problems of symptomatic (episodic drugs taking in order to arrest a headache attack and preventive (regular prolonged drug taking directed on decrease of frequency and severity of headaches medical treatment of migraine and tension-type headaches in pediatric practice.

Treatment of tension-type headache: from old myths to modern concepts.

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Barbanti, P; Egeo, G; Aurilia, C; Fofi, L

2014-05-01

Tension-type headache (TTH) is the second most common human disease, accounting for intense disability, high costs and numerous workdays lost. Tension-type headache is less simple and easy-to-treat than commonly thought. Antidepressants, despite their poor tolerability, are still the first-choice drugs for preventing TTH. The most widely studied non-pharmacological approach to TTH, cognitive-behavioral techniques, effectively relieve pain only in selected patients. The most frequently used and recommended treatments for acute TTH, NSAIDs and paracetamol have scarce efficacy as documented by their low therapeutic gain over placebo in the 2-h pain-free response. Their effectiveness may be increased by a more proper use and by the adjunction of caffeine, antiemetics, myorelaxants or tranquillizers but the risk of medication-overuse headache must be considered. Hence, the need for more effective and tailored treatments in TTH remains.

Treatment of chronic tension-type headache with botulinum toxin: a double-blind, placebo-controlled clinical trial

NARCIS (Netherlands)

Padberg, M.; de Bruijn, S. F. T. M.; de Haan, R. J.; Tavy, D. L. J.

2004-01-01

Botulinum toxin is increasingly advocated as effective treatment in chronic tension-type headache. We conducted a randomized, placebo-controlled clinical trial to prove efficacy of botulinum toxin in chronic tension-type headache. Patients were randomly assigned to receive botulinum toxin (maximum

Tension headache.

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Ziegler, D K

1978-05-01

Headache is an extremely common symptom, and many headaches undoubtedly have a relationship to stressful situations. The clear definition, however, of a "tension headache" complex and its differentiation from migraine in some patients is difficult. The problems are in the identification of a specific headache pattern induced by stress or "tension" and the relationship of the symptom to involuntary contraction of neck and scalp muscles. Treatment consists of analgesics and occasionally mild tranquilizers. Psychotherapy consists of reassurance and often other supportive measures, including modification of life styles. Various feedback techniques have been reported of value, but their superiority to suggestion and hypnosis is still problematic.

Acupuncture for the prevention of tension-type headache.

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Linde, Klaus; Allais, Gianni; Brinkhaus, Benno; Fei, Yutong; Mehring, Michael; Shin, Byung-Cheul; Vickers, Andrew; White, Adrian R

2016-04-19

Acupuncture is often used for prevention of tension-type headache but its effectiveness is still controversial. This is an update of our Cochrane review originally published in Issue 1, 2009 of The Cochrane Library. To investigate whether acupuncture is a) more effective than no prophylactic treatment/routine care only; b) more effective than 'sham' (placebo) acupuncture; and c) as effective as other interventions in reducing headache frequency in adults with episodic or chronic tension-type headache. We searched CENTRAL, MEDLINE, EMBASE and AMED to 19 January 2016. We searched the World Health Organization (WHO) International Clinical Trials Registry Platform to 10 February 2016 for ongoing and unpublished trials. We included randomised trials with a post-randomisation observation period of at least eight weeks, which compared the clinical effects of an acupuncture intervention with a control (treatment of acute headaches only or routine care), a sham acupuncture intervention or another prophylactic intervention in adults with episodic or chronic tension-type headache. Two review authors checked eligibility; extracted information on participants, interventions, methods and results; and assessed study risk of bias and the quality of the acupuncture intervention. The main efficacy outcome measure was response (at least 50% reduction of headache frequency) after completion of treatment (three to four months after randomisation). To assess safety/acceptability we extracted the number of participants dropping out due to adverse effects and the number of participants reporting adverse effects. We assessed the quality of the evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation). Twelve trials (11 included in the previous version and one newly identified) with 2349 participants (median 56, range 10 to 1265) met the inclusion criteria.Acupuncture was compared with routine care or treatment of acute headaches only in two large trials (1265

Acupuncture for the prevention of tension-type headache

Science.gov (United States)

Linde, Klaus; Allais, Gianni; Brinkhaus, Benno; Fei, Yutong; Mehring, Michael; Shin, Byung-Cheul; Vickers, Andrew; White, Adrian R

2016-01-01

Background Acupuncture is often used for prevention of tension-type headache but its effectiveness is still controversial. This is an update of our Cochrane review originally published in Issue 1, 2009 of The Cochrane Library. Objectives To investigate whether acupuncture is a) more effective than no prophylactic treatment/routine care only; b) more effective than ‘sham’ (placebo) acupuncture; and c) as effective as other interventions in reducing headache frequency in adults with episodic or chronic tension-type headache. Search methods We searched CENTRAL, MEDLINE, EMBASE and AMED to 19 January 2016. We searched the World Health Organization (WHO) International Clinical Trials Registry Platform to 10 February 2016 for ongoing and unpublished trials. Selection criteria We included randomised trials with a post-randomisation observation period of at least eight weeks, which compared the clinical effects of an acupuncture intervention with a control (treatment of acute headaches only or routine care), a sham acupuncture intervention or another prophylactic intervention in adults with episodic or chronic tension-type headache. Data collection and analysis Two review authors checked eligibility; extracted information on participants, interventions, methods and results; and assessed study risk of bias and the quality of the acupuncture intervention. The main efficacy outcome measure was response (at least 50% reduction of headache frequency) after completion of treatment (three to four months after randomisation). To assess safety/acceptability we extracted the number of participants dropping out due to adverse effects and the number of participants reporting adverse effects. We assessed the quality of the evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation). Main results Twelve trials (11 included in the previous version and one newly identified) with 2349 participants (median 56, range 10 to 1265) met the inclusion criteria

Effect of manual therapy techniques on headache disability in patients with tension-type headache. Randomized controlled trial.

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Espí-López, G V; Rodríguez-Blanco, C; Oliva-Pascual-Vaca, A; Benítez-Martínez, J C; Lluch, E; Falla, D

2014-12-01

Tension-type headache (TTH) is the most common type of primary headache however there is no clear evidence as to which specific treatment is most effective or whether combined treatment is more effective than individual treatments. To assess the effectiveness of manual therapy techniques, applied to the suboccipital region, on aspects of disability in a sample of patients with tension-type headache. Randomized Controlled Trial. Specialized centre for headache treatment. Seventy-six (62 women) patients (age: 39.9 ± 10.9 years) with episodic chronic TTH. Patients were randomly divided into four treatment groups: 1) suboccipital soft tissue inhibition; 2) occiput-atlas-axis manipulation; 3) combined treatment of both techniques; 4) control. Four sessions were applied over 4 weeks and disability was assessed before and after treatment using the Headache Disability Inventory (HDI). Headache frequency, severity and the functional and emotional subscales of the questionnaire were assessed. Photophobia, phonophobia and pericranial tenderness were also monitored. Headache frequency was significantly reduced with the manipulative and combined treatment (Ptreatment groups (Ptreatment also reduced the score on the emotional subscale of the HDI (Ptreatments were combined, effectiveness was noted for all aspects of disability and other symptoms including photophobia, phonophobia and pericranial tenderness. Although individual manual therapy treatments showed a positive change in headache features, measures of photophobia, photophobia and pericranial tenderness only improved in the group that received the combined treatment suggesting that combined treatment is the most appropriate for symptomatic relief of TTH.

Treating tension-type headache -- an expert opinion

DEFF Research Database (Denmark)

Bendtsen, Lars; Jensen, Rigmor

2011-01-01

INTRODUCTION: Tension-type headache (TTH) is a highly prevalent disorder with enormous costs for the individual and the society. AREAS COVERED: Nonpharmacological and pharmacological treatments are reviewed. Electromyographic (EMG) biofeedback has a documented effect in TTH, while cognitive-behav...... and clarify how treatment programs can be optimized and combined to best suit the individual patient. Frequent TTH may be difficult to treat, but an acceptable result can usually be obtained by a combination of nonpharmacological and pharmacological treatments....

Hypnotic relaxation vs amitriptyline for tension-type headache: let the patient choose.

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Ezra, Yacov; Gotkine, Marc; Goldman, Sylvie; Adahan, Haim Moshe; Ben-Hur, Tamir

2012-05-01

Although both pharmacological and behavioral interventions may relieve tension-type headache, data are lacking regarding treatment preference, long-term patient compliance, and feasibility of behavioral intervention in a standard neurological outpatient clinic setting. To describe patient choice, long-term compliance, and clinical outcome in a neurological clinic setting where patients are given the choice of the approach they wish to pursue. Patients presenting to the headache clinic with a diagnosis of tension-type headache that justified prophylactic therapy (frequent episodic tension-type headache or chronic tension-type headache) were given the choice of amitriptyline (AMT) treatment or hypnotic relaxation (HR), and were treated accordingly. Patients were given the option to cross-over to the other treatment group at each visit. HR was performed during standard length neurology clinic appointments by a neurologist trained to perform hypnosis (Y.E.). Follow-up interviews were performed between 6 and 12 months following treatment initiation to evaluate patient compliance, changes in headache frequency or severity, and quality-of-life parameters. Ninety-eight patients were enrolled, 92 agreed to receive prophylactic therapy of some kind. Fifty-three (57.6%) patients chose HR of which 36 (67.9%) actually initiated this treatment, while 39 (42.4%) chose pharmacological therapy with AMT of which 25 (64.1%) patients actually initiated therapy. Patients with greater analgesic use were more likely to opt for AMT (P= .0002). Eleven of the patients initially choosing AMT and 2 of the patients initially choosing HR crossed over to the other group. Seventy-four percent of the patients in the HR group and 58% of patients in the AMT group had a 50% reduction in the frequency of headaches (P= .16). Long-term adherence to treatment with HR exceeded that of AMT. At the end of the study period, 26 of 47 patients who tried HR compared with 10 of 27 who tried AMT continued

Psychosocial factors associated with migraine and tension-type headache in medical students

DEFF Research Database (Denmark)

Lebedeva, Elena R; Kobzeva, Natalia R; Gilev, Denis V

2017-01-01

BACKGROUND: In our previous study of workers, blood donors and medical students, students stood out with a higher 1-year prevalence of migraine (28%) and tension-type headache (TTH) (74%). General factors associated with headache were common for all groups except low physical activity. The hypoth...

Occlusal stabilization splint therapy in orofacial pain and tension-type headache.

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Kostrzewa-Janicka, J; Mierzwinska-Nastalska, E; Rolski, D; Szczyrek, P

2013-01-01

Studies suggest an association between orofacial pain, accompanying temporomandibular disorders of myogenous origin, and headache, especially its tension-type. The occlusal appliance therapy is one of the options for the treatment of orofacial pain due to masticatory muscles tenderness. The aim of the present study was to assess the effectiveness of occlusal stabilization splint therapy in myofascial pain and tension-type headache in patients with sleep-disordered breathing. Forty three such patients were enrolled into the study group. The patients were treated with stabilization occlusal splint of vertical thickness at vertical jaw separation, established individually for each patient using a cephalometric analysis. The intensity of orofacial pain (numeric rating scale) and headache (analog rating scale), frequency of headache (%), and jaw qualitative function were assessed at baseline and after 2 and 6 months. Medians of headache and orofacial pain intensity were reduced after 6 months of treatment compared with baseline: 6.0 vs. 2.0 (p Pain decreased below 3 score points in 61.8 % of the patients with headache (p = 0.23) and in 85.3 % of patients with orofacial pain (p orofacial pain was observed 81.4 % of patients after using occlusal stabilization splint for 6 months. We conclude that occlusal stabilization splint was effective in reducing painful symptoms of temporomandibular disorders of myogenous origin, a frequent feature of sleep disordered breathing.

Pain perception studies in tension-type headache

DEFF Research Database (Denmark)

Bezov, David; Ashina, Sait; Jensen, Rigmor

2011-01-01

Tension-type headache (TTH) is a disorder with high prevalence and significant impact on society. Understanding of pathophysiology of TTH is paramount for development of effective treatments and prevention of chronification of TTH. Our aim was to review the findings from pain perception studies...... of pathophysiology of TTH as well as to review the research of pathophysiology of TTH. Pain perception studies such as measurement of muscle tenderness, pain detection thresholds, pain tolerance thresholds, pain response to suprathreshold stimulation, temporal summation and diffuse noxious inhibitory control (DNIC...... to integrate pain perception and imaging to confirm this finding. Pharmacological studies have shown that drugs like tricyclic anti-depressant amitriptyline and nitric oxide synthase inhibitors can reverse central sensitization and the chronicity of headache. Finally, low frequency electrical stimulation has...

Associations between stress and migraine and tension-type headache: results from a school-based study in adolescents from grammar schools in Germany.

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Milde-Busch, Astrid; Blaschek, Astrid; Heinen, Florian; Borggräfe, Ingo; Koerte, Inga; Straube, Andreas; Schankin, Christoph; von Kries, Rüdiger

2011-05-01

Stress is considered the major contributor to migraine and tension-type headache in adolescents. Previous studies have focused on general stressors, whereas the aim of the present study was to investigate associations between individuals' stressful experiences and different types of headache. Adolescents from 10th and 11th grades of grammar schools filled in questionnaires. Stressful experiences were measured with the Trier Inventory of Chronic Stress. Type of headache was classified according to the International Classification of Headache Disorders. Linear regressions, adjusted for sex and grade, were calculated to estimate differences in stress scores that can be attributed to migraine, tension-type headache or miscellaneous headache. A total of 1260 questionnaires were analysed. Tension-type headache, migraine and co-existing migraine plus tension-type headache were found in 48.7%, 10.2% and 19.8% of the participants. In subjects with migraine or co-existing migraine plus tension-type headache, high increases in stress scores were found in all investigated dimensions, whereas much weaker and inconsistent associations were found in subjects with tension-type headache only. The characteristic of migraine is more associated with stressful experiences than this is the case for tension-type headache. This suggests that adolescent migraine patients might especially benefit from behavioural interventions regarding stress.

Role of Acupuncture in the Treatment or Prevention of Migraine, Tension-Type Headache, or Chronic Headache Disorders.

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Coeytaux, Remy R; Befus, Deanna

2016-07-01

To summarize the current evidence that evaluates the effectiveness of acupuncture for the treatment or prevention of migraine, tension-type headache, and chronic headache disorders. Findings from selected systematic reviews and meta-analyses are summarized. Recently published systematic reviews and meta-analyses demonstrate that acupuncture is associated with improved clinical outcomes compared to routine care only, medical management, and sham acupuncture 2 months after randomization. The evidence in support of acupuncture's comparative effectiveness at longer follow-up periods is mixed. Cost effectiveness analyses conducted in the United Kingdom and Germany suggest that acupuncture is a cost-effective treatment option in those countries. There are few or no cost-effectiveness studies of acupuncture in the United States. This brief review of the current, published evidence does not include a discussion of potential risks or adverse events associated with acupuncture. There is also the question of the extent to which placebo effects might contribute to acupuncture's clinical effectiveness. From a purely comparative effectiveness perspective, however, the evidence from clinical trials and meta-analyses makes a compelling case in support of a potentially important role for acupuncture as part of a treatment plan for patients with migraine, tension-type headache, and several different types of chronic headache disorders. © 2016 American Headache Society.

Pain sensitivity mediates the relationship between stress and headache intensity in chronic tension-type headache.

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Cathcart, Stuart; Bhullar, Navjot; Immink, Maarten; Della Vedova, Chris; Hayball, John

2012-01-01

A central model for chronic tension-type headache (CTH) posits that stress contributes to headache, in part, by aggravating existing hyperalgesia in CTH sufferers. The prediction from this model that pain sensitivity mediates the relationship between stress and headache activity has not yet been examined. To determine whether pain sensitivity mediates the relationship between stress and prospective headache activity in CTH sufferers. Self-reported stress, pain sensitivity and prospective headache activity were measured in 53 CTH sufferers recruited from the general population. Pain sensitivity was modelled as a mediator between stress and headache activity, and tested using a nonparametric bootstrap analysis. Pain sensitivity significantly mediated the relationship between stress and headache intensity. The results of the present study support the central model for CTH, which posits that stress contributes to headache, in part, by aggravating existing hyperalgesia in CTH sufferers. Implications for the mechanisms and treatment of CTH are discussed.

Pain sensitivity and pericranial tenderness in children with tension-type headache: a controlled study

DEFF Research Database (Denmark)

Soee, ABL; Skov, L; Kreiner, S

2013-01-01

To compare tenderness and pain sensitivity in children (aged 7-17 years) with tension-type headache (TTH) and healthy controls using total tenderness score (TTS), pressure pain threshold (PPT), and pain perceived at suprapressure pain threshold (supraPPT).......To compare tenderness and pain sensitivity in children (aged 7-17 years) with tension-type headache (TTH) and healthy controls using total tenderness score (TTS), pressure pain threshold (PPT), and pain perceived at suprapressure pain threshold (supraPPT)....

Incidence of migraine and tension-type headache in three different populations at risk within the German DMKG headache study.

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Khil, Laura; Pfaffenrath, Volker; Straube, Andreas; Evers, Stefan; Berger, Klaus

2012-03-01

Unlike the prevalence, the incidence of headache disorders has attracted only little attention in epidemiological research. Different definitions of the 'population at risk' among the few published migraine and tension-type headache incidence studies limit their comparability and warrant further research. Therefore, we analysed data from the German Migraine and Headache Society (DMKG). Incidences were assessed in the general population in Germany via standardized headache questions using the International Classification of Headache Disorders, 2nd Edition (ICHD-2). The population was drawn from a 5-year age-group- stratified and gender-stratified random sample from the population register. Of the 1312 baseline participants examined between 2003 and 2004, 1122 (85.5%) participated in the follow-up in 2006 and were the basis for three different populations at risk. We found that the three populations differed in size, age, gender and incidence estimate. The total sample incidence of migraine ranged between 0% and 3.3% and of tension-type headache between 5.3% and 9.2% depending on the definition of 'at risk'. We concluded that one significant problem in headache incidence estimation is the definition of 'at risk', limiting comparability. Thus, this study supports the need for a common definition for prospective headache incidence estimations.

The role of muscles in tension-type headache

DEFF Research Database (Denmark)

Bendtsen, Lars; Fernández-de-la-Peñas, César

2011-01-01

The tenderness of pericranial myofascial tissues and number of myofascial trigger points are considerably increased in patients with tension-type headache (TTH). Mechanisms responsible for the increased myofascial pain sensitivity have been studied extensively. Peripheral activation...... to prolonged nociceptive stimuli from pericranial myofascial tissues seem to be responsible for the conversion of episodic to chronic TTH. Treatment directed toward muscular factors include electromyography biofeedback, which has a documented effect in patients with TTH, as well as physiotherapy and muscle...

Incidental Treatment of a Subclinical Chronic Tension-Type Headache by Cosmetic Use of Botulinum Toxin A: A Case Report

Directory of Open Access Journals (Sweden)

Iselin Saltvig

2017-11-01

Full Text Available Background: Headache is a common disorder of the nervous system; chronic headache in particular may affect quality of life negatively. The pathophysiology is multifactorial and not completely elucidated. Studies have demonstrated the beneficial effects of botulinum toxin A on chronic migraine headaches, but failed to show the same effect on chronic tension-type headaches. Methods: We present the case of a 32-year-old woman who after receiving cosmetic injections with botulinum toxin A for fine lines of the forehead experienced relief of subclinical tension-type headaches. Conclusions: Although the effect of botulinum toxin A on chronic tension-type headaches is limited, several studies demonstrate its pain-modulating effects, and as such it is worth paying attention to this potential beneficial effect when performing cosmetic injections with botulinum toxin A.

Level of physical activity, well-being, stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain.

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Krøll, Lotte Skytte; Hammarlund, Catharina Sjödahl; Westergaard, Maria Lurenda; Nielsen, Trine; Sloth, Louise Bönsdorff; Jensen, Rigmor Højland; Gard, Gunvor

2017-12-01

The prevalence of migraine with co-existing tension-type headache and neck pain is high in the general population. However, there is very little literature on the characteristics of these combined conditions. The aim of this study was to investigate a) the prevalence of migraine with co-existing tension-type headache and neck pain in a clinic-based sample, b) the level of physical activity, psychological well-being, perceived stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain compared to healthy controls, c) the perceived ability of persons with migraine and co-existing tension-type headache and neck pain to perform physical activity, and d) which among the three conditions (migraine, tension-type headache or neck pain) is rated as the most burdensome condition. The study was conducted at a tertiary referral specialised headache centre where questionnaires on physical activity, psychological well-being, perceived stress and self-rated health were completed by 148 persons with migraine and 100 healthy controls matched by sex and average age. Semi-structured interviews were conducted to assess characteristics of migraine, tension-type headache and neck pain. Out of 148 persons with migraine, 100 (67%) suffered from co-existing tension-type headache and neck pain. Only 11% suffered from migraine only. Persons with migraine and co-existing tension-type headache and neck pain had lower level of physical activity and psychological well-being, higher level of perceived stress and poorer self-rated health compared to healthy controls. They reported reduced ability to perform physical activity owing to migraine (high degree), tension-type headache (moderate degree) and neck pain (low degree). The most burdensome condition was migraine, followed by tension-type headache and neck pain. Migraine with co-existing tension-type headache and neck pain was highly prevalent in a clinic-based sample. Persons with migraine and co

Psychological distress and tension-type headache among health professional senior students in a historically black university in south africa.

Directory of Open Access Journals (Sweden)

S.L. Amosun

2002-02-01

Full Text Available Studies in well-defined populations contribute to the body ofevidence that the psychosocial aspects of people’s environment can have a substantial effect on their physical health. Senior students in health professional education programs were interviewed using structured instruments to assess the prevalence of psychological distress and tension-type headaches in a young adult university population.  Almost 70%of the study sample was either at risk of becoming distressed, or already distressed with somatic or depressive symptoms. About two-thirds of thestudents reported symptoms of either tension-type headache or other typesof headache, while over 30% of all the students complained of tension-type headache. Almost 20% of the students whoreported symptoms of tension-type headache were also distressed, while another 47% were at risk of being distressed.The possible impact on the academic performance of the students and their future role as health care professionalsis discussed.

Effectiveness of Physical Therapy in Patients with Tension-type Headache: Literature Review.

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Espí-López, Gemma Victoria; Arnal-Gómez, Anna; Arbós-Berenguer, Teresa; González, Ángel Arturo López; Vicente-Herrero, Teófila

2014-01-01

Tension-type headache (TTH) is a disease with a great incidence on quality of life and with a significant socioeconomic impact. The aim of this review is to determine the effectiveness of physical therapy by using manual therapy (MT) for the relief of TTH. A review was done identifying randomized controlled trials through searches in MEDLINE, PEDro, Cochrane and CINAHL (January 2002 - April 2012). English-language studies, with adult patients and number of subjects not under 11, diagnosed with episodic tension-type headache (ETTH) and chronic tension-type headache (CTTH) were included. Initial search was undertaken with the words Effectiveness, Tension-type headache, and Manual therapy (39 studies). In addition, a search which included terms related to treatments such as physiotherapy, physical therapy, spinal manipulation was performed (25 studies). From the two searches 9 studies met the inclusion criteria and were analysed finding statistically significant results: 1) myofascial release, cervical traction, neck muscles trigger points in cervical thoracic muscles and stretching; 2) Superficial heat and massage, connective tissue manipulation and vertebral Cyriax mobilization; 3) cervical or thoracic spinal manipulation and cervical chin-occipital manual traction; 4) massage, progressive relaxation and gentle stretching, program of active exercises of shoulder, neck and pericranial muscles; 5) massage, passive rhythmic mobilization techniques, cervical, thoracic and lumbopelvic postural correction and cranio-cervical exercises; 6) progressive muscular relaxation combined with joint mobilization, functional, muscle energy, and strain/counterstrain techniques, and cranial osteopathic treatment; 7) massage focused on relieving myofascial trigger point activity; 8) pressure release and muscle energy in suboccipital muscles; 9) combination of mobilizations of the cervical and thoracic spine, exercises and postural correction. All studies used a combination of different

The effect of trigger point management by positional release therapy on tension type headache.

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Ghanbari, Ali; Rahimijaberi, Abbas; Mohamadi, Marzieh; Abbasi, Leila; Sarvestani, Fahimeh Kamali

2012-01-01

The aim of this study was to compare the effectiveness of trigger points' management by Positional Release Therapy (PRT) and routine medical therapy in treatment of Tension Type Headache. Tension Type Headache is the most frequent headache with the basis of myofascial and trigger point disorders. PRT is an indirect technique that treats trigger points. 30 Patients with active trigger points in cervical muscles entered to the study. They were randomly assigned to PRT or medical therapy group. Headache frequency, intensity and duration and tablet count were recorded by use of a daily headache diary. Sensitivity of trigger points was assessed by numeric pain intensity and by use of a digital force gauge (FG 5020). Both groups showed significant reduction in headache frequency and duration and tablet count after treatment phase. However, the reduction of study variables was persisted only in PRT group after follow up phase. There was no significant reduction in headache intensity, neither in PRT and nor in medication group. Sensitivity of trigger points was significantly reduced. In comparison of the two study groups, there was no significant difference in headache frequency, intensity, duration and tablet count (p> 0.05). Both procedures were equally effective according to the study. Thus, PRT can be a treatment choice for patients with T.T.H.

Are Migraine and Tension-Type Headache Genetically Related? An Investigation of Twin Family Data

NARCIS (Netherlands)

Ligthart, Lannie; Huijgen, Annemarie; Willemsen, Gonneke; De Geus, Eco J.C.; Boomsma, Dorret I.

Migraine and tension-type headache (TTH) are often viewed as distinct entities and defined as such in the International Classification of Headache Disorders, 2nd edition (ICHD-II) criteria, although there is also empirical evidence to suggest they may be etiologically similar. This study aims to

Altered pain perception in children with chronic tension-type headache: Is this a sign of central sensitisation?

DEFF Research Database (Denmark)

Soee, AL; Thomsen, LL; Kreiner, S

2013-01-01

The aim of this article is to investigate if children (7-17 years) with frequent episodic tension-type headache (FETTH) or chronic TTH (CTTH) have an altered pain perception compared to healthy controls.......The aim of this article is to investigate if children (7-17 years) with frequent episodic tension-type headache (FETTH) or chronic TTH (CTTH) have an altered pain perception compared to healthy controls....

Is There a Relation between Tension-Type Headache, Temporomandibular Disorders and Sleep?

OpenAIRE

Caspersen, N.; Hirsvang, J. R.; Kroell, L.; Jadidi, F.; Baad-Hansen, L.; Svensson, P.; Jensen, R.

2013-01-01

Introduction. Tension-Type Headache (TTH) is the most prevalent headache often associated with impaired function and quality of life. Temporomandibular Disorders (TMD) and TTH frequently coexist; characterized by pericranial tenderness and impact on daily life. We aim to apply a standardized questionnaire for TMD to characterize and analyse an eventual relation between sleep and oral health in TTH in a controlled design. Material and Methods. 58 consecutive TTH patients and 58 healthy control...

Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) for the prevention of tension-type headache in adults.

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Banzi, Rita; Cusi, Cristina; Randazzo, Concetta; Sterzi, Roberto; Tedesco, Dario; Moja, Lorenzo

2015-05-01

This is an updated version of the Cochrane review published in 2005 on selective serotonin re-uptake inhibitors (SSRIs) for preventing migraine and tension-type headache. The original review has been split in two parts and this review now only regards tension-type headache prevention. Another updated review covers migraine. Tension-type headache is the second most common disorder worldwide and has high social and economic relevance. As serotonin and other neurotransmitters may have a role in pain mechanisms, SSRIs and serotonin-norepinephrine reuptake inhibitors (SNRIs) have been evaluated for the prevention of tension-type headache. To determine the efficacy and tolerability of SSRIs and SNRIs compared to placebo and other active interventions in the prevention of episodic and chronic tension-type headache in adults. For the original review, we searched the Cochrane Central Register of Controlled Trials (CENTRAL 2003, Issue 4), MEDLINE (1966 to January 2004), EMBASE (1994 to May 2003), and Headache Quarterly (1990 to 2003). For this update, we revised the original search strategy to reflect the broader type of intervention (SSRIs and SNRIs). We searched CENTRAL (2014, Issue 10) on the Cochrane Library, MEDLINE (1946 to November 2014), EMBASE (1980 to November 2014), and PsycINFO (1987 to November 2014). We also checked the reference lists of retrieved articles and searched trial registries for ongoing trials. We included randomised controlled trials comparing SSRIs or SNRIs with any type of control intervention in participants 18 years and older, of either sex, with tension-type headache. Two authors independently extracted data (headache frequency, index, intensity, and duration; use of symptomatic/analgesic medication; quality of life; and withdrawals) and assessed the risk of bias of trials. The primary outcome is tension-type headache frequency, measured by the number of headache attacks or the number of days with headache per evaluation period. The original

Autogenic training for tension type headaches: a systematic review of controlled trials.

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Kanji, N; White, A R; Ernst, E

2006-06-01

To determine from the published evidence whether autogenic training as sole therapy is effective for prevention of tension-type headaches in adults. Systematic review of controlled trials. Literature searches were performed in January 2005 in six major databases, specifically Medline, EMBASE, AMED, CENTRAL, PsychInfo and CINAHL and information was extracted and evaluated in a pre-defined manner. Seven controlled clinical trials were included in the review. The methodological quality of these studies was low. Patient samples were generally representative of the more severely affected cases. None of the studies show autogenic training to be convincingly superior to other interventions care. Some trials suggested that the effect of autogenic training is no different from hypnosis and inferior to biofeedback. There is no consistent evidence to suggest that autogenic training is superior to other interventions for prevention of tension headaches, or different from other forms of relaxation. Further studies should investigate the use of standard autogenic training in patients with moderate headache.

Multimodal manual therapy vs. pharmacological care for management of tension type headache: A meta-analysis of randomized trials.

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Mesa-Jiménez, Juan A; Lozano-López, Cristina; Angulo-Díaz-Parreño, Santiago; Rodríguez-Fernández, Ángel L; De-la-Hoz-Aizpurua, Jose L; Fernández-de-Las-Peñas, Cesar

2015-12-01

Manual therapies are generally requested by patients with tension type headache. To compare the efficacy of multimodal manual therapy vs. pharmacological care for the management of tension type headache pain by conducting a meta-analysis of randomized controlled trials. PubMed, MEDLINE, EMBASE, AMED, CINAHL, EBSCO, Cochrane Database of Systematic Reviews, Cochrane Collaboration Trials Register, PEDro and SCOPUS were searched from their inception until June 2014. All randomized controlled trials comparing any manual therapy vs. medication care for treating tension type headache adults were included. Data were extracted and methodological quality assessed independently by two reviewers. We pooled headache frequency as the main outcome and also intensity and duration. The weighted mean difference between manual therapy and pharmacological care was used to determine effect sizes. Five randomized controlled trials met our inclusion criteria and were included in the meta-analysis. Pooled analyses found that manual therapies were more effective than pharmacological care in reducing frequency (weighted mean difference -0.8036, 95% confidence interval -1.66 to -0.44; three trials), intensity (weighted mean difference -0.5974, 95% confidence interval -0.8875 to -0.3073; five trials) and duration (weighted mean difference -0.5558, 95% confidence interval -0.9124 to -0.1992; three trials) of the headache immediately after treatment. No differences were found at longer follow-up for headache intensity (weighted mean difference -0.3498, 95% confidence interval -1.106 to 0.407; three trials). Manual therapies were associated with moderate effectiveness at short term, but similar effectiveness at longer follow-up for reducing headache frequency, intensity and duration in tension type headache than pharmacological medical drug care. However, due to the heterogeneity of the interventions, these results should be considered with caution at this stage. © International Headache

Changes in Clinical Parameters in Patients with Tension-type Headache Following Massage Therapy: A Pilot Study

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Moraska, Albert; Chandler, Clint

2008-01-01

Complementary and alternative medicine approaches to treatment for tension-type headache are increasingly popular among patients, but evidence supporting its efficacy is limited. The objective of this study was to assess short term changes on primary and secondary headache pain measures in patients with tension-type headache (TTH) receiving a structured massage therapy program with a focus on myofascial trigger point therapy. Participants were enrolled in an open label trial using a baseline control with four 3-week phases: baseline, massage (two 3-week phases) and follow-up. Twice weekly, 45-minute massage sessions commenced following the baseline phase. A daily headache diary was maintained throughout the study in which participants recorded headache incidence, intensity, and duration. The Headache Disability Index was administered upon study entry and at 3-week intervals thereafter. 18 subjects were enrolled with 16 completing all headache diary, evaluation, and massage assignments. Study participants reported a median of 7.5 years with TTH. Headache frequency decreased from 4.7±0.7 episodes per week during baseline to 3.7±0.9 during treatment period 2 (Pmassage therapy that targets myofascial trigger points, suggesting the need for more rigorously controlled studies. PMID:19119396

The efficiency of botulinum toxin type A for the treatment of masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache.

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Pihut, Malgorzata; Ferendiuk, Ewa; Szewczyk, Michal; Kasprzyk, Katarzyna; Wieckiewicz, Mieszko

2016-01-01

Temporomandibular joint dysfunction are often accompanied by symptoms of headache such as tension-type headache which is the most frequent spontaneous primary headache. Masseter muscle pain is commonly reported in this group. The purpose of the study was to assess the efficiency of intramuscular botulinum toxin type A injections for treating masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache. This prospective outcome study consisted of 42 subjects of both genders aged 19-48 years diagnosed with masseter muscle pain related to temporomandibular joint dysfunction and tension-type headache. The subjects were treated by the intramuscular injection of 21 U (mice units) of botulinum toxin type A (Botox, Allergan) in the area of the greatest cross-section surface of both masseter bellies. Pain intensity was evaluated using visual analogue scale (VAS) and verbal numerical rating scale (VNRS) 1 week before the treatment and 24 weeks after the treatment. The obtained data were analyzed using the Wilcoxon matched pairs test (p ≤ 0,005). The results of this study showed a decrease in the number of referred pain episodes including a decrease in pain in the temporal region bilaterally, a reduction of analgesic drugs intake as well as a decrease in reported values of VAS and VNRS after injections (p = 0,000). The intramuscular botulinum toxin type A injections have been an efficient method of treatment for masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache.

Cardiovascular responses to cognitive stress in patients with migraine and tension-type headache

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Nilsen Kristian B

2007-08-01

Full Text Available Abstract Background The purpose of this study was to investigate the temporal relationship between autonomic changes and pain activation in migraine and tension-type headache induced by stress in a model relevant for everyday office-work. Methods We measured pain, blood pressure (BP, heart rate (HR and skin blood flow (BF during and after controlled low-grade cognitive stress in 22 migraineurs during headache-free periods, 18 patients with tension-type headache (TTH and 44 healthy controls. The stress lasted for one hour and was followed by 30 minutes of relaxation. Results Cardiovascular responses to cognitive stress in migraine did not differ from those in control subjects. In TTH patients HR was maintained during stress, whereas it decreased for migraineurs and controls. A trend towards a delayed systolic BP response during stress was also observed in TTH. Finger BF recovery was delayed after stress and stress-induced pain was associated with less vasoconstriction in TTH during recovery. Conclusion It is hypothesized that TTH patients have different stress adaptive mechanisms than controls and migraineurs, involving delayed cardiovascular adaptation and reduced pain control system inhibition.

Effect of rajyoga meditation on chronic tension headache.

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Kiran; Girgla, Kawalinder K; Chalana, Harsh; Singh, Harjot

2014-01-01

Chronic tension-type headache (CTTH) is the most common type of headache with no truly effective treatment. This study was designed to correlate the additive effect of meditation on CTTH patients receiving medical treatment. 50 patients (aged 18-58 years) presenting with a clinical diagnosis of CCTH, were divided in 2 groups. Group 1 (n=30) received 8 lessons and practical demonstration of Brahmakumaris spiritual based meditation known as Rajyoga meditation for relaxation therapy, in addition to routine medical treatment (analgesics and muscle relaxants). Group 2 (n=20) patients received analgesics and muscle relaxants twice a day but no relaxation therapy in the form of meditation. Both groups were followed up for 8 weeks period. The parameters studied were severity, frequency and duration of CCTH, and their headache index calculated. Patients in both groups showed a highly significant reduction in headache variables (Pheadache, duration & frequency in Group 1 was 94%, 91% and 97% respectively whereas in Group 2 it was 36%, 36% and 49% respectively. Headache relief as calculated by headache index was 99% in Group 1 as compared to 51% in Group 2. Even Short term spiritual based relaxation therapy (Rajyoga meditation) was highly effective in causing earlier relief in chronic tension headache as measured by headache parameter.

Tricyclic and Tetracyclic Antidepressants for the Prevention of Frequent Episodic or Chronic Tension-Type Headache in Adults: A Systematic Review and Meta-Analysis.

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Jackson, Jeffrey L; Mancuso, Josephine M; Nickoloff, Sarah; Bernstein, Rebecca; Kay, Cynthia

2017-12-01

Tension-type headaches are a common source of pain and suffering. Our purpose was to assess the efficacy of tricyclic (TCA) and tetracyclic antidepressants in the prophylactic treatment of tension-type headache. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, the ISI Web of Science, and clinical trial registries through 11 March 2017 for randomized controlled studies of TCA or tetracyclic antidepressants in the prevention of tension-type headache in adults. Data were pooled using a random effects approach. Among 22 randomized controlled trials, eight included a placebo comparison and 19 compared at least two active treatments. Eight studies compared TCAs to placebo, four compared TCAs to selective serotonin reuptake inhibitors (SSRIs), and two trials compared TCAs to behavioral therapies. Two trials compared tetracyclics to placebo. Single trials compared TCAs to tetracyclics, buspirone, spinal manipulation, transcutaneous electrical stimulation, massage, and intra-oral orthotics. High-quality evidence suggests that TCAs were superior to placebo in reducing headache frequency (weighted mean differences (WMD): -4.8 headaches/month, 95% CI: -6.63 to -2.95) and number of analgesic medications consumed (WMD: -21.0 doses/month, 95% CI: -38.2 to -3.8). TCAs were more effective than SSRIs. Low-quality studies suggest that TCAs are superior to buspirone, but equivalent to behavioral therapy, spinal manipulation, intra-oral orthotics, and massage. Tetracyclics were no better than placebo for chronic tension-type headache. Tricyclic antidepressants are modestly effective in reducing chronic tension-type headache and are superior to buspirone. In limited studies, tetracyclics appear to be ineffective in the prophylactic treatment of chronic tension-type headache.

Treatment of tension-type headache with articulatory and suboccipital soft tissue therapy: A double-blind, randomized, placebo-controlled clinical trial.

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Espí-López, Gemma V; Gómez-Conesa, Antonia; Gómez, Anna Arnal; Martínez, Josep Benítez; Pascual-Vaca, Angel Oliva; Blanco, Cleofás Rodríguez

2014-10-01

This study researches the effectiveness of two manual therapy treatments focused on the suboccipital region for tension-type headache. A randomized double-blind clinical trial was conducted over a period of four weeks with a follow-up at one month. Eighty-four patients with a mean age of 39.7 years (SD 11.4) with tension-type headache were assigned to 4 groups which included the following manual therapy treatment: suboccipital soft tissue inhibition; occiput-atlas-axis global manipulation; combination of both techniques; and a control group. The primary assessment consisted of collecting socio-demographic data and headache characteristics in a one-month base period, data such as age, gender, severity of pain, intensity and frequency of headache, among other. Outcome secondary assessment were: impact of headache, disability, ranges of motion of the craniocervical junction, frequency and intensity of headache, and pericranial tenderness. In the month prior to the study, average pain intensity, was rated at 6.49 (SD 1.69), and 66.7% subjects suffered headaches of moderate intensity. After 8 weeks, statistically significant improvements were noted. OAA manipulative treatment and combined therapy treatments proved to be more effective than suboccipital soft tissue inhibition for tension-type headache. The treatment with suboccipital soft tissue inhibition, despite producing less significant results, also has positive effects on different aspects of headache. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Use of the Cognitive Behavioral Therapy for the Treatment of Migraine and Tension Type Headaches

OpenAIRE

Yasemin Akkoca; Þehnaz Yýldýrým; Levent Ertuðrul Ýnan

2015-01-01

Headache, which affects a large part of the community and causes loss of workforce, is gaining importance in terms of the burden which it brings on the society, by its function of restricting individuals social activities as well as increasing the health expenditure likewise drug consumption. Migraine and tension headaches are primary headaches which any organic causes can not be determined for them. For the treatment of headaches of this type besides the use of medicine, exercises with bio-f...

Migraine and tension type headache in adolescents at grammar school in Germany - burden of disease and health care utilization.

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Albers, Lucia; Straube, Andreas; Landgraf, Mirjam N; Filippopulos, Filipp; Heinen, Florian; von Kries, Rüdiger

2015-01-01

Tension-type headache and migraine are among the most prevalent chronic disorders in children/adolescents. Data on health care utilization for headache in this age group, however, are sparse. In 1399 grammar school students (aged 12-19 years) with headache in the last six months in Germany a) the burden of disease for headache (mean intensity, mean frequency in the last three months and PedMIDAS means), b) medical care utilization defined by proportion of students consulting a physician in the last 12 months and/or taking analgetic drugs in the last three months by headache types (migraine and tension-type headache) and by burden of disease were assessed. Primary headache substantially impaired daily living activities in adolescents which was mainly related to migraine. Medical care utilization and drug use, however, was low (consulting a physician: 12.0 %, 95 %-CI = [10.3-13.8]; taking analgetic drugs: 29.9 %, 95 %-CI = [27.5-32.4]) - even among students with severe headache (physician consultation: headache and 40 % of those with migraine had neither seen a physician nor used analgetic drugs because of their headache in the preceding 12 months. Adolescents with headache might too rarely seek professional help for treatment of headache. Health promotion in adolescents should increase awareness for evidence-based treatment options for headache.

Meta-Analysis of Biofeedback for Tension-Type Headache: Efficacy, Specificity, and Treatment Moderators

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Nestoriuc, Yvonne; Rief, Winfried; Martin, Alexandra

2008-01-01

The aims of the present meta-analysis were to investigate the short- and long-term efficacy, multidimensional outcome, and treatment moderators of biofeedback as a behavioral treatment option for tension-type headache. A literature search identified 74 outcome studies, of which 53 were selected according to predefined inclusion criteria.…

The effects of aerobic exercise for persons with migraine and co-existing tension-type headache and neck pain. A randomized, controlled, clinical trial

DEFF Research Database (Denmark)

Krøll, Lotte Skytte; Hammarlund, Catharina Sjödahl; Linde, Mattias

2018-01-01

Aim To evaluate aerobic exercise in migraine and co-existing tension-type headache and neck pain. Methods Consecutively recruited persons with migraine and co-existing tension-type headache and neck pain were randomized into an exercise group or control group. Aerobic exercise consisted of bike...

Botulinum toxin A is effective to treat tension-type headache caused by hemifacial spasm.

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Mizuma, Atsushi; Nagata, Eiichiro; Yasuda, Takashi; Kouchi, Maiko; Nakayama, Taira; Honma, Kazunari; Tokuoka, Kentaro; Kitagawa, Yasuhisa; Nogawa, Shigeru; Takizawa, Shunya

2017-10-01

We examined the relationship between hemifacial spasm (HFS; a form of cranio-cervical dystonia) and chronic primary headache, including tension-type headache (TTH). We also examined whether botulinum toxin A (BoNT/A) therapy for HFS ameliorates concomitant TTH. Fifty-one HFS patients receiving BoNT/A therapy were recruited. Patients' characteristics (including age, gender, chronic headache history, exercise habits, stiff neck, cervical spondylolysis history), stress factors, worsening/new onset of headache associated with HFS, and dose of BoNT/A were examined. We diagnosed headache types according to The International Classification of Headache Disorders, 3rd edition, beta. Numerical Rating Scale (NRS) and Headache Impact Test-6 (HIT-6) scores for headache severity were compared between the 6-week baseline before BoNT/A therapy and 6-week follow-up after BoNT/A therapy. Of 51 patients with HFS, 17 (33.3%) reported worsening or new onset of headache (especially TTH) associated with HFS (Group-S), and 34 were not aware of headache (Group-N). Twelve patients (70.6%) in group-S reported improvement of headache after BoNT/A therapy. NRS (from 7 [5-9] to 0 [0-5], pheadache (odds ratio 28.53: 2.96-275.10, pheadache, especially TTH, is associated with HFS. BoNT/A therapy for HFS may also be indirectly effective for treatment of TTH. Copyright © 2017 Elsevier Ltd. All rights reserved.

Association Between Chronic Tension-Type Headache Coexistent with Chronic Temporomandibular Disorder Pain and Limitations in Physical and Emotional Functioning: A Case-Control Study.

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Emshoff, Rüdiger; Bertram, Felix; Schnabl, Dagmar; Emshoff, Iris

2017-01-01

To assess the association between chronic tension-type headache coexistent with chronic temporomandibular disorder (TMD) pain and severe limitations in physical and emotional functioning. Sample size estimation was used to determine that this case-control study should include 126 subjects. Subjects suffering from chronic TMD who were aged between 18 and 68 were recruited in routine clinical practice. Of the 126 included subjects, 63 had TMD pain associated with chronic tension-type headache (cases) and 63 had TMD pain without a history of tension-type headache (controls). Clinical diagnosis of TMD was made according to the Research Diagnostic Criteria for TMD (RDC/TMD) Axis I criteria, and clinical diagnosis of headache was made according to the International Classification of Headache (ICHD-II). RDC/TMD Axis II criteria were applied to record the scores from the Graded Chronic Pain Scale (GCPS) and the Symptoms Checklist-90-Revised Depression (SCL-DEP) and Somatization (SCL-SOM) scales. A logistic regression analysis was used to assess the relationship between TMD pain with chronic tension-type headache and high levels of depression and somatization severity as scored on the SCLDEP and SCL-SOM scales, respectively, and high pain-related disability (GCPS grade III or IV). Data were adjusted to take into account age, gender, time since TMD pain onset, chronic TMD pain intensity, and characteristic pain intensity. The presence of chronic tension-type headache was significantly associated with severe SCL-DEP (odds ratio [OR] = 7.2; P headache coexistent with chronic TMD pain and key aspects of physical and emotional functioning reflected in severe depression, severe somatization, and high pain-related disability.

Temporo-mandibular disorders are an important comorbidity of migraine and may be clinically difficult to distinguish them from tension-type headache

Directory of Open Access Journals (Sweden)

Ariovaldo Alberto da Silva Júnior

2014-02-01

Full Text Available Clinical differentiation between the primary headaches and temporomandibular disorders (TMD can be challenging. Objectives : To investigate the relationship between TMD and primary headaches by conducting face to face assessments in patients from an orofacial pain clinic and a headache tertiary center. Method : Sample consists of 289 individuals consecutively identified at a headache center and 78 individuals seen in an orofacial pain clinic because of symptoms suggestive of TMD. Results : Migraine was diagnosed in 79.8% of headache sufferers, in headache tertiary center, and 25.6% of those in orofacial pain clinic (p<0.001. Tension-type headache was present in 20.4% and 46.1%, while the TMD painful occurred in 48.1% and 70.5% respectively (p<0.001. Conclusion : TMD is an important comorbidity of migraine and difficult to distinguish clinically from tension-type headache, and this headache was more frequent in the dental center than at the medical center.

Abnormal pain processing in chronic tension-type headache: a high-density EEG brain mapping study

DEFF Research Database (Denmark)

Buchgreitz, L.; Egsgaard, L.L.; Jensen, R.

2008-01-01

Central sensitization caused by prolonged nociceptive input from muscles is considered to play an important role for chronification of tension-type headache. In the present study we used a new high-density EEG brain mapping technique to investigate spatiotemporal aspects of brain activity...... in response to muscle pain in 19 patients with chronic tension-type headache (CTTH) and 19 healthy, age- and sex-matched controls. Intramuscular electrical stimuli (single and train of five pulses delivered at 2 Hz) were applied to the trapezius muscle and somatosensory evoked potentials were recorded...... with 128-channel EEG both in- and outside a condition with induced tonic neck/shoulder muscle pain (glutamate injection into the trapezius muscle). Significant reduction in magnitude during and after induced tonic muscle pain was found in controls at the P200 dipole in response to both the first (baseline...

Efficacy of manual and manipulative therapy in the perception of pain and cervical motion in patients with tension-type headache: a randomized, controlled clinical trial.

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Espí-López, Gemma V; Gómez-Conesa, Antonia

2014-03-01

The purpose of this study was to evaluate the efficacy of manipulative and manual therapy treatments with regard to pain perception and neck mobility in patients with tension-type headache. A randomized clinical trial was conducted on 84 adults diagnosed with tension-type headache. Eighty-four subjects were enrolled in this study: 68 women and 16 men. Mean age was 39.76 years, ranging from 18 to 65 years. A total of 57.1% were diagnosed with chronic tension-type headache and 42.9% with tension-type headache. Participants were divided into 3 treatment groups (manual therapy, manipulative therapy, a combination of manual and manipulative therapy) and a control group. Four treatment sessions were administered during 4 weeks, with posttreatment assessment and follow-up at 1 month. Cervical ranges of motion pain perception, and frequency and intensity of headaches were assessed. All 3 treatment groups showed significant improvements in the different dimensions of pain perception. Manual therapy and manipulative treatment improved some cervical ranges of motion. Headache frequency was reduced with manipulative treatment (P treatment reported improvement after the treatment (P treatment and at follow-up with manipulative therapy (P treatment (P treatments, administered both separately and combined together, showed efficacy for patients with tension-type headache with regard to pain perception. As for cervical ranges of motion, treatments produced greater effect when separately administered.

Neck and shoulder muscle strength in patients with tension-type headache

DEFF Research Database (Denmark)

Madsen, Bjarne K; Søgaard, Karen; Andersen, Lars L.

2016-01-01

in TTH patients and healthy controls by examining maximal voluntary isometric contraction (MVC) during shoulder abduction, neck flexion and extension as well as the extension/flexion strength ratio of the neck. METHODS: Sixty TTH patients and 30 sex- and age-matched healthy controls were included......INTRODUCTION: Tension-type headache (TTH) is highly prevalent in the general population, and it is characterized by increased muscle tenderness with increasing headache frequency and intensity. AIM: The aim of this case-control study was to compare muscle strength in neck and shoulder muscles....... Patients were included if they had TTH ≥8 days per month. The MVC neck extensor and flexor muscles were tested with the participant seated upright. MVC shoulder abduction was tested with the individual lying supine. RESULTS: Compared to controls TTH patients had significantly weaker muscle strength in neck...

Computer animated relaxation therapy in children between 7 and 13 years with tension-type headache

DEFF Research Database (Denmark)

Tornoe, Birte; Skov, Liselotte

2012-01-01

This pilot study evaluated the effect of computer animated relaxation therapy in children between 7 and 13 years with tension-type headache and the children's experiences with the therapy. The therapy consisted of an uncontrolled nine-session course in modified progressive relaxation therapy assi...

Supraorbital electrical stimulation in management of chronic type tension headache: A randomized controlled study.

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Hamed, Nashwa S

2018-02-01

Headache disorders are considered one of the ten most disabling conditions, for both males and females, according to the World Health Organization. Chronic type tension headache (CTTH) has a prevalence of 2-3% within the general population. The purpose of this research was to investigate the effect of stimulating noninvasively the trigeminal nerve in the supraorbital area (SOES) for treatment of CTTH. In an 8-week period of intervention, 45 patients were divided equally into three groups. Both group A "study" and group B received conventional physical therapy program three times a week. Group A received additional SOES for 20 minutes daily. Group C was on prescribed medications only. Assessments occurred pre and post intervention using Headache Impact Test (HIT), headache frequency, and visual analogue scale (VAS) for pain. In between groups, comparison showed statistically significant differences between all groups (p headache frequencies than group C. SOES had positive therapeutic results for treatment of CTTH.

Central pain processing in chronic tension-type headache

DEFF Research Database (Denmark)

Lindelof, Kim; Ellrich, Jens; Jensen, Rigmor

2009-01-01

OBJECTIVE: Chronic tension-type headache (CTTH) affects 3% of the population. Directly and indirectly it causes high costs and considerable loss of quality of life. The mechanisms of this disorder are poorly understood and the treatment possibilities are therefore limited. The blink reflex (BR......) reflects neuronal excitability due to nociceptive input in the brainstem. The aim of this study was to investigate nociceptive processing at the level of the brainstem in an experimental pain model of CTTH symptoms. METHODS: The effect of conditioning pain, 5 min infusion of hypertonic saline into the neck...... muscles, was investigated in 20 patients with CTTH and 20 healthy controls. In addition, a pilot study with isotonic saline was performed with 5 subjects in each group. The BR was elicited by electrical stimuli with an intensity of four times the pain threshold, with a superficial concentric electrode. We...

Efficacy of strength training on tension-type headache

DEFF Research Database (Denmark)

Madsen, Bjarne K; Søgaard, Karen; Andersen, Lars L

2018-01-01

Background Strength training has shown effects in reducing neck pain. As neck pain is highly prevalent in tension-type headache (TTH), it is relevant to examine the effect of strength training of the shoulder muscles on TTH patients. Aim To examine the effect of strength training of the shoulder....../neck muscles on TTH frequency and duration. Methods Sixty patients with TTH were randomised into strength training or a control group. The strength training group trained ten weeks with elastic resistance bands. The control group performed ergonomic and posture correction. Efficacy was evaluated at follow......-up after 19-22 weeks. Results Twenty-three patients completed strength training and 21 completed ergonomic and posture correction (per-protocol). No between-group effect was detected, but within groups numerical reductions were noted in both groups from baseline to follow-up. Frequency of TTH...

Serum oxidant and antioxidant status of patients with chronic tension-type headache: possible effects of medical treatment.

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Gökçe Çokal, Burcu; Aytaç, Bilal; Durak, Zahide Esra; Güneş, Hafize Nalan; Öztürk, Bahadır; Keskin Güler, Selda; Durak, İlker; Yoldaş, Tahir Kurtuluş

2015-10-01

Tension-type headache (TTH) is one of the most common and costly primary types of headache in clinical practice, with an unknown etiology. This study assessed to investigate oxidative and antioxidative status in patients with chronic tension-type headache (CTTH), and to evaluate possible effect of medical treatment. The study included 41 CTTH patients and 19 age- and sex-matched healthy subjects without headache as controls. The CTTH group comprised 20 patients receiving treatment and 21 untreated patients. We evaluated oxidant/antioxidant status by measuring serum malondialdehyde (MDA) levels and activities of antioxidant enzymes, namely glutathione peroxidase (GSH-Px) and catalase (CAT). Comparison of oxidative parameters in the patient and control groups revealed significantly lower CAT activities and higher MDA level and GSH-Px activities in the patient group. In the CTTH group, serum CAT activities were found to be significantly decreased in patient groups, while serum MDA levels and GSH-Px activities were found to be higher in the untreated CTTH patients. These findings suggest that oxidative stress is increased in the patients with CTTH, and medical treatment abolishes the stress in part. It has been concluded that antioxidant support might be helpful for the patients with CTTH to prevent oxidant stress and peroxidation damages further.

[Clinical evaluation of the efficacy of the paracetamol and caffeine combination in the treatment of tension headache].

Science.gov (United States)

Rabello, G D; Forte, L V; Galvão, A C

2000-03-01

Tension type headache in both its forms, episodic and chronic, is the most common type of headache experienced by the population. The headache attack or the prevention of new crises may be treated with pharmacological as well as non-pharmacological measures. This study included 5,490 patients from out-patient clinics and medical offices covering various regions of Brazil. Approximately 95% of the subjects had episodic tension type headache, while 5% had chronic tension type headache. The majority of the patients presented with crisis of moderate intensity (62.19%). In 5,419 patients a tension type headache crisis was treated with acetaminophen 1000 mg and caffeine 130 mg. In 93.98%, onset of relief occurred within 2 hours of taking the medication. In 77.61%, complete reversion of the crisis occurred within 2 hours. Good/excellent efficacy ratings were achieved in 61.93%/37.80% of the cases according to the physician's assessment and in 48.51%/40.29% according to the patients' assessment. Adverse events, commonly gastrointestinal manifestations, were reported by 5.57% of the patients. This is a Brazilian study of the efficacy and safety of the combined use of acetaminophen-caffeine for the treatment of tension type headache.

Level of physical activity, well-being, stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain

DEFF Research Database (Denmark)

Krøll, Lotte Skytte; Hammarlund, Catharina Sjödahl; Westergaard, Maria Lurenda

2017-01-01

where questionnaires on physical activity, psychological well-being, perceived stress and self-rated health were completed by 148 persons with migraine and 100 healthy controls matched by sex and average age. Semi-structured interviews were conducted to assess characteristics of migraine, tension......-existing tension-type headache and neck pain in a clinic-based sample, b) the level of physical activity, psychological well-being, perceived stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain compared to healthy controls, c) the perceived ability of persons...... well-being, higher level of perceived stress and poorer self-rated health compared to healthy controls. They reported reduced ability to perform physical activity owing to migraine (high degree), tension-type headache (moderate degree) and neck pain (low degree). The most burdensome condition...

Restricted neck mobility in children with chronic tension type headache: a blinded, controlled study.

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Fernández-Mayoralas, Daniel M; Fernández-de-las-Peñas, César; Palacios-Ceña, Domingo; Cantarero-Villanueva, Irene; Fernández-Lao, Carolina; Pareja, Juan A

2010-10-01

The main purpose of this study was to analyze the differences in neck mobility between children with chronic tension type headache (CTTH) and healthy children, and to determine the influence of cervical mobility on headache intensity, frequency and duration. Fifty children, 13 boys and 37 girls (mean age 8.5 ± 1.6 years) with CTTH associated to peri-cranial tenderness (IHS 2.3.1) and 50 age- and sex matched children without headache (13 boys, 37 girls, mean age 8.5 ± 1.8 years, P = 0.955) participated. Cervical range of motion (CROM) was objectively assessed with a cervical goniometer by an assessor blinded to the children's condition. Children completed a headache diary for 4 weeks to confirm the diagnosis. Children with CTTH showed decreased CROM as compared to children without headache for flexion (z = -6.170; P 0.125) or gender (P > 0.250) did not influence CROM in either children with CTTH or without headache. Current results support the hypothesis that the cervical spine should be explored in children with headache. Further research is also needed to clearly define the potential role of the cervical spine in the genesis or maintenance of CTTH.

Massage Therapy and Frequency of Chronic Tension Headaches

Science.gov (United States)

Quinn, Christopher; Chandler, Clint; Moraska, Albert

2002-01-01

Objectives. The effect of massage therapy on chronic nonmigraine headache was investigated. Methods. Chronic tension headache sufferers received structured massage therapy treatment directed toward neck and shoulder muscles. Headache frequency, duration, and intensity were recorded and compared with baseline measures. Results. Compared with baseline values, headache frequency was significantly reduced within the first week of the massage protocol. The reduction of headache frequency continued for the remainder of the study (P = .009). The duration of headaches tended to decrease during the massage treatment period (P = .058). Headache intensity was unaffected by massage (P = .19). Conclusions. The muscle-specific massage therapy technique used in this study has the potential to be a functional, nonpharmacological intervention for reducing the incidence of chronic tension headache. PMID:12356617

Aspirin is first-line treatment for migraine and episodic tension-type headache regardless of headache intensity.

Science.gov (United States)

Lampl, Christian; Voelker, Michael; Steiner, Timothy J

2012-01-01

(1) To establish whether pre-treatment headache intensity in migraine or episodic tension-type headache (ETTH) predicts success or failure of treatment with aspirin; and (2) to reflect, accordingly, on the place of aspirin in the management of these disorders. Stepped care in migraine management uses symptomatic treatments as first-line, reserving triptans for those in whom this proves ineffective. Stratified care chooses between symptomatic therapy and triptans as first-line on an individual basis according to perceived illness severity. We questioned the 2 assumptions underpinning stratified care in migraine that greater illness severity: (1) reflects greater need; and (2) is a risk factor for failure of symptomatic treatment but not of triptans. With regard to the first assumption, we developed a rhetorical argument that need for treatment is underpinned by expectation of benefit, not by illness severity. To address the second, we reviewed individual patient data from 6 clinical trials of aspirin 1000 mg in migraine (N = 2079; 1165 moderate headache, 914 severe) and one of aspirin 500 and 1000 mg in ETTH (N = 325; 180 moderate, 145 severe), relating outcome to pre-treatment headache intensity. In migraine, for headache relief at 2 hours, a small (4.7%) and non-significant risk difference (RD) in therapeutic gain favored moderate pain; for pain freedom at 2 hours, therapeutic gains were almost identical (RD: -0.2%). In ETTH, for headache relief at 2 hours, RDs for both aspirin 500 mg (-4.2%) and aspirin 1000 mg (-9.7%) favored severe pain, although neither significantly; for pain freedom at 2 hours, RDs (-14.2 and -3.6) again favored severe pain. In neither migraine nor ETTH does pre-treatment headache intensity predict success or failure of aspirin. This is not an arguable basis for stratified care in migraine. In both disorders, aspirin is first-line treatment regardless of headache intensity. © 2011 American Headache Society.

The effect of foetal growth restriction on the development of migraine and tension-type headache in adulthood. The HUNT Study.

Directory of Open Access Journals (Sweden)

Sigrid Børte

Full Text Available There is little knowledge about how factors early in life affect the development of migraine and tension-type headache. We aimed to examine whether growth restriction in utero is associated with development of migraine and frequent tension-type headache in adults.The population-based Nord-Trøndelag Health Study (HUNT 3 contained a validated headache questionnaire, which differentiated between migraine and tension-type headache. These data were linked to information on weight and gestational age at birth from the Norwegian Medical Birth Registry. In total 4557 females and 2789 males, aged 19-41 years, were included in this registry-based study. Participants were categorized as appropriate for gestational age (AGA, 10th-90th percentile, small for gestational age (SGA, 3rd-10th percentile or very small for gestational age (VSGA, < 3rd percentile. Logistic regression was used to calculate odds ratios (OR with 95% confidence intervals (CI for migraine and tension-type headache, with exposure being growth restriction at birth.The effect of growth restriction on migraine was modified by sex, with a significant association in males (p<0.001, but not in females (p = 0.20. In particular, males born VSGA were at increased risk of developing migraine (OR 2.73, 95% CI 1.63-4.58, p<0.001, with an intermediate risk among those born SGA (OR 1.50, 95% CI 0.96-2.35, p = 0.08 compared to those born AGA. There was no significant association between growth restriction and frequent TTH (p = 0.051.Growth restriction was associated with increased risk of migraine in adulthood among males, but not among females. This suggests that migraine might, in part, be influenced by early life events, and that males seem to be particularly vulnerable.

A non-selective (amitriptyline), but not a selective (citalopram), serotonin reuptake inhibitor is effective in the prophylactic treatment of chronic tension-type headache.

OpenAIRE

Bendtsen, L; Jensen, R; Olesen, J

1996-01-01

OBJECTIVES: Although the tricyclic antidepressant amitriptyline is extensively used in the prophylactic treatment of chronic tension-type headache, only few studies have investigated the efficacy of this treatment and the results are contradictory. In addition, the new selective serotonin reuptake inhibiting antidepressants, which are widely used in depression and of potential value in pain management, have never been investigated in a placebo controlled study of tension-type headache. The ai...

Assessment of deep dynamic mechanical sensitivity in individuals with tension-type headache: The dynamic pressure algometry.

Science.gov (United States)

Palacios-Ceña, M; Wang, K; Castaldo, M; Guerrero-Peral, Á; Caminero, A B; Fernández-de-Las-Peñas, C; Arendt-Nielsen, L

2017-09-01

To explore the validity of dynamic pressure algometry for evaluating deep dynamic mechanical sensitivity by assessing its association with headache features and widespread pressure sensitivity in tension-type headache (TTH). One hundred and eighty-eight subjects with TTH (70% women) participated. Deep dynamic sensitivity was assessed with a dynamic pressure algometry set (Aalborg University, Denmark © ) consisting of 11 different rollers including fixed levels from 500 g to 5300 g. Each roller was moved at a speed of 0.5 cm/s over a 60-mm horizontal line covering the temporalis muscle. Dynamic pain threshold (DPT-level of the first painful roller) was determined and pain intensity during DPT was rated on a numerical pain rate scale (NPRS, 0-10). Headache clinical features were collected on a headache diary. As gold standard, static pressure pain thresholds (PPT) were assessed over temporalis, C5/C6 joint, second metacarpal, and tibialis anterior muscle. Side-to-side consistency between DPT (r = 0.843, p  r > 0.656, all p headaches supporting that deep dynamic pressure sensitivity within the trigeminal area is consistent with widespread pressure sensitivity. Assessing deep static and dynamic somatic tissue pain sensitivity may provide new opportunities for differentiated diagnostics and possibly a new tool for assessing treatment effects. The current study found that dynamic pressure algometry in the temporalis muscle was associated with widespread pressure pain sensitivity in individuals with tension-type headache. The association was independent of the frequency of headaches. Assessing deep static and dynamic somatic tissue pain sensitivity may provide new opportunities for differentiated diagnostics and possibly a tool for assessing treatment effects. © 2017 European Pain Federation - EFIC®.

An individually tailored behavioral medicine treatment in physical therapy for tension-type headache - two experimental case studies.

Science.gov (United States)

Söderlund, Anne; Lagerlöf, Helena

2016-01-01

The aim of this study was to describe and evaluate the effect of an individually tailored behavioral medicine treatment in physical therapy, based on a functional behavioral analysis (FBA), for tension-type headache (TTH). Two case studies with A1-A2-B-A3 design of two patients with TTH was conducted. Outcome variables were headache frequency, headache index (mean intensity), consumption of analgesics, self-efficacy in headache management (Headache Management Self-efficacy Scale [HMSE]), disability, and perceived loss of happiness for activities with family and friends. The results showed that headache frequency and headache index decreased for one of the patients. Self-efficacy in headache management increased markedly for both patients. A behavioral medicine treatment in physical therapy based on an FBA can be a way for physical therapists to handle patients with TTH. Future investigations should focus on large group studies with longer observation periods.

Test-retest repeatability of strength capacity, aerobic power and pericranial tenderness of neck and shoulder muscles in children - relevant for tension-type headache

DEFF Research Database (Denmark)

Tornøe, Birte; Andersen, Lars L; Skotte, J H

2013-01-01

Frequent or chronic tension-type headache in children is a prevalent and debilitating condition for the child, often leading to medication overuse. To explore the relationship between physical factors and tension-type headache in children, the quality of repeated measures was examined. The aim of...... of the present study was to determine the test-retest repeatability of parameters determining isometric neck and shoulder strength and stability, aerobic power, and pericranial tenderness in children....

Influence of psychological factors on acute exacerbation of tension-type headache: Investigation by ecological momentary assessment.

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Kikuchi, Hiroe; Yoshiuchi, Kazuhiro; Ando, Tetsuya; Yamamoto, Yoshiharu

2015-09-01

In this study, we investigated whether psychological factors were associated with subsequent acute exacerbation of tension-type headache (TTH) in a prospective and ecologically valid manner with computerized ecological momentary assessment. Eighteen women and five men with TTH wore watch-type computers that acted as an electronic diary for 1week. The subjects recorded momentary headache intensity, psychological stress, anxiety, and depressive mood with a visual analog scale of 0-100 approximately every 6h as well as when waking up, when going to bed, and at acute headache exacerbations. Multilevel logistic regression analysis with acute headache exacerbation occurrence as the outcome was conducted. Person-mean centering was applied to psychological factors to disaggregate between- and within-individual association. Momentary psychological stress was associated with subsequent increase in headache exacerbation within 3h [Odds Ratio (95% CI)=1.32 (1.07, 1.64) for 10-point increments] while the individual mean of psychological stress was not. These results support the possibility that psychological stress could trigger acute exacerbations of TTH. Copyright © 2015 Elsevier Inc. All rights reserved.

Memantine for prophylaxis of chronic tension-type headache--a double-blind, randomized, crossover clinical trial

DEFF Research Database (Denmark)

Lindelof, K; Bendtsen, L; Lindelof, K

2009-01-01

Treatment for chronic tension-type headache (CTTH) is unsatisfactory. Our aim was to investigate the efficacy of the N-methyl D-aspartate (NMDA) antagonist memantine in the prophylactic treatment of CTTH. We included 40 patients in a randomized, double-blind, placebo-controlled, crossover trial....... Memantine 20-40 mg/day or placebo was each given for 10 weeks separated by a 2-week wash-out period; 29 patients completed the study. The primary efficacy variable, area-under-the-headache curve (duration x intensity), did not differ between memantine (1352 +/- 927) and placebo (1449 +/- 976; P = 0.......10). Headache intensity in both sexes was significantly lower on a 0-10 verbal rating scale with memantine (3.8) than with placebo (4.1; P = 0.03). In women, area-under-the-headache curve was significantly lower with memantine (1343 +/- 919) than with placebo (1555 +/- 1019; P = 0.01). The most common side...

Effects of physical therapy and relaxation techniques on the parameters of pain in university students with tension-type headache: A randomised controlled clinical trial.

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Álvarez-Melcón, A C; Valero-Alcaide, R; Atín-Arratibel, M A; Melcón-Álvarez, A; Beneit-Montesinos, J V

2018-05-01

Non-pharmacological treatments help control tension-type headache; however, evidence about their effectiveness is still limited. This study evaluates the effectiveness of physical therapy based on cervical spine kinesiotherapy and posture correction exercises compared to a programme of relaxation techniques only (Schultz's Autogenic Training, AT). Tension-type headache is very common among university students. We randomly selected 152 university students with a diagnosis of tension-type headache according to the criteria of the International Headache Society. Eighty-four were women (55.3%) and 68 were men (44.7%). Mean age was 20.42±2.36 years. The study design is a randomised controlled trial of a non-pharmacological intervention with a blinded evaluation of response variables. We compared the results of two independent samples: AT was used in one of the groups while the other group received AT plus cervical spine kinesiotherapy and posture correction training. Patients recorded any changes in the parameters of pain (frequency, intensity, and duration) and drug consumption in a headache diary before treatment, at 4 weeks, and at 3 months. Both interventions achieved a decrease in all the parameters of pain; however, decreases in frequency and intensity were more significant in the combined treatment group (Pcervical spine kinesiotherapy, and especially the combination of both, effectively reduce tension-type headache by preventing and managing the potential psychophysical causes of this disorder. Future research should aim to assess the long-term effects of these interventions. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Has aerobic exercise effect on pain perception in persons with migraine and coexisting tension-type headache and neck pain? A randomized, controlled, clinical trial.

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Krøll, L S; Sjödahl Hammarlund, C; Gard, G; Jensen, R H; Bendtsen, L

2018-04-10

A large subset of persons with migraine suffers from coexisting tension-type headache and neck pain which may adversely affect the prognosis of migraine. Aerobic exercise has been shown to decrease migraine burden in these persons. Therefore, the aim of this study was to investigate whether the effect of aerobic exercise in persons with migraine and coexisting tension-type headache and neck pain can be explained by changes in pain perception. Seventy consecutively recruited persons with migraine and coexisting tension-type headache and neck pain were randomized into exercise group or control group. Aerobic exercise consisted of bike/cross-trainer/brisk walking for 45 min, three times/week for 3 months. Controls continued their usual daily activities. Pericranial tenderness, pain thresholds, supra-thresholds and temporal summation were assessed at baseline, after treatment and at follow-up (6 months from baseline). Fifty-two persons with migraine and coexisting tension-type headache and neck pain completed the study. Aerobic exercise did not induce consistent changes in nociceptive pathways measured by pericranial tenderness, pressure pain thresholds and sensitivity to electrical stimulation. The effect of aerobic exercise cannot be explained by measurable effects on the pain modulation system. Thus, the positive effect on migraine burden may rather be explained by positive alteration of avoidance behaviour. Aerobic exercise can be recommended as a safe and inexpensive migraine treatment strategy. This study adds further knowledge about the positive effect of aerobic exercise for persons with migraine and coexisting tension-type headache and neck pain. This effect cannot be measured by changes in pain modulation, but may rather be explained by positive alteration of avoidance behaviour. © 2018 European Pain Federation - EFIC®.

The effects of aerobic exercise for persons with migraine and co-existing tension-type headache and neck pain. A randomized, controlled, clinical trial.

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Krøll, Lotte Skytte; Hammarlund, Catharina Sjödahl; Linde, Mattias; Gard, Gunvor; Jensen, Rigmor Højland

2018-01-01

Aim To evaluate aerobic exercise in migraine and co-existing tension-type headache and neck pain. Methods Consecutively recruited persons with migraine and co-existing tension-type headache and neck pain were randomized into an exercise group or control group. Aerobic exercise consisted of bike/cross-trainer/brisk walking for 45 minutes, three times/week. Controls continued usual daily activities. Pain frequency, intensity, and duration; physical fitness, level of physical activity, well-being and ability to engage in daily activities were assessed at baseline, after treatment and at follow-up. Results Fifty-two persons completed the study. Significant between-group improvements for the exercise group were found for physical fitness, level of physical activity, migraine burden and the ability to engage in physical activity because of reduced impact of tension-type headache and neck pain. Within the exercise group, significant reduction was found for migraine frequency, pain intensity and duration, neck pain intensity, and burden of migraine; an increase in physical fitness and well-being. Conclusions Exercise significantly reduced the burden of migraine and the ability to engage in physical activity because of reduced impact of tension-type headache and neck pain. Exercise also reduced migraine frequency, pain intensity and duration, although this was not significant compared to controls. These results emphasize the importance of regular aerobic exercise for reduction of migraine burden.

Ibuprofen for acute treatment of episodic tension-type headache in adults.

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Derry, Sheena; Wiffen, Philip J; Moore, R Andrew; Bendtsen, Lars

2015-07-31

Tension-type headache (TTH) affects about one person in five worldwide. It is divided into infrequent episodic TTH (fewer than one headache per month), frequent episodic TTH (1 to 14 headaches per month), and chronic TTH (15 headaches a month or more). Ibuprofen is one of a number of analgesics suggested for acute treatment of headaches in frequent episodic TTH. To assess the efficacy and safety of oral ibuprofen for treatment of acute episodic TTH in adults. We searched CENTRAL (The Cochrane Library), MEDLINE, EMBASE, and our own in-house database to January 2015. We sought unpublished studies by asking personal contacts and searching on-line clinical trial registers and manufacturers' websites. We included randomised, placebo-controlled studies (parallel-group or cross-over) using oral ibuprofen for symptomatic relief of an acute episode of TTH. Studies had to be prospective and include at least 10 participants per treatment arm. Two review authors independently assessed studies for inclusion, and extracted data. Numbers of participants achieving each outcome were used to calculate risk ratio (RR) and number needed to treat for an additional beneficial outcome (NNT) or number needed to treat for an additional harmful outcome (NNH) of oral ibuprofen compared to placebo for a range of outcomes, predominantly those recommended by the International Headache Society (IHS). We included 12 studies, all of which enrolled adult participants with frequent episodic TTH. Nine used the IHS diagnostic criteria, but two used the older classification of the Ad Hoc Committee, and one did not describe diagnostic criteria but excluded participants with migraines. While 3094 people with TTH participated in these studies, the numbers available for any form of analysis were lower than this; placebo was taken by 733, standard ibuprofen 200 mg by 127, standard ibuprofen 400 mg by 892, and fast-acting ibuprofen 400 mg by 230. Participants had moderate or severe pain at the start of

Cognitive behavior therapy for comorbid migraine and/or tension-type headache and major depressive disorder: An exploratory randomized controlled trial.

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Martin, Paul R; Aiello, Rachele; Gilson, Kathryn; Meadows, Graham; Milgrom, Jeannette; Reece, John

2015-10-01

Numerous studies have demonstrated comorbidity between migraine and tension-type headache on the one hand, and depression on the other. Presence of depression is a negative prognostic indicator for behavioral treatment of headaches. Despite the recognised comorbidity, there is a limited research literature evaluating interventions designed for comorbid headaches and depression. Sixty six participants (49 female, 17 male) suffering from migraine and/or tension-type headache and major depressive disorder were randomly allocated to a Routine Primary Care control group or a Cognitive Behavior Therapy group that also received routine primary care. The treatment program involved 12 weekly 50-min sessions administered by clinical psychologists. Participants in the treatment group improved significantly more than participants in the control group from pre-to post-treatment on measures of headaches, depression, anxiety, and quality of life. Improvements achieved with treatment were maintained at four month follow-up. Comorbid anxiety disorders were not a predictor of response to treatment, and the only significant predictor was gender (men improved more than women). The new integrated treatment program appears promising and worthy of further investigation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Treatment of myofascial trigger points in female patients with chronic tension-type headache - A randomized controlled trial

DEFF Research Database (Denmark)

Berggreen, S.; Wiik, E.; Lund, Hans

2012-01-01

The aim of this study was to evaluate the efficacy of myofascial trigger point massage in the muscles of the head, neck and shoulders regarding pain in the treatment of females with chronic tension-type headache. They were randomized into either a treatment group (n = 20) (one session of trigger......: 8.8 (95% CI 0.1117.4), p = 0.047). Furthermore, a significant decrease in the number of trigger points was observed in the treatment group compared with the control group. Myofascial trigger point massage has a beneficial effect on pain in female patients with chronic tension-type headache....... point massage per week for 10 weeks) or a control group receiving no treatment (n = 19). The patients kept a diary to record their pain on a visual analogue scale (VAS), and the daily intake of drugs (mg) during the 4 weeks before and after the treatment period. The McGill Pain Questionnaire...

Identification of subgroups of patients with tension type headache with higher widespread pressure pain hyperalgesia.

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Fernández-de-Las-Peñas, César; Benito-González, Elena; Palacios-Ceña, María; Wang, Kelun; Castaldo, Matteo; Arendt-Nielsen, Lars

2017-12-01

Identification of subgroups of patients with different levels of sensitization and clinical features can help to identify groups at risk and the development of better therapeutic strategies. The aim of this study was to identify subgroups of patients with tension type headache (TTH) with different levels of sensitization, clinical pain features, and psychological outcomes. A total of 197 individuals with TTH participated. Headache intensity, frequency, and duration and medication intake were collected with a 4-weeks diary. Pressure pain thresholds were assessed bilaterally over the temporalis muscle, C5-C6 joint, second metacarpal and tibialis anterior muscle to determine widespread pressure pain hyperalgesia. The Hospital Anxiety and Depression Scale assessed anxiety and depression. The State-Trait Anxiety Inventory evaluated the state and trait levels of anxiety. The Headache Disability Inventory evaluated the burden of headache. Health-related quality of life was determined with the SF-36 questionnaire. Groups were considered as positive (three or more criteria) or negative (less than three criteria) on a clinical prediction rule: headache duration patients with TTH with higher sensitization, higher chronicity of headaches and worse quality of life but lower frequency and duration of headache episodes. This subgroup of individuals with TTH may need particular attention and specific therapeutic programs for avoiding potential chronification.

Effect of Flunarizine on Serum Glutamate Levels and its Correlation with Headache Intensity in Chronic Tension-Type Headache Patients.

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Surbakti, Khairul Putra; Sjahrir, Hasan; Juwita-Sembiring, Rosita; Mutiara, Erna

2017-10-15

Some of the excitatory neurotransmitters including glutamate have been suggested to be involved in headache pathophysiology. To our knowledge, there is a lack of publication about flunarizine efficacy in chronic tension-type headache (CTTH) treatments and the roles of glutamate in CTTH pathophysiology. This study aimed to investigate the flunarizine effect on serum levels of glutamate and its correlation with headache intensity based on the Numeric Rating Scale for pain (NRS) scores in CTTH patients. In a prospective randomised, double-blind study with pre and post-test design, seventy-three CTTH patients were randomly allocated with flunarizine 5 mg, flunarizine 10 mg and amitriptyline 12.5 mg groups. The serum levels of glutamate and NRS scores were measured before and after 15-day treatment. Flunarizine 5 mg was more effective than flunarizine 10 mg and amitriptyline 12.5 mg in reducing serum glutamate levels, whereas amitriptyline 12.5 mg was the most effective in reducing headache intensity. There was found nonsignificant, but very weak negative correlation between headache intensity and serum glutamate levels after flunarizine 5 mg administration (r = -0.062; P = 0.385), nonsignificant very weak negative correlation after flunarizine 10 mg administration (r = -0.007; P = 0.488) and there was found a significant moderate positive correlation (r = 0.508; P = 0.007) between headache intensity and serum glutamate levels after amitriptyline 12.5 mg administration. Since there was no significant correlation found between serum glutamate and headache intensity after treatment with flunarizine, it is suggested that decreasing of headache intensity after flunarizine treatment occurred not through glutamate pathways in CTTH patients.

Is There a Relation between Tension-Type Headache, Temporomandibular Disorders and Sleep?

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N. Caspersen

2013-01-01

Full Text Available Introduction. Tension-Type Headache (TTH is the most prevalent headache often associated with impaired function and quality of life. Temporomandibular Disorders (TMD and TTH frequently coexist; characterized by pericranial tenderness and impact on daily life. We aim to apply a standardized questionnaire for TMD to characterize and analyse an eventual relation between sleep and oral health in TTH in a controlled design. Material and Methods. 58 consecutive TTH patients and 58 healthy controls were included. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD questionnaire, Oral Health Impact profile (OHIP and questionnaires for sleep were applied. Results. TTH-patients had significantly higher pain scores (, decreased quality of life (, and higher total sleep scores ( compared to controls. Conclusion. For the first time we have identified a clear relation between TTH and TMD symptoms, depression, anxiety, poor sleep, and impairments of oral function in carefully classified patients. These findings indicate a close, but incomplete, overlap between TTH and TMD. Their underlying pathophysiological mechanisms need further research.

The effects of cervical traction, cranial rhythmic impulse, and Mckenzie exercise on headache and cervical muscle stiffness in episodic tension-type headache patients.

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Choi, Sung-Yong; Choi, Jung-Hyun

2016-03-01

[Purpose] The purpose of this study was to examine the effects of cervical traction treatment, cranial rhythmic impulse treatment, a manual therapy, and McKenzie exercise, a dynamic strengthening exercise, on patients who have the neck muscle stiffness of the infrequent episodic tension-type (IETTH) headache and frequent episodic tension-type headache(FETTH), as well as to provide the basic materials for clinical interventions. [Subjects] Twenty-seven subjects (males: 15, females: 12) who were diagnosed with IETTH and FETTH after treatment by a neurologist were divided into three groups: (a cervical traction group (CTG, n=9), a cranial rhythmic contractiongroup (CRIG, n=9), and a McKenzie exercise group (MEG, n=9). An intervention was conducted for each group and the differences in their degrees of neck pain and changes in muscle tone were observed. [Results] In the within-group comparison of each group, headache significantly decreased in CTG. According to the results of the analysis of the muscle tone of the upper trapezius, there was a statistically significant difference in MEG on the right side and in CRIG on the left side. According to the results of the analysis of the muscle tone of the sternocleidomastoid muscle, there was a statistically significant difference in MEG on the right side and in CRIG on the left side. [Conclusion] In the comparison of the splenius capitis muscle between the groups, there was a statistically significant difference on the right side. Hence, compared to the other methods, cervical traction is concluded to be more effective at reducing headaches in IETTH and FETTH patients.

The working mechanism of manual therapy in participants with chronic tension-type headache.

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Castien, René; Blankenstein, Annette; van der Windt, Daniëlle; Heymans, Martijn W; Dekker, Joost

2013-10-01

Prospective longitudinal study. To explore the working mechanism of manual therapy, we investigated whether 3 cervical spine variables were mediators of the effect of manual therapy on headache frequency. Background Manual therapy has been shown to reduce headache frequency in participants with chronic tension-type headache (CTTH). To what extent specific elements of treatment contribute to the effectiveness of manual therapy in CTTH is unknown. One hundred eighty-two participants with CTTH participated in a prospective longitudinal study: 142 underwent manual therapy and 40 participants received usual care by their general practitioner. Regression analysis was performed according to the steps described by Baron and Kenny, and the proportion of mediated effect was estimated for 3 potential mediators: (1) cervical range of motion, (2) neck flexor endurance, and (3) forward head posture. Outcome was defined as a 50% or greater reduction in headache days. Neck flexor endurance mediated 24.5% of the effect of manual therapy. Cervical range of motion and forward head posture showed no mediated effect. Increased neck flexor endurance appears to be a working mechanism of manual therapy. This finding supports isometric training of neck flexors in participants with CTTH. Trial registered with Netherlands Trial Register (TR 1074).

The Use of the Cognitive Behavioral Therapy for the Treatment of Migraine and Tension Type Headaches

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Yasemin Akkoca

2015-04-01

Full Text Available Headache, which affects a large part of the community and causes loss of workforce, is gaining importance in terms of the burden which it brings on the society, by its function of restricting individuals social activities as well as increasing the health expenditure likewise drug consumption. Migraine and tension headaches are primary headaches which any organic causes can not be determined for them. For the treatment of headaches of this type besides the use of medicine, exercises with bio-feedbacks and acupuncture; in recent years cognitive behavioral treatments (CBT appears to be effective. It’s shown that the negative mode of thinking onindividuals which have recurrent headaches, stimulates the headache, increase its severity and complicates the management of it. CBT provides for the person a self-help opportunity even the therapy is terminated, besides behavioral methods such as relaxation exercises, by developing strategies of self-monitoring, education, abilities of pain management and coping with the maladaptive beliefs and houghts. The purpose of this text is, providing information about the use of the cognitive behavioral therapies on primary headaches and basic principles of treatment. [JCBPR 2015; 4(1.000: 10-17

Behavioral Treatments of Chronic Tension-Type Headache in Adults : Are They Beneficial ?

NARCIS (Netherlands)

Verhagen, Arianne P.; Damen, Leonie; Berger, Marjolein Y.; Passchier, Jan; Koes, Bart W.

2009-01-01

To assess the efficacy of behavioral treatments in patients with tension headache. Medline, Cinahl, EMBASE, and the Cochrane library were searched from inception to October 2007 and reference lists were checked. We selected randomized trials evaluating behavioral treatments (e.g., relaxation,

Reduced neck-shoulder muscle strength and aerobic power together with increased pericranial tenderness are associated with tension-type headache in girls

DEFF Research Database (Denmark)

Tornoe, Birte; Andersen, Lars L; Skotte, Jørgen H

2013-01-01

BACKGROUND: Tension-type headaches (TTH) are common among children worldwide and mean a potential risk of disability and medication overuse headache. The associated mechanisms, however, remain unsolved. Our study investigated muscle strength in the neck-shoulder region, aerobic power and pericran......BACKGROUND: Tension-type headaches (TTH) are common among children worldwide and mean a potential risk of disability and medication overuse headache. The associated mechanisms, however, remain unsolved. Our study investigated muscle strength in the neck-shoulder region, aerobic power...... and pericranial tenderness in girls with TTH compared with healthy controls. METHODS: A blinded case-control study comprising 41 girls with TTH and 41 age-matched healthy controls. Standardised testing of isometric maximal voluntary contraction (MVC) and force steadiness of neck flexion and extension, as well.......3 (95% CI 1.0-1.6) and 5.2 (95% CI: 1.4-19.6) for each unit of decrease in VO2 max. CONCLUSIONS: Reduced neck-shoulder strength and aerobic power together with increased pericranial tenderness are associated with TTH in girls. Future interventions should be directed towards health promoting patient...

Associations between stress and migraine and tension-type headache: Results from a school-based study in adolescents from grammar schools in Germany

OpenAIRE

Milde-Busch, Astrid; Blaschek, Astrid; Heinen, Florian; Borggräfe, Ingo; Koerte, Inga; Straube, Andreas; Schankin, Christoph; Kries, Rüdiger

2011-01-01

Introduction: Stress is considered the major contributor to migraine and tension-type headache in adolescents. Previous studies have focused on general stressors, whereas the aim of the present study was to investigate associations between individuals’ stressful experiences and different types of headache. Methods: Adolescents from 10th and 11th grades of grammar schools filled in questionnaires. Stressful experiences were measured with the Trier Inventory of Chronic Stress. Type of heada...

Evidence to Use Botulinum Toxin Injections in Tension-Type Headache Management: A Systematic Review.

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Wieckiewicz, Mieszko; Grychowska, Natalia; Zietek, Marek; Wieckiewicz, Gniewko; Smardz, Joanna

2017-11-15

Tension-type headache (TTH) is the most common type of chronic recurring head pain. It can occur twice as often in women as in men. It is the most common type of headache. Its lifetime prevalence is 30% to 78% in the general population. TTH treatment should be multilevel. It often consists of taking pain medication, muscle relaxants, antidepressants, using biofeedback therapy, acupuncture, and attending behavioral therapy. Several clinical trials also suggest that botulinum toxin (BTX) may be an effective treatment option for such patients. The aim of this study was to evaluate if BTX can be used as a treatment method in TTH in the light of current medical literature. The authors searched the PubMed, EBSCOhost, OVID, Web of Knowledge, Cochrane Library and CINAHL databases to identify relevant publications. The authors finally included 11 papers-prospective and retrospective cohort studies. Among most of the selected studies, there was a significant correlation between using BTX and reduction of TTH pain intensity and severity. By analyzing qualified studies, it can be concluded that botulinum toxin seems to be effective in TTH management.

Headache

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... most common type of headache is a tension headache. Tension headaches are due to tight muscles in your shoulders, neck, scalp and jaw. They are often related to stress, depression or anxiety. You are more likely to ...

Epidemiologic and Clinical Characteristics of Migraine and Tension-Type Headaches among Hospitals Staffs of Shiraz (Iran

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Ayatollahi Seyyed Mohammad Taghi

2009-05-01

Full Text Available Headache is a common symptom that constitutes a major health problem to all countries in the world. This study was conducted to estimate the prevalence of migraine and tension -type headaches(TTH, its associated occupational risk factors among Shiraz hospitals staffs, and to report on clinical characteristics of migraine and TTH with using the International Headache Society (IHS diagnosis criteria. A random sample of 1023 staffs constituting a 20% sample of the hospitals staff population was selected. Sampling method was categorical random sampling. Within each group sampling was carried out systematically. Data were collected by screening questionnaire followed by clinical interviews, general physical and neurological examination, and diagnostic criteria of IHS. Prevalence of migraine, TTH and coexisting migraine and TTH were estimated as 11.2% (115 cases, 19.5% (199 subjects and 3.2% (33 subjects respectively. In this study , clinical characteristics of headache including type, site, number , intensity ,concomitant symptom of headaches had been surveyed. TTH and migraine headaches were significantly associated with self reported abnormal sleep pattern and female gender (P < 0.001. Also TTH was negatively associated with total 24hr duration of sleep and history of involvement in second job significantly (P<0.026. The average of prevalence of migraine and TTH were lower than their counter parts in western countries but higher than previous studies conducted in other Asian countries. Clinical characteristics were almost parallel with IHS criteria, headache- related missed work rates were higher for subjects with migraine headache, and also TTH and migraine were separate disorders and were not as a part of a continuum of headache disorders. Headache disorders deserve more attention, especially concerning strategies leading to adequate primary prevention, diagnosis and treatment.

Is There a Relation between Tension-Type Headache, Temporomandibular Disorders and Sleep?

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Caspersen, N; Hirsvang, J R; Kroell, L; Jadidi, F; Baad-Hansen, L; Svensson, P; Jensen, R

2013-01-01

Introduction. Tension-Type Headache (TTH) is the most prevalent headache often associated with impaired function and quality of life. Temporomandibular Disorders (TMD) and TTH frequently coexist; characterized by pericranial tenderness and impact on daily life. We aim to apply a standardized questionnaire for TMD to characterize and analyse an eventual relation between sleep and oral health in TTH in a controlled design. Material and Methods. 58 consecutive TTH patients and 58 healthy controls were included. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire, Oral Health Impact profile (OHIP) and questionnaires for sleep were applied. Results. TTH-patients had significantly higher pain scores (P < 0.001), decreased quality of life (P < 0.001), and higher total sleep scores (P < 0.001) compared to controls. Conclusion. For the first time we have identified a clear relation between TTH and TMD symptoms, depression, anxiety, poor sleep, and impairments of oral function in carefully classified patients. These findings indicate a close, but incomplete, overlap between TTH and TMD. Their underlying pathophysiological mechanisms need further research.

Different types of headache in patients with systemic lupus erythematosus.

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Badry, Reda; Gamal, Rania M

2015-05-01

Headache in patients with systemic lupus erythematosus (SLE) is considered a common neurological finding, although the relationship is unclear. In this study, we aimed to evaluate frequency and characteristics of different types of headache in patients with SLE. 40 SLE patients were chosen from those referred to the out patient clinic using the American College of Rheumatology (ACR) criteria for the diagnosis of SLE. Headache classification was done regarding the ICD-II criteria in the patients. Headache severity was assessed by visual analog scale (VAS), and subjects with VAS ≥4 were included in the study. 30 patients out of 40 SLE patients (75%) have different headache types: tension type in 37.5% (n = 15) and migraine in 30% (n = 12), cluster 2.5% (n = 1), and intracranial hypertension 5% (n = 2) of all patients. Headache is frequent in SLE especially tension and migraine types, but overall, it is not associated with disease activity.

Interaction between anxiety, depression, quality of life and clinical parameters in chronic tension-type headache.

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Peñacoba-Puente, Cecilia; Fernández-de-Las-Peñas, César; González-Gutierrez, Jose L; Miangolarra-Page, Juan C; Pareja, Juan A

2008-10-01

Our aim was to investigate the mediating or moderating role of anxiety and depression in the relationship between headache clinical parameters and quality of life in Chronic Tension-Type Headache (CTTH). Twenty-five patients diagnosed with CTTH according to the criteria of the International Headache Society were studied. A headache diary was kept for 4 weeks in order to substantiate the diagnosis and record the pain history. Quality of life was assessed by means of the Medical Outcome Study (MOS) 36-Item Short-Form (SF-36) questionnaire. The Beck Depression Inventory (BDI-II) was used to assess depression, and the Trait Anxiety Scale (TA) from the State-Trait Anxiety Inventory was administered in order to assess anxiety. Moderating and mediating analyses were conducted with ordinary least squares multiple regression analysis using the SPSS General Linear Model procedure. Anxiety mediated the effect between headache frequency and quality of life, but not the effect of either headache intensity or duration. Anxiety totally mediated the effects of headache frequency on vitality, social functioning and mental health. On the other hand, depression modulated the effect in the mental health domain. The effect in the mental health domain was a function of the interaction between headache duration and depression (beta=-0.34, panxiety to be a moderating factor between intensity, frequency or duration of headache and perceived quality of life. Anxiety exerts a mediating effect, conditioning the relationship between headache frequency and some quality of life domains; depression seems to play an inherent role in the reduced quality of life of these patients, that is, it has a moderating effect.

Intravenous dipyrone for the acute treatment of episodic tension-type headache: A randomized, placebo-controlled, double-blind study

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M.E. Bigal

2002-10-01

Full Text Available Acute headaches are responsible for a significant percentage of the case load at primary care units and emergency rooms in Brazil. Dipyrone (metamizol is easily available in these settings, being the most frequently used drug. We conducted a randomized, placebo-controlled, double-blind study to assess the effect of dipyrone in the acute treatment of episodic tension-type headache. Sixty patients were randomized to receive placebo (intravenous injection of 10 ml saline or 1 g dipyrone in 10 ml saline. We used seven parameters of analgesic evaluation. The patients receiving dipyrone showed a statistically significant improvement (P<0.05 of pain compared to placebo up to 30 min after drug administration. The therapeutic gain was 30% in 30 min and 40% in 60 min. The number of patients needed to be treated for at least one to have benefit was 3.3 in 30 min and 2.2 in 60 min. There were statistically significant reductions in the recurrence (dipyrone = 25%, placebo = 50% and use of rescue medication (dipyrone = 20%, placebo = 47.6% for the dipyrone group. Intravenous dipyrone is an effective drug for the relief of pain in tension-type headache and its use is justified in the emergency room setting.

Muscles and their role in episodic tension-type headache: implications for treatment.

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Bendtsen, L; Ashina, S; Moore, A; Steiner, T J

2016-02-01

Tension-type headache (TTH) imposes a heavy burden on the global population but remains incompletely understood and poorly managed. Here, we review current knowledge of peripheral factors involved in the mechanism of TTH and make recommendations for the treatment of episodic TTH based on these. Peripheral activation or sensitization of myofascial nociceptors is most probably involved in the development of muscle pain and the acute episode of TTH. Repetitive episodes of muscle pain may sensitize the central nervous system resulting in progression of TTH to the chronic form. Thus, muscular factors may be responsible not only for the acute headache episode but also for chronification of the disorder. Simple analgesics and non-steroidal anti-inflammatory drugs are the mainstays of management of individual headache episodes. Ibuprofen 400 mg and aspirin 1000 mg are recommended as drugs of first choice based on treatment effect, safety profile and costs. Non-pharmacological therapies include electromyographic biofeedback, physiotherapy and muscle relaxation therapy. Future studies should aim to identify the triggers of peripheral nociception and how to avoid peripheral and central sensitization. There is a need for more effective, faster acting drugs for acute TTH. Muscular factors play an important role in episodic TTH. Ibuprofen 400 mg and aspirin 1000 mg are recommended as drugs of first choice. © 2015 European Pain Federation - EFIC®

Interrelationships between chronic tension-type headache, musculoskeletal pain, and vitamin D deficiency: Is osteomalacia responsible for both headache and musculoskeletal pain?

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Sanjay Prakash

2013-01-01

Full Text Available Background: Headache, musculoskeletal symptoms, and vitamin D deficiency are common in the general population. However, the interrelations between these three have not been delineated in the literature. Materials and Methods: We retrospectively studied a consecutive series of patients who were diagnosed as having chronic tension-type headache (CTTH and were subjected to the estimation of serum vitamin D levels. The subjects were divided into two groups according to serum 25(OH D levels as normal (>20 ng/ml or vitamin D deficient (<20 ng/ml. Results: We identified 71 such patients. Fifty-two patients (73% had low serum 25(OH D (<20 ng/dl. Eighty-three percent patients reported musculoskeletal pain. Fifty-two percent patients fulfilled the American College of Rheumatology criteria for chronic widespread pain. About 50% patients fulfilled the criteria for biochemical osteomalacia. Low serum 25(OH D level (<20 ng/dl was significantly associated with headache, musculoskeletal pain, and osteomalacia. Discussion: These suggest that both chronic musculoskeletal pain and chronic headache may be related to vitamin D deficiency. Musculoskeletal pain associated with vitamin D deficiency is usually explained by osteomalacia of bones. Therefore, we speculate a possibility of osteomalacia of the skull for the generation of headache (osteomalacic cephalalgia?. It further suggests that both musculoskeletal pain and headaches may be the part of the same disease spectrum in a subset of patients with vitamin D deficiency (or osteomalacia, and vitamin D deficiency may be an important cause of secondary CTTH.

MEASUREMENT OF BLOOD FLOW IN ARTERIA MENINGEA MEDIA OF PATIENTS WITH FREQUENT EPISODIC TENSION-TYPE HEADACHE NOT ASSOCIATED WITH PERICRANIAL TENDERNESS

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A.A. Skoromets

2008-06-01

Full Text Available Twenty seven patients with frequent episodic tension-type headache not associated with pericrania! tenderness (TTH aged from 18 to 69 years old were examined. Arteria meningea media (AMM and brachiocephalic arteries (BCA were examined by supersonic power Doppler scanning during the paroxysm of headache and without the paroxysm of headache. Results: Blood flow in AMM of patients with TTH was significantly different during the paroxysm of headache and without the paroxysm of headache (p<0.01. Blood flow in arteria carotid external did not change (p>0.05. The pattern of hypoperfusion in AMM was displayed in two groups during the paroxysm of headache. The increase of average blood velocity (TAmx in groups of patients with TTH in comparison with the control group.

Multimodal Physiotherapy Based on a Biobehavioral Approach as a Treatment for Chronic Tension-Type Headache: A Case Report.

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Beltran-Alacreu, Hector; Lopez-de-Uralde-Villanueva, Ibai; La Touche, Roy

2015-12-01

Tension-type headache (TTH) is the most common primary headache affecting the general population, which is characterized by bilateral headache and mild to moderate pain. This disorder causes high levels of disability and recent scientific evidence suggests that manual therapy (MT) and therapeutic exercise are effective in reducing medication intake and decreasing the frequency and intensity of headaches in patients with TTH. A 34-year-old woman was known to have chronic TTH. Initially, the patient presented moderate headaches 5 days per week, mechanical neck pain and no positive response to analgesics. A battery of self-reports was given to the patient to assess disability (using the Spanish versions of the Headache Impact Test-6 and the neck disability index), pain (visual analogue scale) and psychosocial issues (Spanish version of the pain catastrophizing scale) involved in the headaches. All measurements were taken four times during 161 days. Eleven sessions of treatment including MT, motor control therapeutic exercise (MCTE) and therapeutic patient education (TPE) were applied. This biobehavioral-based multimodal physical rehabilitation treatment combining MT, TPE and MCTE produced a substantial reduction in pain intensity, pain catastrophizing, disability and the impact of headaches on patient's life.

Headaches in Children

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... his or her head to indicate severe pain. Tension-type headache Tension-type headaches can cause: A pressing tightness ... headaches. Be alert for things that may cause stress in your child's life, such as difficulty ... Keep a headache diary. A diary can help you determine what ...

Clinical characteristics of migraine and episodic tension-type headache in relation to old and new diagnostic criteria

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Iversen, Helle Klingenberg; Langemark, M; Andersson, P G

1990-01-01

Eighty-one patients were diagnosed as having migraine, tension headache or both according to previously used criteria. Then we performed a standardized interview to determine the frequency and severity of headache characteristics used in the new operational diagnostic criteria of the International...... Headache Society (IHS). In every patient the original diagnosis fulfilled also the IHS criteria, but in 9 patients the criteria were only fulfilled in half or less of the attacks, and applying the IHS criteria they also achieved an additional diagnosis. In one patient these attacks did not fulfill the pain...... criteria and in 8 (4 migraine, 4 tension headache) they did not fulfill the criteria for accompanying symptoms. Overall the IHS criteria are sensitive and specific, but they may possibly be improved with regard to accompanying symptoms. The present study suggests that recording of frequency and graded...

Early Maladaptive Schemas in Patients with and without Migraine and Tension Headaches

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Ebrahim Rezaei Dogaheh

2015-12-01

Methods:  The present study was of cross sectional and correlational studies. The measures included  Headache Disability Inventory and Young Early Maladaptive Schemas Questionnaire (Short Form. The  population of the study was Tehran adult patients with migraine and tension headache aged 18 to 55  years. The final study sample included 69 participants with migraine or tension headaches and 86 non- clinical samples of both genders. After referring by psychiatrists, they were selected by convenient and  targeted sampling. The two groups were matched based on sex and education. Results: Migraine and tension headache sufferers and non-clinical participants were significantly  different in 9 schemas including Emotional deprivation, Abandonment/instability, Mistrust/abuse, Social  isolation/alienation, Failure to achieve, Enmeshment/Undeveloped Self, Subjugation, Self-sacrifice and  Emotional inhibition. In addition, a series of EMSs could significantly predict 61 percent of the total  change in position of tension headaches or migraine group correctly. Discussion: It seems that EMSs are important factors influencing migraine and tension headaches. The  recognition and manipulation of these schemas along with other medical therapies can result in reducing  the symptoms of the disorder. 

Pilot trial of osteopathic manipulative therapy for patients with frequent episodic tension-type headache.

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Rolle, Guido; Tremolizzo, Lucio; Somalvico, Francesco; Ferrarese, Carlo; Bressan, Livio C

2014-09-01

Osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) may be used for managing headache pain and related disability, but there is a need for high-quality randomized controlled trials to assess the effectiveness of this intervention. To explore the efficacy of OMTh for pain management in frequent episodic tension-type headache (TTH). Single-blind randomized placebo-controlled pilot study. Patients were recruited from 5 primary care settings. Forty-four patients who were affected by frequent episodic TTH and not taking any drugs for prophylactic management of episodic TTH were recruited. Patients were randomly allocated to an experimental or control group. The experimental group received corrective OMTh techniques, tailored for each patient; the control group received assessment of the cranial rhythmic impulse (sham therapy). The study included a 1-month baseline period, a 1-month treatment period, and a 3-month follow-up period. The primary outcome was the change in patient-reported headache frequency, and secondary outcomes included changes in headache pain intensity (discrete score, 1 [lowest perceived pain] to 5 [worst perceived pain]), over-the-counter medication use, and Headache Disability Inventory score. Forty patients completed the study (OMTh, n=21; control, n=19). The OMTh group had a significant reduction in headache frequency over time that persisted 1 month (approximate reduction, 40%; Ptreatment. Moreover, there was an absolute difference between the 2 treatment groups at the end of the study, with a 33% lower frequency of headache in the OMTh group (Ptreatment modalities and may benefit patients who have adverse effects to medications or who have difficulty complying with pharmacologic regimens. This protocol may serve as a model for future studies. © 2014 The American Osteopathic Association.

Patients with chronic tension-type headache demonstrate increased mechano-sensitivity of the supra-orbital nerve.

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Fernández-de-Las-Peñas, César; Coppieters, Michel W; Cuadrado, María Luz; Pareja, Juan A

2008-04-01

This study aimed to establish whether increased sensitivity to mechanical stimuli is present in neural tissues in chronic tension-type headache (CTTH). Muscle hyperalgesia is a common finding in CTTH. No previous studies have investigated the sensitivity of peripheral nerves in patients with CTTH. A blinded controlled study. Pressure pain thresholds (PPT) and pain intensity following palpation of the supra-orbital nerve (V1) were compared between 20 patients with CTTH and 20 healthy matched subjects. A pressure algometer and numerical pain rate scale were used to quantify PPT and pain to palpation. A headache diary was kept for 4 weeks to substantiate the diagnosis and record the pain history. The analysis of variance demonstrated significantly lower PPT for patients (0.86+/-0.13 kg/cm2) than controls (1.50+/-0.19 kg/cm2) (Por=0.72; P<.001). These findings reveal that mechanical hypersensitivity is not limited to muscles but also occurs in cranial nerves, and that the level of sensitization, either due to peripheral or central processes, is related to the severity of the primary headache.

Psychosocial factors associated with migraine and tension-type headache in medical students.

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Lebedeva, Elena R; Kobzeva, Natalia R; Gilev, Denis V; Kislyak, Nadezhda V; Olesen, Jes

2017-11-01

Background In our previous study of workers, blood donors and medical students, students stood out with a higher 1-year prevalence of migraine (28%) and tension-type headache (TTH) (74%). General factors associated with headache were common for all groups except low physical activity. The hypothesis of this study was therefore that a number of psychosocial factors relating to the personal sphere would better explain the high prevalence of migraine and TTH in students. Methods The study population consisted of 1042 students (719 females, 323 males, mean age 20.6, range 17-40). Headache diagnoses and associated factors were identified by direct professional semi-structured interview. We also interviewed about the following psychosocial factors: dissatisfaction with study, dissatisfaction with family life, dissatisfaction for personal reasons, bad financial situation, overwork, stress, not enough sleep, insomnia, depressed mood, anxiety, irritability, tendency towards conflicts and not being married. We report psychosocial factors associated with headache according to diagnosis and sex using univariate and multivariate logistic regression analyses. Results Several factors were significantly associated with migraine and TTH in the univariate analysis. In the multivariate analysis, two psychosocial factors were statistically significantly associated with migraine in all students: irritability (OR 2.2, 95% CI 1.4-3.6) and overwork (OR 2.2, 95% CI 1.4-3.5). Insomnia (2.7, 95% CI 1.1-6.9) and depressed mood (OR 2.1, 95% CI 1.1-4.2) were associated with migraine only in females. Two psychosocial factors were associated with TTH: dissatisfaction with study in males (OR 2.0, 95% CI 1.0-3.8) and depressed mood in females (OR 1.8, 95% CI 1.0-3.5). Conclusion Psychosocial factors from the personal sphere showed significant association with migraine and TTH in students. Such factors should therefore be major targets for preventive efforts to reduce the prevalence of primary

Referred pain elicited by manual exploration of the lateral rectus muscle in chronic tension-type headache.

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Fernández-de-Las-Peñas, César; Cuadrado, Maria Luz; Gerwin, Robert D; Pareja, Juan A

2009-01-01

To analyze the presence of referred pain elicited by manual examination of the lateral rectus muscle in patients with chronic tension-type headache (CTTH). A case-control blinded study. It has been found previously that the manual examination of the superior oblique muscle can elicit referred pain to the head in some patients with migraine or tension-type headache. However, a referred pain from other extraocular muscles has not been investigated. Fifteen patients with CTTH and 15 healthy subjects without headache history were included. A blinded assessor performed a manual examination focused on the search for myofascial trigger points (TrPs) in the right and left lateral rectus muscles. TrP diagnosis was made when there was referred pain evoked by maintained pressure on the lateral corner of the orbit (anatomical projection of the lateral rectus muscle) for 20 seconds, and increased referred pain while the subject maintained a medial gaze on the corresponding side (active stretching of the muscle) for 15 seconds. On each side, a 10-point numerical pain rate scale was used to assess the intensity of referred pain at both stages of the examination. Ten patients with CTTH (66.6%) had referred pain that satisfied TrPs diagnostic criteria, while only one healthy control (0.07%) reported referred pain upon the examination of the lateral rectus muscles (P < 0.001). The elicited referred pain was perceived as a deep ache located at the supraorbital region or the homolateral forehead. Pain was evoked on both sides in all subjects with TrPs, with no difference in pain intensity between the right and the left. The average pain intensity was significantly greater in the patient group (P < 0.001). All CTTH patients with referred pain recognized it as the frontal pain that they usually experienced during their headache attacks, which was consistent with active TrPs. In some patients with CTTH, the manual examination of lateral rectus muscle TrPs elicits a referred pain that

AUTOGENIC THERAPY IN TENSION HEADACHE

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Amruthraj, Brunda; Mishra, H.; Kumaraiah, V.

1987-01-01

SUMMARY Ten subjects diagnosed as Psychalgia were taken for study. A multiple baseline design was adapted and clients were subjected to 30 sessions of autogenic training. They were assessed using physiological (EMG and thermal change) and behavioural measures (Visual analogue scale and behavioural symptom checklist). Findings revealed autogenic therapy to be effective in reducing tension headache. PMID:21927245

AUTOGENIC THERAPY IN TENSION HEADACHE

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Amruthraj, Brunda; Mishra, H.; Kumaraiah, V.

1987-01-01

SUMMARY Ten subjects diagnosed as Psychalgia were taken for study. A multiple baseline design was adapted and clients were subjected to 30 sessions of autogenic training. They were assessed using physiological (EMG and thermal change) and behavioural measures (Visual analogue scale and behavioural symptom checklist). Findings revealed autogenic therapy to be effective in reducing tension headache.

[The influence of cognitive-behavioral therapy on the P300 potential in children with psychogenic nonepileptic seizures and tension headache].

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Stolarska-Weryńska, Urszula; Steczkowska, Małgorzata; Kaciński, Marek

2016-01-01

Explaining associations between neurophysiological and neuropsychological parameteres in children and improving the measurement methods would lead to a better understanding of the pathogenesis and course of psychosomatic disease. Goal: clinical assessment of the efficacy of cognitive-behavioral therapy in the treatment of psychogenic no- nepileptic seizures and tension type headaches in children. Determining the influence of cognitive behavioral therapy on the cognitive P300 potential and whether P300 parameters in children correlate with neuropsychological parameters. 20 children with nonepileptic psychogenic seizures and 30 children with tension type headaches, aged 11.3 - 17.11 years. The final diagnosis was made in the Paediatric Neurology Clinic. The P300 examination was performed before/after therapy, with/without hyperventilation. A fixed structure therapy was implemented (10 sessions, 90 minutes each), during two weeks of hospitalization or in an outpatient clinic (9 children with tension type headache). The psychological assessment comprised of temperament questionnaires, auditory and visual memory trials, executive function and attention trials, and in some cases also intelligence testing. More significant correlations were found in children with psychogenic seizures: attention parameters correlated negatively with reaction time, and this correlation tended to fade in the second examination, after psychotherapy. In children with tension type headache a statistically insignificant tendency was found of a positive correlation between those parameters. Medium P300 parameteres in this group were better. In 17/20 of children with psychogenic seizures a clinical improvement was observed, in 3 children the symptoms persisted in a 6 month follow up, but of a lower frequency. In 11/27 of chil- dren with tension headache the symptoms persisted, also with a lower frequency. cognitive-behavioral therapy is effective in the reduction of symptoms in many cases of

An individually tailored behavioral medicine treatment in physical therapy for tension-type headache – an experimental single-case study

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Söderlund A

2016-11-01

Full Text Available Anne Söderlund,1 Helena Lagerlöf2 1Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Västerås, 2Fysiokliniken Västra Aros AB, Västerås, Sweden Aim: The aim of this study was to describe and evaluate the effect of an individually tailored behavioral medicine treatment in physical therapy, based on a functional behavioral analysis (FBA, for tension-type headache (TTH. Patients and methods: A single-case study with A1-A2-B-A3 design of two patients with TTH was conducted. Outcome variables were headache frequency, headache index (mean intensity, consumption of analgesics, self-efficacy in headache management (Headache Management Self-efficacy Scale [HMSE], disability, and perceived loss of happiness for ­activities with family and friends. Results: The results showed that headache frequency and headache index decreased for one of the patients. Self-efficacy in headache management increased markedly for both patients. Conclusion: A behavioral medicine treatment in physical therapy based on an FBA can be a way for physical therapists to handle patients with TTH. Future investigations should focus on large group studies with longer observation periods. Keywords: headache index, self-efficacy, loss of happiness, functional behavioral analysis

PEMBERIAN INFRA RED, STRIPPING DAN STRETCHING TERHADAP NYERI TENSION HEADACHE DI PUSKESMAS TAPUS

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Cici Apriza Yanti

2018-03-01

Full Text Available Prevalence of headache in Indonesia is very high. More than 90% of patients consult a doctor. The aim of research is to know the difference of pain after giving Infra Red, Stripping, and Stretching to the pain of tension headache. This research design is quasi experiment with pre and post test design. Population in this research is all patient of tension headache at Tapus Health Center. Sampling using accidental sampling with 10 samples. The data were collected using observation sheet of pain caused by tension headache. Data analysis was done by computerized using Wilcoxon test. The results showed that the mean intensity of pain before the 5.60 decreased to 4.78 after intervention and the mean intensity of tenderness before the 6.10 decreased to 5.27 after the intervention. The results of analysis showed that there was a difference in the intensity of pain (p = 0,005 and tenderness (p = 0,005.It can be concluded that therapy with Infra Red (IR, Stripping, and Stretching is effective to decreased pain intensity due to tension headache. For that it is expected to patients with pain complaints to tension headache to be always active and disciplined follow effective therapy in reducing the intensity of pain. Prevalensi sakit kepala di Indonesia sangatlah tinggi. Lebih dari 90% pasien yang berkonsultasi ke dokter. Penelitian ini bertujuan untuk mengetahui perbedaan nyeri tekan dan gerak setelah pemberian Infra Red, Stripping, dan Stretching terhadap nyeri pada kasus tension headache di Puskesmas Tapus Kabupaten Pasaman tahun 2016. Desain penelitian ini adalah quasi eksperiment dengan desain pre dan post test. Populasi pada penelitian adalah seluruh pasien tension headache di Puskesmas Tapus pada bulan Juni sampai Juli tahun 2016. Pengambilan sampel menggunakan teknik accidental sampling sehingga didapatkan sampel sebanyak 10 orang. Pengumpulan data penelitian menggunakan lembar observasi intensitas nyeri akibat tension headache. Analisis data

Head pain referral during examination of the neck in migraine and tension-type headache.

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Watson, Dean H; Drummond, Peter D

2012-09-01

To investigate if and to what extent typical head pain can be reproduced in tension-type headache (TTH), migraine without aura sufferers, and controls when sustained pressure was applied to the lateral posterior arch of C1 and the articular pillar of C2, stressing the atlantooccipital and C2-3 segments respectively. Occipital and neck symptoms often accompany primary headache, suggesting involvement of cervical afferents in central pain processing mechanisms in these disorders. Referral of head pain from upper cervical structures is made possible by convergence of cervical and trigeminal nociceptive afferent information in the trigemino-cervical nucleus. Upper cervical segmental and C2-3 zygapophysial joint dysfunction is recognized as a potential source of noxious afferent information and is present in primary headache sufferers. Furthermore, referral of head pain has been demonstrated from symptomatic upper cervical segments and the C2-3 zygapophysial joints, suggesting that head pain referral may be a characteristic of cervical afferent involvement in headache. Thirty-four headache sufferers and 14 controls were examined interictally. Headache patients were diagnosed according the criteria of the International Headache Society and comprised 20 migraine without aura (females n = 18; males n = 2; average age 35.3 years) and 14 TTH sufferers (females n = 11; males n = 3; average age 30.7 years). Two techniques were used specifically to stress the atlantooccipital segments (Technique 1 - C1) and C2-3 zygapophysial joints (Technique 2 - C2). Two techniques were also applied to the arm--the common extensor origin and the mid belly of the biceps brachii. Participants reported reproduction of head pain with "yes" or "no" and rated the intensity of head pain and local pressure of application on a scale of 0 -10, where 0 = no pain and 10 = intolerable pain. None of the subjects reported head pain during application of techniques on the arm. Head pain referral during the

Aspirin for acute treatment of episodic tension-type headache in adults.

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Derry, Sheena; Wiffen, Philip J; Moore, R Andrew

2017-01-13

Tension-type headache (TTH) affects about 1 person in 5 worldwide. It is divided into infrequent episodic TTH (fewer than one headache per month), frequent episodic TTH (two to 14 headache days per month), and chronic TTH (15 headache days per month or more). Aspirin is one of a number of analgesics suggested for acute treatment of episodic TTH. To assess the efficacy and safety of aspirin for acute treatment of episodic tension-type headache (TTH) in adults compared with placebo or any active comparator. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and the Oxford Pain Relief Database from inception to September 2016, and also reference lists of relevant published studies and reviews. We sought unpublished studies by asking personal contacts and searching online clinical trial registers and manufacturers' websites. We included randomised, double-blind, placebo-controlled studies (parallel-group or cross-over) using oral aspirin for symptomatic relief of an acute episode of TTH. Studies had to be prospective, with participants aged 18 years or over, and include at least 10 participants per treatment arm. Two review authors independently assessed studies for inclusion and extracted data. For various outcomes (predominantly those recommended by the International Headache Society (IHS)), we calculated the risk ratio (RR) and number needed to treat for one additional beneficial outcome (NNT), one additional harmful outcome (NNH), or to prevent one event (NNTp) for oral aspirin compared to placebo or an active intervention.We assessed the evidence using GRADE and created a 'Summary of findings' table. We included five studies enrolling adults with frequent episodic TTH; 1812 participants took medication, of which 767 were included in comparisons of aspirin 1000 mg with placebo, and 405 in comparisons of aspirin 500 mg or 650 mg with placebo. Not all of these participants provided data for outcomes of interest in this review

Changes in Psychological Parameters in Patients with Tension-type Headache Following Massage Therapy: A Pilot Study

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Moraska, Albert; Chandler, Clint

2009-01-01

Investigations into complementary and alternative medicine (CAM) approaches to address stress, depression, and anxiety of those experiencing chronic pain are rare. The objective of this pilot study was to assess the value of a structured massage therapy program, with a focus on myofascial trigger points, on psychological measures associated with tension-type headache. Participants were enrolled in an open-label trial using a baseline control with four 3-week phases: baseline, massage (two 3-week periods) and a follow-up phase. Eighteen subjects with episodic or chronic tension-type headache were enrolled and evaluated at 3-week intervals using the State-Trait Anxiety Inventory, Beck Depression Inventory, and the Perceived Stress Scale. The Daily Stress Inventory was administered over 7-day periods during baseline and the final week of massage. Twice weekly, 45-minute massage therapy sessions commenced following the baseline phase and continued for 6 weeks. A significant improvement in all psychological measures was detected over the timeframe of the study. Post hoc evaluation indicated improvement over baseline for depression and trait anxiety following 6 weeks of massage, but not 3 weeks. A reduction in the number of events deemed stressful as well as their respective impact was detected. This pilot study provides evidence for reduction of affective distress in a chronic pain population, suggesting the need for more rigorously controlled studies using massage therapy to address psychological measures associated with TTH. PMID:20046550

[Headache Treatment].

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Diener, Hans Christoph; Holle-Lee, Dagny; Nägel, Steffen; Gaul, Charly

2017-03-01

A precondition for the successful treatment of headaches is the correct headache diagnosis. Triptans are effective for attack treatment of migraine and cluster headache. However, there are not effective for the treatment of tension-type headache. For the prevention of frequent episodic migraine betablockers, flunarizine, topiramate and amitriptyline are recommended. For the prevention of chronic migraine evidence is only available for onabotulinumtoxinA and topiramate. For prophylactic treatment of tension-type headaches tricyclic antidepressants are used. In cluster headache verapamil (in combination with steroids) is the most frequently used prophylactic agent. This article focusses on the current acute and prophylactic treatment of common headache syndromes. © Georg Thieme Verlag KG Stuttgart · New York.

Myofascial trigger point-focused head and neck massage for recurrent tension-type headache: A randomized, placebo-controlled clinical trial

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Moraska, Albert F.; Stenerson, Lea; Butryn, Nathan; Krutsch, Jason P.; Schmiege, Sarah J.; Mann, J. Douglas

2014-01-01

Objective Myofascial trigger points (MTrPs) are focal disruptions in skeletal muscle that can refer pain to the head and reproduce the pain patterns of tension-type headache (TTH). The present study applied massage focused on MTrPs of subjects with TTH in a placebo-controlled, clinical trial to assess efficacy on reducing headache pain. Methods Fifty-six subjects with TTH were randomized to receive 12 massage or placebo (detuned ultrasound) sessions over six weeks, or to wait-list. Trigger point release (TPR) massage focused on MTrPs in cervical musculature. Headache pain (frequency, intensity and duration) was recorded in a daily headache diary. Additional outcome measures included self-report of perceived clinical change in headache pain and pressure-pain threshold (PPT) at MTrPs in the upper trapezius and sub-occipital muscles. Results From diary recordings, group differences across time were detected in headache frequency (p=0.026), but not for intensity or duration. Post hoc analysis indicated headache frequency decreased from baseline for both massage (pheadache pain for massage than placebo or wait-list groups (p=0.002). PPT improved in all muscles tested for massage only (all p'streatment of TTH, and 2) TTH, like other chronic conditions, is responsive to placebo. Clinical trials on headache that do not include a placebo group are at risk for overestimating the specific contribution from the active intervention. PMID:25329141

[P300 potential in chldren with psychogenic nonepileptic events and tension headache].

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Steczkowska, Małgorzata; Stolarska-Weryńska, Urszula; Fiederer, Krystyna; Kaciński, Marek

2016-01-01

Psychotherapy is being used as the primary treatment in nonepileptic psychogenic seizures and tension headaches in children. Children's intelectual functioning is related to certain endogenous neurophysiological parameters. The goal of this study was to establish whether the endogenous potential P300 is different in children with nonepileptic psychogenic events and with tension headaches, and whether it changes under the influence of the cognitive-behavioral psychotherapy. The study included a group of 47 children: 20 with nonepileptic psychogenic seizures (18 girls and 2 boys), aged 11.09-17.11 years, and 27 children with tension headache (25 girls and 2 boys), aged 10.11-17.11 years. The P300 potential was induced using an auditory stimulus. The reaction time, the amount of mistakes and the percentage of attention focus was measured in all children. All children attended 8-10 psychotherapy sessions. The P300 potential was registered before and after the course of therapy, and additionally in both cycles also after a 3 minutes hyperventilation. Medium P300 parameters were closer to normal in the group of children with tension headaches rather than in the group with nonepileptic seizures. The shorter was the reaction time in the first measurement, the higher the attention score and the shorter the reaction time in the second measurement - this was visible in the results of children with nonepileptic seizures, in contrast to children with tension headaches. The use of hyperventilation caused a noticeable extension of the reaction time in the P300 measurement, with other components unchanged (mistake count and percentage of attention focus). The endogenous potential P300 does vary, although on a statistically insignificant level, in groups of children with tension headaches and nonepileptic seizures.

Multimodal compared to pharmacologic treatments for chronic tension-type headache in adolescents.

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Przekop, Peter; Przekop, Allison; Haviland, Mark G

2016-10-01

Chronic tension-type headache (CTTH) in children and adolescents is a serious medical condition, with considerable morbidity and few effective, evidence-based treatments. We performed a chart review of 83 adolescents (age range = 13-18 years; 67 girls and 16 boys) diagnosed with CTTH. Two treatment protocols were compared: multimodal (osteopathic manipulative treatments, mindfulness, and qi gong) and pharmacologic (amitriptyline or gabapentin). Four outcomes (headache frequency, pain intensity, general health, and health interference) were assessed at three time points (baseline, 3 months, and 6 months). A fifth outcome, number of bilateral tender points, was recorded at baseline and 6 months. All five were evaluated statistically with a linear mixed model. Although both multimodal and pharmacologic treatments were effective for CTTH (time effects for all measures were significant at p treatment (the five group by time interaction effects were significant at or below the p Headache frequency in the pharmacologic group, for example, reduced from a monthly average (95% Confidence Interval shown in parentheses) of 23.9 (21.8, 26.0) to 16.4 (14.3, 18.6) and in the multimodal group from 22.3 (20.1, 24.5) to 4.9 (2.6, 7.2) (a substantial group difference). Pain intensity (worst in the last 24 hours, 0-10 scale) was reduced in the pharmacologic group from 6.2 (5.6, 6.9) to 3.4 (2.7, 4.1) and from 6.1 (5.4, 6.8) to 2.0 (1.2, 2.7) in the multimodal group (a less substantial difference). Across the other three assessments, group differences were larger for general health and number of tender points and less so for pain restriction. Multimodal treatment for adolescent CTTH appears to be effective. Randomized controlled trials are needed to confirm these promising results. Copyright © 2015 Elsevier Ltd. All rights reserved.

Intra-oral orthosis vs amitriptyline in chronic tension-type headache: a clinical and laser evoked potentials study

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Sardaro Michele

2006-05-01

Full Text Available Abstract Background In the present study, we examined clinical and laser-evoked potentials (LEP features in two groups of chronic tension-type headache (CTTH patients treated with two different approaches: intra-oral appliance of prosthesis, aiming to reduce muscular tenderness, and 10 mg daily amitriptyline. Methods Eighteen patients with diagnosed CTTH participated in this open label, controlled study. A baseline evaluation was performed for clinical features, Total Tenderness Score (TTS and a topographic analysis of LEPs obtained manually and the pericranial points stimulation in all patients vs. healthy subjects. Thereafter, patients were randomly assigned to a two-month treatment by either amitriptyline or intra-oral appliance. Results and discussion Both the intra-oral appliance and amitriptyline significantly reduced headache frequency. The TTS was significantly reduced in the group treated with the appliance. The amplitude of P2 response elicited by stimulation of pericranial zones showed a reduction after amitriptyline treatment. Both therapies were effective in reducing headache severity, the appliance with a prevalent action on the pericranial muscular tenderness, amitriptyline reducing the activity of the central cortical structures subtending pain elaboration Conclusion The results of this study may suggest that in CTTH both the interventions at the peripheral and central levels improve the outcome of headache.

[Tricyclic antidepressant therapy in headache].

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Magyar, Máté; Csépány, Éva; Gyüre, Tamás; Bozsik, György; Bereczki, Dániel; Ertsey, Csaba

2015-12-01

The two most important representatives of the primary headaches are migraine and tension-type headache. More than 10% of the population suffer from migraine and even a greater part, approximately 30-40% from tension-type headache. These two headache types have a great effect both on the individual and on the society. There are two types of therapeutic approaches to headaches: the abortive and the prophylactic therapy. Prophylactic treatment is used for frequent and/or difficult-to-treat headache attacks. Although both migraine and tension-type headache are often associated with depression, for their treatment - in contrast to the widespread medical opinion - not all antidepressants were found to be effective. Amitriptyline, which is a tricyclic antidepressant, is used as a prophylactic therapy for headache since 1968. Its efficacy has been demonstrated in several double-blind, placebo-controlled studies. Although the newer types of antidepressant, such as selective serotonin reuptake inhibitors and selective serotonin-norepinephrine reuptake inhibitor, have a more favorable side-effect profile than tricyclic antidepressants, their headache prophylactic effect has not been proven yet.

The association of headache frequency with pain interference and the burden of disease is mediated by depression and sleep quality, but not anxiety, in chronic tension type headache.

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Palacios-Ceña, María; Fernández-Muñoz, Juan J; Castaldo, Matteo; Wang, Kelun; Guerrero-Peral, Ángel; Arendt-Nielsen, Lars; Fernández-de-Las-Peñas, César

2017-12-01

A better understanding of potential relationship between mood disorders, sleep quality, pain, and headache frequency may assist clinicians in determining optimal therapeutic programs. The aim of the current study was to analyze the effects of sleep quality, anxiety, depression on potential relationships between headache intensity, burden of headache, and headache frequency in chronic tension type headache (CTTH). One hundred and ninety-three individuals with CTTH participated. Headache features were collected with a 4-weeks headache diary. The Hospital Anxiety and Depression Scale was used for assessing anxiety and depression. Headache Disability Inventory evaluated the burden of headache. Pain interference was determined with the bodily pain domain (SF-36 questionnaire). Sleep quality was assessed with Pittsburgh Sleep Quality Index. Path analyses with maximum likelihood estimations were conducted to determine the direct and indirect effects of depression, anxiety, and sleep quality on the frequency of headaches. Two paths were observed: the first with depression and the second with sleep quality as mediators. Direct effects were noted from sleep quality, emotional burden of disease and pain interference on depression, and from depression to headache frequency. The first path showed indirect effects of depression from emotional burden and from sleep quality to headache frequency (first model R 2  = 0.12). Direct effects from the second path were from depression and pain interference on sleep quality and from sleep quality on headache frequency. Sleep quality indirectly mediated the effects of depression, emotional burden and pain interference on headache frequency (second model R 2  = 0.18). Depression and sleep quality, but not anxiety, mediated the relationship between headache frequency and the emotional burden of disease and pain interference in CTTH.

[Preventive treatment of tension headache in children and adolescents].

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Shypilova, E M; Zavadenko, N N; Nesterovskiy, Yu E

To assess the efficacy of noophen (γ-amino-β-phenylbutyric acid hydrochloride) in the preventive treatment of tension-type headache (TTH) in children and adolescents. The study included 30 patients with TTH, aged from 8 to 16 years, treated with noophen in dose of 15-20 mg/kg per day (2-3 times perorally) during 2 month. Before and during the treatment characteristics of headache, its influence on daily activities were assessed with HIT-6 and PedMIDAS, anxiety disorders were assessed with SCAS, the dynamics of sleep disturbances in children were evaluated. A significant decrease in the frequency, duration and intensity of TTH as well as positive changes in daily life activities and reduction of anxiety and sleep disorders manifestations, which are the risk factors for TTH, were demonstrated during the treatment with noophen. Starting from the first month of treatment, there was a significant decrease in the number of days completely lost because of headache and days with the reduced activity (a decrease in the productivity by >50%).

The quality of diagnosis and management of migraine and tension-type headache in three social groups in Russia.

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Lebedeva, Elena R; Kobzeva, Natalia R; Gilev, Denis V; Olesen, Jes

2017-03-01

Background Three successive editions of the International Classification of Headache Disorders and multiple guideline papers on headache care have described evidence based diagnosis and treatment of headache disorders. It remains unknown, however, to which extent this has improved the diagnosis and management of headache. That was the aim of our study in which we also analysed differences between three social groups in Russia. Methods We studied 1042 students (719 females, 323 males, mean age 20.6, age range 17-40), 1075 workers (146 females, 929 males, mean age 40.4, age range 21-67) and 1007 blood donors (484 females, 523 males, mean age 34.1, age range 18-64). We conducted a semi-structured, validated, face-to-face professional interview. Data on prevalence and associated factors have previously been published. A section of the interview focused on previous diagnosis and treatment, the topic of this paper. Results Only 496 of 2110 participants (23%) with headache in Russia had consulted because of headache. Students consulted more frequently (35%), workers and blood donors less often (13% and 14%). Only 12% of the patients with ICHD-3beta diagnosis of migraine and 11.7% with ICHD-3beta diagnosis of tension-type headache (TTH) had previously been correctly diagnosed. Triptans were used by only 6% of migraine patients. Only 0.4% of migraine patients and no TTH patients had received prophylactic treatment. Conclusion Despite existing guidelines about diagnosis and treatment, both remain poor in Russia. According to the literature this is only slightly better in Europe and America. Dissemination of existing knowledge should have higher priority in the future.

Effectiveness of manual therapy compared to usual care by the general practitioner for chronic tension-type headache: design of a randomised clinical trial

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Dekker Joost

2009-02-01

Full Text Available Abstract Background Patients with Chronic Tension Type Headache (CTTH report functional and emotional impairments (loss of workdays, sleep disturbances, emotional well-being and are at risk for overuse of medication. Manual therapy may improve symptoms through mobilisation of the spine, correction of posture, and training of cervical muscles. We present the design of a randomised clinical trial (RCT evaluating the effectiveness of manual therapy (MT compared to usual care by the general practitioner (GP in patients with CTTH. Methods and design Patients are eligible for participation if they present in general practice with CTTH according to the classification of the International Headache Society (IHS. Participants are randomised to either usual GP care according to the national Dutch general practice guidelines for headache, or manual therapy, consisting of mobilisations (high- and low velocity techniques, exercise therapy for the cervical and thoracic spine and postural correction. The primary outcome measures are the number of headache days and use of medication. Secondary outcome measures are severity of headache, functional status, sickness absence, use of other healthcare resources, active cervical range of motion, algometry, endurance of the neckflexor muscles and head posture. Follow-up assessments are conducted after 8 and 26 weeks. Discussion This is a pragmatic trial in which interventions are offered as they are carried out in everyday practice. This increases generalisability of results, but blinding of patients, GPs and therapists is not possible. The results of this trial will contribute to clinical decision making of the GP regarding referral to manual therapy in patients with chronic tension headache.

A comparison of conservative and invasive dental approaches in the treatment of tension-type headache.

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Troeltzsch, Markus; Messlinger, Karl; Brodine, Brian; Gassling, Volker; Troeltzsch, Matthias

2014-10-01

To investigate the efficacy of conservative dental treatment (occlusal splint and pharmacologic therapy) and invasive therapy (prosthetic restorations) in the treatment of tension-type headache (TTH). The study sample was composed of 70 patients who presented with symptomatic TTH and were assigned to three treatment groups according to their treatment needs. Group A (30 patients): a conservative treatment protocol with a combination of an occlusal splint and analgesic and muscle relaxant medication. Group B (10 patients): invasive prosthodontic procedures. Group C (30 patients): patients who refused any type of treatment but consented to the study served as a control group. Pain quality was measured with the Headache Impact Test (HIT-6). The statistical analysis was performed with the Wilcoxon rank test (P≤.05). Conservative treatment with splints and analgesic medication and invasive treatment by prosthetic rehabilitation relieved the TTH symptoms. The patients who received treatment experienced a significant reduction in their discomfort after 6 months (P≤.01), whereas the patients who refused therapy remained, on average, at the same pain level (P≤.117). In group A, the HIT-6 score was reduced for 26 patients, and in group B for 8 patients. In group C a reduction of HIT-6 scores was observed in 10 patients. Conservative or invasive occlusal adjustments may serve as a useful tool in the treatment of TTH.

Myofascial trigger points, neck mobility, and forward head posture in episodic tension-type headache.

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Fernández-de-Las-Peñas, César; Cuadrado, Maria L; Pareja, Juan A

2007-05-01

To assess the differences in the presence of trigger points (TrPs) in head and neck muscles, forward head posture (FHP) and neck mobility between episodic tension-type headache (ETTH) subjects and healthy controls. In addition, we assess the relationship between these muscle TrPs, FHP, neck mobility, and several clinical variables concerning the intensity and the temporal profile of headache. TTH is a headache in which musculoskeletal disorders of the craniocervical region might play an important role in its pathogenesis. Design.-A blinded, controlled pilot study. Fifteen ETTH subjects and 15 matched controls without headache were studied. TrPs in both upper trapezius, both sternocleidomastoids, and both temporalis muscles were identified according to Simons and Gerwin diagnostic criteria (tenderness in a hypersensible spot within a palpable taut band, local twitch response elicited by snapping palpation, and elicited referred pain with palpation). Side-view pictures of each subject were taken in both sitting and standing positions, in order to assess FHP by measuring the craniovertebral angle. A cervical goniometer was employed to measure neck mobility. All measures were taken by a blinded assessor. A headache diary was kept for 4 weeks in order to assess headache intensity, frequency, and duration. The mean number of TrPs for each ETTH subject was 3.7 (SD: 1.3), of which 1.9 (SD: 0.9) were active, and 1.8 (SD: 0.9) were latent. Control subjects only had latent TrPs (mean: 1.5; SD: 1). TrP occurrence between the 2 groups was significantly different for active TrPs (P .05). Differences in the distribution of TrPs were significant for the right upper trapezius muscles (P= .04), the left sternocleidomastoid (P= .03), and both temporalis muscles (P < .001). Within the ETTH group, headache intensity, frequency, and duration outcomes did not differ depending on TrP activity, whether the TrP was active or latent. The craniovertebral angle was smaller, ie, there was a

[Botulinum toxin type A in headache treatment : Established and experimental indications].

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Gaul, C; Holle-Lee, D; Straube, A

2016-08-01

In recent years botulinum toxin type A has been used increasingly more in the treatment of specific headache disorders. Especially regarding chronic migraine with and without combined medication overuse, convincing randomized studies have proven the efficacy of this treatment option and have led to approval for this indication. Regarding other headache entities, such as episodic migraine, tension-type headache, trigeminal autonomic cephalalgia (TAC), neuralgic, neuropathic and myofascial pain, currently available scientific data on the efficacy of botulinum toxin type A are scarce and often ambiguous. The exact underlying mechanisms of the influence of botulinum toxin type A on the pathophysiology of headache are not completely clear but an influence on the release of calcitonin gene-related peptide (CGRP) seems to play a crucial role. This article summarizes the most important studies as well as experiences of treatment with botulinum toxin type A regarding different headache entities.

Modelo biopsicossocial e formulação comportamental: compreendendo a cefaléia do tipo tensional Modelo biopsicosocial y formulación comportamental: comprendiendo la cefalea del tipo tensional The bio-psychosocial model and behavioral formulation: understanding the tension-type headache

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Adriana Mayon Neiva Flores

2008-03-01

Full Text Available A cefaléia do tipo tensional constitui um tipo freqüente de dor de cabeça, que tende a ocasionar uma série de comportamentos de evitação, com prejuízos físicos, sociais e psicológicos aos indivíduos afetados. O presente trabalho descreve algumas contribuições do modelo biopsicossocial de saúde para a compreensão da cefaléia do tipo tensional, descreve os tratamentos mais freqüentemente oferecidos e discute as vantagens de modalidades terapêuticas que utilizam a formulação comportamental. Destaca-se a relevância da consideração de fatores psicossociais presentes nas formas mais comuns de evolução da cefaléia do tipo tensional, o que contribui para a elaboração de planos de tratamento mais eficientes e coerentes com uma proposta realmente sistêmica e idiográfica.La cefalea del tipo tensional constituye un tipo frecuente de dolor de cabeza, que tiene la tendencia a ocasionar una serie de comportamientos de evitación, con daños físicos, sociales y psicológicos a los individuos afectados. El presente trabajo describe algunas contribuciones del modelo biopsicosocial de salud para la comprensión de la cefalea del tipo tensional, describe los tratamientos más frecuentemente ofrecidos y discute las ventajas de modalidades terapéuticas que utilizan la formulación comportamental. Se destaca la relevancia de la consideración de factores psicosociales presentes en las formas más comunes de evolución de la cefalea del tipo tensional, lo que contribuye para la elaboración de planes de tratamiento más eficientes y coherentes con una propuesta realmente sistémica e idiográfica.Tension-type headache are a frequent source of complaints in health assistance units. It tends to cause avoidance behaviors with adverse consequences in physical, psychological and social aspects. Contributions from the Bio-Psychosocial perspective are described for a better understanding of the tension-type headache problem. Study also analyzes

Neck/shoulder function in tension-type headache patients and the effect of strength training

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Madsen, Bjarne K; Søgaard, Karen; Andersen, Lars L.

2018-01-01

Introduction: Muscle pain has been associated with reduced maximal muscle strength, and reduced rate of force development (RFD). Strength training (ST) has shown an effect in not only normalizing muscle function but also reducing neck muscle pain. Aim: The aims of this study were to compare muscle...... function in terms of strength, force steadiness in neck flexion, as well as extension, and rate of RFD of the shoulder in tension-type headache (TTH) patients and healthy controls and to examine the correlation to tenderness. Furthermore, the aim of the study was to examine the effect of ST on neck...... steadiness (ST: p=0.011 and EP: pfunction, indicated by a lower force steadiness and RFD, compared to the healthy controls. The effect of ST was not larger than EP as both groups of TTH patients showed some improvement in neck and shoulder...

Epidemiology, etiology and study of clinical findings of headache

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Ghaffarpoor M

1998-09-01

Full Text Available In a cross-sectional epidemiological study of headache disorders in neurology clinic of Fatemieh hospital of Semnan (August 22-November 20.1996, information on types of headaches, quality, severity, location, duration, frequency, precipitating factors, age of onset, influence of menstruation and pregnancy, positive familial history, use of oral contraceptive pills and other epidemiological factors including socioeconomic and age/sex composition was collected. The presence of any types of headaches was ascertained by a clinical interview and examination using the operational diagnostic criteria of the International Headaches Society. The prevalence of migraine and tension type headache was also analysed in relation to variables of life style (physical activity and sleep pattern and associated signs and symptoms (nausea, vomiting, photophobia and phonophobia. In this study migraine and tension headache were also compared in variable aspects with each other. 1 Headache was more prevalent in women than men (F/M=3/1. 2 The most common types of headache included: tension type headache (41.4%, migraine (31.2% and unclassified headaches (17.2%. 3 Migraine and T.T.H were more prevalent in early adult life and middle ages. 4 In both migraine and tension type headache the time profiles (duration, frequency, age of onset, quality and location were like that noted in textbook and previous studies. 5 In both migraine and tension type headache the most conspicuous precipitating factor was stress and mental tension and frequent headaches were accompanied with psychiatric problems (e.g depression and or anxiety. 6 Nausea, vomiting, phonophobia and photophobia were the most common associated symptoms in both of them. 7 Positive familial history and aggravation of headache in perimenstual period were more commonly seen in patients with migraine than tension type headache. In conclusion using the operational diagnostic criteria of International Headache Society in

The Role of Regular Home Practice in the Relaxation Treatment of Tension Headache.

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Blanchard, Edward B.; And Others

1991-01-01

Gave 27 tension headache sufferers progressive muscle relaxation (PMR) training, with 14 of those subjects also receiving home practice and application instructions. Compared to third group of sufferers (n=6) who merely monitored headache activity, both treated groups showed significant reduction in headache activity. Treatment groups did not…

Principles of headaches evaluation

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Camila Rosa Rolim de Andrade

2011-06-01

Full Text Available ABSTRACT However common tension-type headache is in epidemiologic population-based studies, migraine is the most common diagnosis in patients seeking treatment for headache in primary care. The appropriate evaluation of headache should be as follows: 1 To rule out the most serious underlying pathologies and to look for other secondary causes of headache, 2 To determine the type of primary headache using the patient's history as a primary diagnostic tool. Symptoms can always overlap, particularly between migraine and tension-type headache and between migraine and some secondary causes of headache (such as neurologic or systemic disease. A brief headache screen based only on anamnesis and physical examination data which direct to an underlying pathology is useful to primary care physicians in particular. An imaging study is not necessary in the vast majority of patients presenting with headache. Nevertheless, imaging (usually CT scan is warranted in the patients outlined above.

Quality of life in healthy children and in children with tension headaches--a comparative analysis.

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Talarska, D

2005-01-01

The aim of this study was the assessment of the quality of life of children and adolescents with tension headaches in comparison with healthy peers. The study was conducted on 135 middle school and high school students in Poznań and on 86 children with tension headaches, that were treated in the out-patient clinic of The Chair and Clinic of Development Age Neurology of Karol Marcinkowski University of Medical Sciences in Poznań. The research tool for both groups was Pediatric Quality of Life Inventory, version 4.0 (PedsQL 4.0) questionnaire. In the analysed groups dominated 14- and 16-year-old children. Among children with tension headaches, the ailments usually appeared once or twice a week in 39 (45%) of them. With the use of the PedsQL 4.0 questionnaire the following fields of activity were analyzed: biological, emotional, social functioning and mood. The biggest discrepancies between the group of healthy children and those with headaches were noted in the field of emotional functioning and mood. Adolescents with tension headaches more frequently reported the feeling of fear and sleep disorders in comparison to healthy students. Children with headaches look at the future in a more pessimistic way and are less satisfied with their lives.

Tension-Type Headache - The Normal and Most Prevalent Headache

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Jensen, Rigmor Højland

2018-01-01

diagnosis of TTH are highlighted and the situations more likely to raise doubts are discussed. POTENTIAL SOLUTION: A structured approach to the patient and a better comprehension of the very frequent coexistence of migraine and medication overuse headache in the clinical population are emphasized. According...

Lower immunglobulin A levels but not lower cortisol or α-amylase activity in children with chronic tension-type headache.

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Fernández-de-Las-Peñas, César; Fernández-Mayoralas, Daniel M; Arroyo-Morales, Manuel; Ambite-Quesada, Silvia; Rivas-Martínez, Inés; Ortega-Santiago, Ricardo; Díaz-Rodríguez, Lourdes; Pareja, Juan A

2011-03-01

The study was designed to investigate the differences in salivary cortisol (hypothalamic-pituitary-adrenocortical [HPA] axis), immunoglobulin A (IgA) (immune system) concentrations and α-amylase (sympathetic nervous system [SNS]) activity between children with chronic tension-type headache (CTTH) and healthy children. Thirty-six children, 10 boys and 26 girls (age: 9 ± 2 years) with CTTH and 36 age- and sex-matched healthy children were recruited. Salivary cortisol, α-amylase activity, salivary flow rate, IgA concentration and IgA rate were collected from non-stimulated saliva. A headache diary was used for collecting data on intensity, frequency and duration of headache for four weeks. Children with CTTH showed lower IgA concentration (p = .008) and IgA rate (p = .039), but not lower cortisol concentration (p = .447), salivary flow rate (p = .289) or α-amylase activity (p = .559), as compared to healthy children. Neither age (p > .582) nor gender (p > .227) influenced salivary markers. A significant association between the number of years with headache and IgA concentration (r(s) = - 0.385; p = .023) was found: the greater the number of years with headache, the lower the IgA concentration. These results suggest that children with CTTH present with deficits in the immune system, but not dysfunction in the HPA axis or SNS. Future studies are needed to elucidate the direction of these relationships.

Cortical plasticity between the pain and pain-free phases in patients with episodic tension-type headache.

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Chen, Bing; He, Yuan; Xia, Lei; Guo, Li-Li; Zheng, Jin-Long

2016-12-01

State-related brain structural alterations in patients with episodic tension-type headache (ETTH) are unclear. We aimed to conduct a longitudinal study to explore dynamic gray matter (GM) changes between the pain and pain-free phases in ETTH. We recruited 40 treatment-naïve ETTH patients and 40 healthy controls. All participants underwent brain structural scans on a 3.0-T MRI system. ETTH patients were scanned in and out of pain phases. Voxel-based morphometry analysis was used to determine the differences in regional gray matter density (GMD) between groups. Additional regression analysis was used to identify any associations between regional GMD and clinical symptoms. ETTH patients exhibited reduced GMD in the bilateral primary somatosensory cortex, and increased GMD in the bilateral anterior cingulate cortex (ACC) and anterior insula for the in pain phase compared with the out of pain phase. The out of pain phase of ETTH patients exhibited no regions with higher or lower GMD compared with healthy controls. GMD in the left ACC and left anterior insula was negatively correlated with headache days. GMD in the left ACC was negatively correlated with anxiety and depressive symptoms in ETTH patients. This is the first study to demonstrate dynamic and reversible GMD changes between the pain and pain-free phases in ETTH patients. However, this balance might be disrupted by increased headache days and progressive anxiety and depressive symptoms.

Computed tomography scan of the head in patients with migraine or tension-type headache Tomografia computadorizada do crânio em pacientes com migrânea ou cefaléia tensional

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Marcelo Moraes Valença

2002-09-01

Full Text Available A retrospective study was performed in order to evaluate the frequency of abnormalities found by computed tomography (CT scan of the head in 78 patients with migraine or tension-type headache. In the present study CT scan was normal in 61.5% of the patients with migraine or tension-type headache. A number of abnormalities were encountered in more than one third of the patients studied, including inflammatory sinus disease (19.2%, cysticercosis (3.9%, unruptuted cerebral aneurysm (2.6%, basilar impression (2.6%, intracranial lipoma (2.6%, arachnoid cyst (2.6%, empty sella (2.6%, intracranial neoplasm (2.6%, and others (2.6%. None of these lesions were symptomatic or responsible by the headache picture, therefore, considered incidental findings. In conclusion, the fortuitous encounter of some abnormalities on CT scan of the head is often higher than what we could predict in patients suffering migraine or tension-type headache. We briefly discuss clinical, epidemiologic, and practical management of some of the abnormalities detected by CT scan as well as the indication to request a neuroimaging investigation.Um estudo retrospectivo foi realizado visando avaliar a frequência de anormalidades encontradas durante a realização de estudo por tomografia computadorizada (TC em 78 pacientes com migrânea ou cefaléia do tipo tensional. A TC foi normal em 61,5% dos pacientes examinados. Em um terço dos pacientes estudados foram detectadas anormalidades, como doença inflamatória dos seios paranasais (19,2%, cisticercose (3,9%, aneurisma cerebral não-roto (2,6%, impressão basilar (2,6%, lipoma intracraniano (2,6%, cisto aracnoideo (2,6%, sela vazia (2,6%, neoplasia intracraniana (2,6% e outras afecções (2,6%. Nenhuma destas lesões era sintomática (achado incidental. Concluindo, o encontro fortuito de algumas anormalidades na TC é frequentemente mais elevado do que se prediz em pacientes com cefaléia primária. Nós discutimos brevemente alguns

The effect of manipulation plus massage therapy versus massage therapy alone in people with tension-type headache. A randomized controlled clinical trial.

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Espí-López, Gemma V; Zurriaga-Llorens, Rosario; Monzani, Lucas; Falla, Deborah

2016-10-01

Manipulative techniques have shown promising results for relief of tension-type headache (TTH), however prior studies either lacked a control group, or suffered from poor methodological quality. The aim of this study was to compare the effect of spinal manipulation combined with massage versus massage alone on range of motion of the cervical spine, headache frequency, intensity and disability in patients with TTH. Randomized, single-blinded, controlled clinical trial. University clinic. We enrolled 105 subjects with TTH. Participants were divided into two groups: 1) manipulation and massage; 2) massage only (control). Four treatment sessions were applied over four weeks. The Headache Disability Inventory (HDI) and range of upper cervical and cervical motion were evaluated at baseline, immediately after the intervention and at a follow-up, 8 weeks after completing the intervention. Both groups demonstrated a large (ƒ=1.22) improvement on their HDI scores. Those that received manipulation reported a medium-sized reduction (ƒ=0.33) in headache frequency across all data points (Pheadache. Although massage provided relief of headache in TTH sufferers, when combined with cervical manipulation, there was a stronger effect on range of upper cervical spine motion.

Review of botulinum toxin type A for the prophylactic treatment of chronic daily headache

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Stefan Evers

2007-05-01

Full Text Available Stefan EversDepartment of Neurology, University of Münster, Münster, GermanyAbstract: Botulinum toxin A is increasingly used in the treatment of idiopathic and symptomatic headache disorders. However, only few controlled trials are available and many trials can hardly be compared to each other because of different endpoints and different trial designs. In particular chronic daily headache, which is defined as an idiopathic headache occurring on more than 15 days per month for at least 3 months and a daily duration of at least 4 hours, is considered as a headache disorder with possible efficacy of botulinum toxin A. For the prophylactic treatment of chronic tension-type headache and chronic migraine, no sufficient positive evidence for a successful treatment can be obtained from randomized, double-blind, and placebo-controlled trials to date. For the treatment of chronic daily headache including medication overuse headache, there is some positive evidence for efficacy in a subgroup of patients. To date, the majority of double-blind and placebo-controlled studies do not suggest that botulinum toxin A is efficacious in the treatment of chronic idiopathic headache disorders. However, it is possible that some subgroups of patients with chronic daily headache will benefit from a long-term treatment with botulinum toxin A.Keywords: botulinum toxin A, chronic daily headache, chronic tension-type headache, chronic migraine

Efficacy of single versus three sessions of high rate repetitive transcranial magnetic stimulation in chronic migraine and tension-type headache.

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Kalita, Jayantee; Laskar, Sanghamitra; Bhoi, Sanjeev Kumar; Misra, Usha Kant

2016-11-01

We report the efficacy of three versus single session of 10 Hz repetitive transcranial magnetic stimulation (rTMS) in chronic migraine (CM) and chronic tension-type headache (CTTH). Ninety-eight patients with CM or CTTH were included and their headache frequency, severity, functional disability and number of abortive medications were noted. Fifty-two patients were randomly assigned to group I (three true sessions) and 46 to group II (one true and two sham rTMS sessions) treatment. 10 Hz rTMS comprising 600 pulses was delivered in 412.4 s on the left frontal cortex. Outcomes were noted at 1, 2 and 3 months. The primary outcome was 50 % reduction in headache frequency, and secondary outcomes were improvement in severity, functional disability, abortive drugs and side effects. The baseline headache characteristics were similar between the two groups. Follow up at different time points revealed significant improvement in headache frequency, severity, functional disability and number of abortive drugs compared to baseline in both group I and group II patients, although these parameters were not different between the two groups. In group I, 31 (79.4 %) had reduction of headache frequency and 29 (74.4 %) converted to episodic headache. In group II, these were 24 (64.8 %) and 22 (59.2 %), respectively. In chronic migraine, the severity of headache at 2 months reduced in group I compared to group II (62.5 vs 35.3 %; P = 0.01). Both single and three sessions of 10 Hz rTMS were found to be equally effective in CM and CTTH, and resulted in conversion of chronic to episodic headache in 67.1 % patients.

[Headache: classification and diagnosis].

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Carbaat, P A T; Couturier, E G M

2016-11-01

There are many types of headache and, moreover, many people have different types of headache at the same time. Adequate treatment is possible only on the basis of the correct diagnosis. Technically and in terms of content the current diagnostics process for headache is based on the 'International Classification of Headache Disorders' (ICHD-3-beta) that was produced under the auspices of the International Headache Society. This classification is based on a distinction between primary and secondary headaches. The most common primary headache types are the tension type headache, migraine and the cluster headache. Application of uniform diagnostic concepts is essential to come to the most appropriate treatment of the various types of headache.

Outpatient Combined Group and Individual Cognitive-Behavioral Treatment for Patients With Migraine and Tension-Type Headache in a Routine Clinical Setting.

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Christiansen, Sandra; Jürgens, Tim P; Klinger, Regine

2015-09-01

To test the long-term clinical effectiveness (follow-up at 3, 6 and 12 months) of an outpatient combined group and individual cognitive-behavioral treatment (CBT) for headache patients following standard medical care. A decrease in headache intensity, frequency, headache-specific impairment, depression, and change of pain-related cognitions was expected. The efficacy of CBT for primary headaches has been confirmed in research, yet the translation into clinical practice has remained untested thus far. In this single-group outcome study, 87 headache patients diagnosed with migraine and/or tension-type headache received (1) headache-specific medication for 10 weeks and (2) a subsequent CBT treatment made up of 13 individual and 12 group sessions consisting of psychoeducation, progressive muscle relaxation, coping strategies for pain and stress, and goal setting skills. Booster group sessions after 3 and 6 months were implemented to stimulate individual goal attainment, and follow-up measures were recorded up to 12 months. A significant decrease was found for all primary and secondary outcome criteria, ie, average headache intensity (prae M: 6.0, standard deviation [SD]: 1.5 vs follow-up [FU] 1 year M: 5.1, SD: 1.9), headache frequency (prae M: 16.0, SD: 9.5 vs FU 1 year M: 13.4, SD: 9.9), and catastrophizing (prae M: 3.4, SD: 1.0 vs FU 1 year M: 2.6, SD: 1.1). Coping strategies were increased (prae M: 3.4, SD: .9 vs FU 1 year M: 4.0, SD: 1.0). CBT treatment is a useful component within a routine clinical setting and can improve standard medical care thereby helping patients in managing their headache pain. © 2015 American Headache Society.

Anxiety and hopelessness levels in patients with migraine and tension headache

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Yüksel Kıvrak

2009-01-01

Full Text Available Aim: Migraine and tension type headache (TTH are two most common headaches. In this study, we aimed to investigate whether the hopelessness, anxiety and social self-esteem scores are different in two headache groups.Materials and Methods: This study was conducted with 72 migraine patients, 28 TTH patients and 50 healthy controls. Participants filled the General Information Form, Hopeless-ness Scale (HS, Spielberger Trait Anxiety Inventory (STAI-II and Social Comparison Scale (SCS. Results: There were no differences between the groups with respect to gender, age, education years, marital status and economical status. Hopelessness scores of the TTH group was higher than the migraine and control group (p=0.001. There were no statistical differences between the migraine and TTH groups with respect to STAI-II scores but TTH group scores higher in study groups (p=0.003. Control group SCS scores were higher than both patient groups with no significant differences (p=0.072.Conclusion: These findings indicate that the patients with TTH have more hopelessness than the migraine group and more anxious than the healthy control group.

Effect of mindfulness-based stress reduction on pain severity and mindful awareness in patients with tension headache: a randomized controlled clinical trial.

Science.gov (United States)

Omidi, Abdollah; Zargar, Fatemeh

2014-09-01

Programs to improve the pain and health status in illnesses with pain such as headache are still in their infancy. Mindfulness-based stress reduction (MBSR) is a new psychotherapy that appears to be effective in treating chronic pain. This study evaluated efficacy of MBSR in improving pain severity and mindful awareness in patients with tension headache. This study was a randomized controlled clinical trial that was conducted in 2012 in Shahid Beheshti Hospital of Kashan City. Sixty patients who were diagnosed with tension-type headache according to the International Headache Classification Subcommittee were randomly assigned to treatment as usual (TAU) or MBSR groups. The MBSR group received eight weekly treatments. Any session lasted 120 minutes. The sessions were based on MBSR protocol. Diary scale for measuring headache and Mindful Attention Awareness Scale (MAAS) were administered at pretreatment, and posttreatment, and three-month follow-up in both groups. The data was analyzed using repeated measures analysis of variance. The mean of pain severity was 7.36 ± 1.25 before intervention that was significantly reduced to 5.62 ± 1.74 and 6.07 ± 1.08 after the intervention and follow-up (P headache. It appears that MBSR is an effective psychotherapy for treatment of patients with tension headache.

Clinical variables associated with recovery in patients with chronic tension-type headache after treatment with manual therapy.

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Castien, René F; van der Windt, Daniëlle A W M; Blankenstein, Annette H; Heymans, Martijn W; Dekker, Joost

2012-04-01

The aims of this study were to describe the course of chronic tension-type headache (CTTH) in participants receiving manual therapy (MT), and to develop a prognostic model for predicting recovery in participants receiving MT. Outcomes in 145 adults with CTTH who received MT as participants in a previously published randomised clinical trial (n=41) or in a prospective cohort study (n=104) were evaluated. Assessments were made at baseline and at 8 and 26 weeks of follow-up. Recovery was defined as a 50% reduction in headache days in combination with a score of 'much improved' or 'very much improved' for global perceived improvement. Potential prognostic factors were analyzed by univariable and multivariable regression analysis. After 8 weeks 78% of the participants reported recovery after MT, and after 26 weeks the frequency of recovered participants was 73%. Prognostic factors related to recovery were co-existing migraine, absence of multiple-site pain, greater cervical range of motion and higher headache intensity. In participants classified as being likely to be recovered, the posterior probability for recovery at 8 weeks was 92%, whereas for those being classified at low probability of recovery this posterior probability was 61%. It is concluded that the course of CTTH is favourable in primary care patients receiving MT. The prognostic models provide additional information to improve prediction of outcome. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Efficacy of manual therapy in the treatment of tension-type headache. A systematic review from 2000-2013.

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Lozano López, C; Mesa Jiménez, J; de la Hoz Aizpurúa, J L; Pareja Grande, J; Fernández de Las Peñas, C

2016-01-01

To study the efficacy of manual therapy in the treatment of tension-type headache (TTH) by assessing the quality of randomized control trials (RCTs) published from the year 2000 to April 2013. A search was performed in the following databases: MEDLINE, EBSCO, CINAHL, SCOPUS, PEDRO and OVID. An analysis was made of RCT including patients with TTH receiving any manual therapy, and assessing outcome measures including the intensity, and frequency or duration of the headache. Two independent referees reviewed the methodological quality of RCTs using the Jadad scale. Data from the studies were extracted by two different reviewers. A total of fourteen RCTs were selected. Twelve studies showed acceptable quality (Jadad scale ≥3), and the remaining 2 had low quality (Jadad=2). The studies showed positive results, including reduction in headache intensity and/or frequency, reduction of medication consumption, and improvement in quality of life. The effectiveness of manual therapy for TTH cannot be completely assessed due to the heterogeneity in study design, outcome measures, and different treatments. Nevertheless, the results suggest patients with TTH receiving manual therapies showed better progress than those receiving conventional treatment or placebo. Further studies of high quality using manual therapy protocols, and also including standardized outcome measures, are now needed to clarify the efficacy of manual therapy in the management of TTH. Copyright © 2013 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Genetic contribution of catechol-O-methyltransferase polymorphism (Val158Met) in children with chronic tension-type headache.

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Fernández-de-las-Peñas, César; Ambite-Quesada, Silvia; Rivas-Martínez, Inés; Ortega-Santiago, Ricardo; de-la-Llave-Rincón, Ana Isabel; Fernández-Mayoralas, Daniel M; Pareja, Juan A

2011-10-01

Our aim was to investigate the relationship between Val158Met polymorphisms, headache, and pressure hypersensitivity in children with chronic tension-type headache (CTTH). A case-control study with blinded assessor was conducted. Seventy children with CTTH associated with pericranial tenderness and 70 healthy children participated. After amplifying Val158Met polymorphism by polymerase chain reactions, we assessed genotype frequencies and allele distributions. We classified children according to their Val158Met polymorphism: Val/Val, Val/Met, Met/Met. Pressure pain thresholds (PPT) were bilaterally assessed over the temporalis, upper trapezius, second metacarpal, and tibialis anterior muscles. The distribution of Val158Met genotypes was not significantly different (p = 0.335), between children with CTTH and healthy children, and between boys and girls (p = 0.872). Children with CTTH with the Met/Met genotype showed a longer headache history compared with those with Met/Val (p = 0.001) or Val/Val (p = 0.002) genotype. Children with CTTH with Met/Met genotype showed lower PPT over upper trapezius and temporalis muscles than children with CTTH with Met/Val or Val/Val genotype (p < 0.01). The Val158Met catechol-O-methyltransferase (COMT) polymorphism does not appear to be involved in predisposition to suffer from CTTH in children; nevertheless, this genetic factor may be involved in the phenotypic expression, as pressure hypersensitivity was greater in those CTTH children with the Met/Met genotype.

Headache among medical and psychology students.

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Ferri-de-Barros, João Eliezer; Alencar, Mauricio José de; Berchielli, Luis Felipe; Castelhano Junior, Luis Carlos

2011-06-01

Headaches occur frequently and thus are a key component of sociocentric medical education. To study headaches among students of medicine and psychology in a single university. This was a questionnaire-based survey of a cohort of students of medicine and psychology. The overall lifetime prevalence of headache was 98% and over the last year, 91%. Tensional headache accounted for 59% and migraine 22% in medicine; and 48.5% and 32% respectively in psychology. Forty-five percent reported that headaches had a variable sporadic impact on their productivity. The self-medication rate was 77%. Thirty-six percent reported worsening since admission to the university. The prevalence of headaches was very high. Tension-type headaches predominated in males and migraine in females. Tension-type was more frequent among medical students than among psychology students; migraine was more frequent in psychology (more females) than in medicine. Both kinds of students reported that headaches caused low interference with daily activities. The students reported that their symptoms had worsened since admission to the university.

Headache in Schoolchildren : Epidemiology, Pain Comorbidity and Psychosocial Factors

OpenAIRE

Laurell, Katarina

2005-01-01

Headache is the most frequently reported pain in children and is associated with missed schooldays, anxiety, depressive symptoms and various physical symptoms. A secular trend of increasing headache prevalence has been suggested. Few studies have focused on tension-type headache among children from the general population. The aims of this thesis were to describe the prevalence, incidence and prognosis of tension-type headache, migraine and overall headache in schoolchildren, to identify medi...

Effectiveness of an intensive multidisciplinary headache treatment program.

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Gunreben-Stempfle, Birgit; Griessinger, Norbert; Lang, Eberhard; Muehlhans, Barbara; Sittl, Reinhard; Ulrich, Kathrin

2009-07-01

To investigate if the effectiveness of a 96-hour multidisciplinary headache treatment program exceeds the effectiveness of a 20-hour program and primary care. When dealing with chronic back pain, low-intensity multidisciplinary treatment yields no significantly better results than standard care and monodisciplinary therapy; however, high-intensity treatment does. For multidisciplinary headache treatment, such comparisons are not yet available. In a previous study undertaken by our Pain Center, the outcome of a minimal multidisciplinary intervention model (20-hour) did not exceed primary care. Forty-two patients suffering from frequent headaches (20 +/- 9 headache days/month; range: 8-30) were treated and evaluated in a 96-hour group program. The results were compared with the outcomes of the previous study. Subjects who had undergone either the 20-hour multidisciplinary program or the primary care were used as historical control groups. A significant reduction in migraine days (P tension-type headache days (P tension-type headache days (P = .016), and frequency of migraine attacks (P = .016). In comparison with the 20-hour multidisciplinary program, the 96-hour program showed significantly better effects only in the reduction of migraine days (P = .037) and depression score (P = .003). The responder-rates (> or =50% improvement) in the 96-hour program were significantly higher than in the 20-hour program (migraine days, P = .008; tension-type headache days, P = .044) and primary care (migraine days, P = .007; tension-type headache days, P = .003; tension-type headache intensity, P = .037). The effect sizes were small to medium in the 96-hour program. Particularly with the reduction of migraine symptomatology, the 96-hour program performed better than the 20-hour program, which produced only negligible or small effects. Intensive multidisciplinary headache treatment is highly effective for patients with chronic headaches. Furthermore, migraine symptomatology

Headache - what to ask your doctor

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... Migraine - what to ask your doctor; Tension-type headache - what to ask your doctor; Cluster headache - what to ask your doctor ... How can I tell if the headache I am having is dangerous? What are ... headache ? A migraine headache ? A cluster headache ? What medical ...

Headaches and Migraines: Understanding Headaches, From Mild to Migraine

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... address them. Regular exercise helps me with the stress trigger. Also, I avoid chocolate. "The point is," Eckhart declares, "medical research has really made a difference for me." Fast Fasts The most common type of headache is a tension headache. These usually are due ...

Primary headache diagnosis among chronic daily headache patients

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Krymchantowski Abouch Valenty

2003-01-01

Full Text Available Chronic daily headache (CDH refers to a group of non-paroxysmal daily or near-daily headaches with peculiar characteristics that are highly prevalent in populations of neurological clinics and not uncommon among non-patient populations. Most of the patients with CDH had, as primary diagnosis, episodic migraine, which, with the time, presented a progressive frequency, pattern modification and loss of specific migraine characteristics. Other CDH patients had chronic tension-type headache, new daily persistent headache and hemicrania continua, which evolved thru the time to the daily or near-daily presentation. The objective of this study was to determine the primary headache diagnosis among a population of chronic daily headache patients attending a tertiary center for headache treatment. During a 5-year period 651 consecutive chronic daily headache patients attending a private subspecialty center were studied prospectively. The criteria adopted were those proposed by Silberstein et al (1994, revised 1996. Five hundred seventy four patients (88.1% had episodic migraine as primary headache before turning into daily presentation, 52 (8% had chronic tension-type headache, 14 (2.2% had hemicrania continua and 11 patients (1.7% had new daily persistent headache. CDH is quite frequent in patients from clinic-based studies suggesting a high degree of disability. Emphasis on education of patients suffering from frequent primary headaches with regard to measures that are able to decrease suffering and disability as well as better medical education directed to more efficient ways to handle these patients are necessary to improve outcome of such a prevalent condition.

Prevalence and impact of headache in undergraduate students in Southern Brazil

OpenAIRE

Falavigna,Asdrubal; Teles,Alisson Roberto; Velho,Maíra Cristina; Vedana,Viviane Maria; Silva,Roberta Castilhos da; Mazzocchin,Thaís; Basso,Maira; Braga,Gustavo Lisbôa de

2010-01-01

OBJECTIVE: To determine the prevalence, characteristics and impact of headache among university students. METHOD: The criteria established by the International Headache Society were used to define the primary headache subtypes and the Migraine Disability Assessment Questionnaire (MIDAS), to assess the disability. The students were then grouped into six categories: [1] migraine; [2] probable migraine; [3] tension-type headache; [4] probable tension-type headache; [5] non-classifiable headache;...

Pain sensitivity and pericranial tenderness in children with tension-type headache: a controlled study

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Soee ABL

2013-06-01

Full Text Available Ann-Britt L Soee,1 Liselotte Skov,1 Svend Kreiner,4 Birte Tornoe,1,2 Lise L Thomsen3 1Department of Paediatrics, Children's Headache Clinic, Copenhagen University Hospital Herlev, Copenhagen, Denmark; 2Department of Physiotherapy, Medical Department O, Copenhagen University Hospital Herlev, Copenhagen, Denmark; 3Department of Neuropediatrics, Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen Denmark; 4Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark Purpose: To compare tenderness and pain sensitivity in children (aged 7–17 years with tension-type headache (TTH and healthy controls using total tenderness score (TTS, pressure pain threshold (PPT, and pain perceived at suprapressure pain threshold (supraPPT. Patients and methods: Twenty-three children with frequent episodic TTH, 36 with chronic TTH, and 57 healthy controls were included. TTS was measured bilaterally at seven pericranial myofascial structures. PPT and supraPPT were assessed in the finger, m. temporalis, and m. trapezius by a Somedic® algometer. SupraPPT was defined as the pain perceived at a stimulus calculated as the individual site-specific PPT + 50%. Statistics: The effect of group, sex, age, headache frequency, intensity, and years on TTS, PPT, and supraPPT was analyzed by general linear models. Confirmatory factor analysis was analyzed for mutual relations between measurements. Results and conclusion: Tenderness increased uniformly in both frequent episodic TTH (median 14; interquartile range [IQR] 10–18; P < 0.001 and chronic TTH (median 13; IQR 9–20; P < 0.001 compared to controls (median 5, IQR 3–11. However, the children with frequent episodic TTH and chronic TTH did not show significantly increased sensitivity when measured by PPT or supraPPT. Factor analysis confirmed that the site-specific measurements depended on general latent variables. Consequently, the PPT and supraPPT tests can be assumed to measure

Headaches: Treatment Depends on Your Diagnosis and Symptoms

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... keep a headache diary to help diagnose your headache type. Write down when your headaches occur, accompanying symptoms, and any potential triggers such as food, changes in sleep or stress. Tension-type headaches, the most common variety of ...

Pain perception studies in tension-type headache

DEFF Research Database (Denmark)

Bezov, David; Ashina, Sait; Jensen, Rigmor

2011-01-01

to integrate pain perception and imaging to confirm this finding. Pharmacological studies have shown that drugs like tricyclic anti-depressant amitriptyline and nitric oxide synthase inhibitors can reverse central sensitization and the chronicity of headache. Finally, low frequency electrical stimulation has...

Headache in children's drawings.

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Wojaczyńska-Stanek, Katarzyna; Koprowski, Robert; Wróbel, Zygmunt; Gola, Małgorzata

2008-02-01

Headache is a common health problem in childhood. Children's drawings are helpful in the diagnosis of headache type. Children, especially younger ones, communicate better through pictures than verbally. The aim of the present study is to evaluate the usefulness of drawings of the child's headache in the diagnostic process carried out by a pediatrician and a pediatric neurologist. At the beginning of a visit in a neurological clinic, or on the first day of hospitalization, the child was asked, "Please draw your headache," or "How do you feel your headache?" without any additional explanations or suggestions. Clinical diagnosis of headache type was made on the basis of the standard diagnostic evaluation. For the purpose of this study, children's headaches were categorized as migraine, tension-type headache, or "the others." One hundred twenty-four drawings of children with headaches were analyzed by 8 pediatricians and 8 pediatric neurologists. The analysts were unaware of the clinical history, age, sex, and diagnosis of the patients. The clinical diagnosis was considered the "gold standard" to which the headache drawing diagnosis was compared. There were 68 girls 5-18 years of age and 56 boys 7-18 years of age. Of the 124 children, 40 were clinically diagnosed with migraine (32.2%), 47 with tension-type headache (37.9%), and 37 (29.8%) as the others. Children with migraine most frequently draw sharp elements. Children with tension-type headache mainly drew compression elements and pressing elements. In the group of "the other" headaches, 21 children were diagnosed with somatoform disorders. The most frequent element in this group's drawings was a whirl in the head. Colors used most frequently were black and red, which signify severe pain. There was no difference in sensitivity of diagnoses between neurologists and pediatricians. Because the evaluation of drawings by children with headaches done both by pediatricians and pediatric neurologists was correct for

Are headache and temporomandibular disorders related? A blinded study

DEFF Research Database (Denmark)

Ballegaard, V.; Thede-Schmidt-Hansen, P.; Svensson, P.

2008-01-01

differences in TMD prevalence were revealed between headache groups, although TMD prevalence tended to be higher in patients with combined migraine and tension-type headache. Moderate to severe depression was experienced by 54.5% of patients. Patients with coexistent TMD had a significantly higher prevalence...... of depression-most markedly in patients with combined migraine and tension-type headache. Our studies indicate that a high proportion of headache patients have significant disability because of ongoing chronic TMD pain. The trend to a higher prevalence of TMD in patients with combined migraine and tension......-type headache suggests that this could be a risk factor for TMD development. A need for screening procedures and treatment strategies concerning depression in headache patients with coexistent TMD is underlined by the overrepresentation of depression in this group. Our findings emphasize the importance...

A basic diagnostic headache diary (BDHD) is well accepted and useful in the diagnosis of headache. a multicentre European and Latin American study

DEFF Research Database (Denmark)

Jensen, Rigmor Højland; Tassorelli, C; Rossi, P

2011-01-01

Aims: We tested the usability and usefulness of the basic diagnostic headache diary (BDHD) for the diagnosis of migraine, tension-type headache and medication-overuse headache in European and Latin American countries. Methods: Patients were subdivided into two groups according to a 1:1 randomizat......Aims: We tested the usability and usefulness of the basic diagnostic headache diary (BDHD) for the diagnosis of migraine, tension-type headache and medication-overuse headache in European and Latin American countries. Methods: Patients were subdivided into two groups according to a 1...

Classification of headache on the basis of the IHS diagnostic criteria

NARCIS (Netherlands)

de Bruijn-Kofman, AT; van de Wiel, H; Sorbi, MJ

1999-01-01

Objective: To test the effects of a mass-media behavioral treatment program on migraine and tension-type headache, patients with pure migraine, and with pure tension-type headache were to be selected. Patient Selection: A random sample of 233 headache sufferers of 15,000 subscribers to the program.

Effects of mindfulness-based stress reduction on perceived stress and psychological health in patients with tension headache.

Science.gov (United States)

Omidi, Abdollah; Zargar, Fatemeh

2015-11-01

Programs for improving health status of patients with illness related to pain, such as headache, are often still in their infancy. Mindfulness-based stress reduction (MBSR) is a new psychotherapy that appears to be effective in treating chronic pain and stress. This study evaluated efficacy of MBSR in treatment of perceived stress and mental health of client who has tension headache. This study is a randomized clinical trial. Sixty patients with tension type headache according to the International Headache Classification Subcommittee were randomly assigned to the Treatment As Usual (TAU) group or experimental group (MBSR). The MBSR group received eight weekly classmates with 12-min sessions. The sessions were based on MBSR protocol. The Brief Symptom Inventory (BSI) and Perceived Stress Scale (PSS) were administered in the pre- and posttreatment period and at 3 months follow-up for both the groups. The mean of total score of the BSI (global severity index; GSI) in MBSR group was 1.63 ± 0.56 before the intervention that was significantly reduced to 0.73 ± 0.46 and 0.93 ± 0.34 after the intervention and at the follow-up sessions, respectively (P stress in comparison with the control group at posttest evaluation. The mean of perceived stress before the intervention was 16.96 ± 2.53 and was changed to 12.7 ± 2.69 and 13.5 ± 2.33 after the intervention and at the follow-up sessions, respectively (P stress in the TAU group at pretest was 15.9 ± 2.86 and that was changed to 16.13 ± 2.44 and 15.76 ± 2.22 at posttest and follow-up, respectively (P stress and improve general mental health in patients with tension headache.

Paracetamol (acetaminophen) for acute treatment of episodic tension-type headache in adults.

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Stephens, Guy; Derry, Sheena; Moore, R Andrew

2016-06-16

Tension-type headache (TTH) affects about 1 person in 5 worldwide. It is divided into infrequent episodic TTH (fewer than one headache per month), frequent episodic TTH (two to 14 headaches per month), and chronic TTH (15 headache days a month or more). Paracetamol (acetaminophen) is one of a number of analgesics suggested for acute treatment of headaches in frequent episodic TTH. To assess the efficacy and safety of paracetamol for the acute treatment of frequent episodic TTH in adults. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (CRSO), MEDLINE, EMBASE, and the Oxford Pain Relief Database to October 2015, and also reference lists of relevant published studies and reviews. We sought unpublished studies by asking personal contacts and searching online clinical trial registers and manufacturers' websites. We included randomised, double-blind, placebo-controlled studies (parallel-group or cross-over) using oral paracetamol for symptomatic relief of an acute episode of TTH. Studies had to be prospective, with participants aged 18 years or over, and include at least 10 participants per treatment arm. Two review authors independently assessed studies for inclusion and extracted data. We used the numbers of participants achieving each outcome to calculate the risk ratio (RR) and number needed to treat for one additional beneficial outcome (NNT) or one additional harmful outcome (NNH) for oral paracetamol compared to placebo or an active intervention for a range of outcomes, predominantly those recommended by the International Headache Society (IHS).We assessed the evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation) and created 'Summary of findings' tables. We included 23 studies, all of which enrolled adults with frequent episodic TTH. Twelve studies used the IHS diagnostic criteria or similar, six used the older classification of the Ad Hoc Committee, and five did not describe specific diagnostic criteria

Laboratory tests of headache disorders - Dawn of a new era?

DEFF Research Database (Denmark)

Schytz, Henrik Winther; Olesen, Jes

2016-01-01

secondary headaches. Background In this narrative review we present and discuss published tests that might be useful in phenotyping and/or diagnosis of long-lasting headache disorders such as migraine, tension-type headache, trigeminal autonomic cephalalgias, trigeminal neuralgia and persisting secondary...... headaches. Aim The palpometer test, quantitative sensory testing, nociceptive blink reflex and autonomic tests may be valuable to phenotype and/or diagnose subforms of migraine, tension-type headache, cluster headache, trigeminal neuralgia and medication-overuse headache. Provocation tests with glyceryl...... if well-reputed tertiary headache centers commence developing and implementing laboratory tests in order to improve the classification and treatment of headache patients....

Effect of the emotional freedom technique on perceived stress, quality of life, and cortisol salivary levels in tension-type headache sufferers: a randomized controlled trial.

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Bougea, Anastasia M; Spandideas, Nick; Alexopoulos, Evangelos C; Thomaides, Thomas; Chrousos, George P; Darviri, Christina

2013-01-01

To evaluate the short-term effects of the emotional freedom technique (EFT) on tension-type headache (TTH) sufferers. We used a parallel-group design, with participants randomly assigned to the emotional freedom intervention (n = 19) or a control arm (standard care n = 16). The study was conducted at the outpatient Headache Clinic at the Korgialenio Benakio Hospital of Athens. Thirty-five patients meeting criteria for frequent TTH according to International Headache Society guidelines were enrolled. Participants were instructed to use the EFT method twice a day for two months. Study measures included the Perceived Stress Scale, the Multidimensional Health Locus of Control Scale, and the Short-Form questionnaire-36. Salivary cortisol levels and the frequency and intensity of headache episodes were also assessed. Within the treatment arm, perceived stress, scores for all Short-Form questionnaire-36 subscales, and the frequency and intensity of the headache episodes were all significantly reduced. No differences in cortisol levels were found in any group before and after the intervention. EFT was reported to benefit patients with TTH. This randomized controlled trial shows promising results for not only the frequency and severity of headaches but also other lifestyle parameters. Copyright © 2013 Elsevier Inc. All rights reserved.

A Comparison of Pharmacological (Amitriptyline HCL) and Nonpharmacological (Cognitive-Behavioral) Therapies for Chronic Tension Headaches.

Science.gov (United States)

Holroyd, Kenneth A.; And Others

1991-01-01

Randomly assigned 41 recurrent tension headache sufferers to either cognitive-behavioral therapy or to amitriptyline therapy. Both therapies yielded clinically significant improvements in headache activity. In instances where differences in treatment effectiveness were observed, cognitive-behavioral therapy yielded somewhat more positive outcomes…

Effectiveness of a Treatment Involving Soft Tissue Techniques and/or Neural Mobilization Techniques in the Management of Tension-Type Headache: A Randomized Controlled Trial.

Science.gov (United States)

Ferragut-Garcías, Alejandro; Plaza-Manzano, Gustavo; Rodríguez-Blanco, Cleofás; Velasco-Roldán, Olga; Pecos-Martín, Daniel; Oliva-Pascual-Vaca, Jesús; Llabrés-Bennasar, Bartomeu; Oliva-Pascual-Vaca, Ángel

2017-02-01

To evaluate the effects of a protocol involving soft tissue techniques and/or neural mobilization techniques in the management of patients with frequent episodic tension-type headache (FETTH) and those with chronic tension-type headache (CTTH). Randomized, double-blind, placebo-controlled before and after trial. Rehabilitation area of the local hospital and a private physiotherapy center. Patients (N=97; 78 women, 19 men) diagnosed with FETTH or CTTH were randomly assigned to groups A, B, C, or D. (A) Placebo superficial massage; (B) soft tissue techniques; (C) neural mobilization techniques; (D) a combination of soft tissue and neural mobilization techniques. The pressure pain threshold (PPT) in the temporal muscles (points 1 and 2) and supraorbital region (point 3), the frequency and maximal intensity of pain crisis, and the score in the Headache Impact Test-6 (HIT-6) were evaluated. All variables were assessed before the intervention, at the end of the intervention, and 15 and 30 days after the intervention. Groups B, C, and D had an increase in PPT and a reduction in frequency, maximal intensity, and HIT-6 values in all time points after the intervention as compared with baseline and group A (P<.001 for all cases). Group D had the highest PPT values and the lowest frequency and HIT-6 values after the intervention. The application of soft tissue and neural mobilization techniques to patients with FETTH or CTTH induces significant changes in PPT, the characteristics of pain crisis, and its effect on activities of daily living as compared with the application of these techniques as isolated interventions. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Chronic daily headaches

Directory of Open Access Journals (Sweden)

Fayyaz Ahmed

2012-01-01

Full Text Available Chronic Daily Headache is a descriptive term that includes disorders with headaches on more days than not and affects 4% of the general population. The condition has a debilitating effect on individuals and society through direct cost to healthcare and indirectly to the economy in general. To successfully manage chronic daily headache syndromes it is important to exclude secondary causes with comprehensive history and relevant investigations; identify risk factors that predict its development and recognise its sub-types to appropriately manage the condition. Chronic migraine, chronic tension-type headache, new daily persistent headache and medication overuse headache accounts for the vast majority of chronic daily headaches. The scope of this article is to review the primary headache disorders. Secondary headaches are not discussed except medication overuse headache that often accompanies primary headache disorders. The article critically reviews the literature on the current understanding of daily headache disorders focusing in particular on recent developments in the treatment of frequent headaches.

Temporomandibular disorders and migraine headache

OpenAIRE

Demarin, Vida; Bašić Kes, Vanja

2010-01-01

Migraine headache and temporomandibular disorders show significant overlap in the area or distribution of pain, the gender prevalence and age distribution. Temporomandibular disorders may cause headaches per se, worsen existent primary headaches, and add to the burden of headache disorders. The patients with combined migraine and tension-type headaches had a higher prevelance of temporomandibular disorders. Evidence supporting a close relationship include the increased masticatory...

A comparative study of efficacy of emg bio-feedback and progressive muscular relaxation in tension headache.

Science.gov (United States)

Gada, M T

1984-04-01

The aim of the present study was to find out efficacy of frontalis EMG Biofeedback therapy, deep muscular relaxation therapy and compare the efficacy of both in cases of tension headache. During two week basal-data recording period all patients were taught deep muscular relaxation by Jacobson's technique. Simultaneously patients were instructed to keep headache diary. Headache diary yielded three different parameters a) number of headache-free days per week, b) peak headache intensity (or each week and c) average daily headache activity score per week. These parameters were used to find out therapeutic efficacy of each treatment. Patients were randomly divided in two groups. EMG Biofeedback group was given frontalis EMG feedback through EMG J 33 muscle trainer of Cyborg Corporation (U.S.A.). Patients in each group were given 20 sessions (two sessions per week); each session lasting 30 minutes. Patients were instructed to practice at least one 30 minute session of relaxation at home. The data were subjected to statistical calculation. The results indicate that frontalis EMG Biofeedback therapy and deep muscle relaxation therapy are significantly effective in cases of tension headache. Both treatments are equally effective. The findings are discussed in relation to Indian situation.

Nitric oxide-related drug targets in headache

DEFF Research Database (Denmark)

Olesen, Jes

2010-01-01

-called delayed headache that fulfils criteria for migraine without aura in migraine sufferers. Blockade of nitric oxide synthases (NOS) by L-nitromonomethylarginine effectively treats attacks of migraine without aura. Similar results have been obtained for chronic the tension-type headache and cluster headache....... Inhibition of the breakdown of cyclic guanylate phosphate (cGMP) also provokes migraine in sufferers, indicating that cGMP is the effector of NO-induced migraine. Similar evidence suggests an important role of NO in the tension-type headache and cluster headache. These very strong data from human...... experimentation make it highly likely that antagonizing NO effects will be effective in the treatment of primary headaches. Nonselective NOS inhibitors are likely to have side effects whereas selective compounds are now in early clinical trials. Antagonizing the rate limiting cofactor tetrahydrobiopterin seems...

The influence of ictal cutaneous allodynia on the response to occipital transcutaneous electrical stimulation in chronic migraine and chronic tension-type headache: a randomized, sham-controlled study.

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Bono, F; Salvino, D; Mazza, M R; Curcio, M; Trimboli, M; Vescio, B; Quattrone, A

2015-04-01

The objective of this article is to determine whether cutaneous allodynia (CA) influences the response to treatment with occipital transcutaneous electrical stimulation (OTES) in chronic migraine (CM) and chronic tension-type headache (CTTH). One hundred and sixty consecutive patients with CM or CTTH were randomized to be treated with real or sham OTES stimulation three times a day for two consecutive weeks. All patients completed the validated 12-item allodynia symptom checklist for assessing the presence and the severity of CA during headache attack. Primary end-point was change (≥50%) in number of monthly headache-free days. There was a significant difference in the percentage of responders in the real OTES compared with sham OTES group (p headache-free days in the allodynic patients with CM and CTTH treated both with real and sham OTES, while the number of headache-free days per month was significantly reduced in the real (86%) but not in the sham group (7%) of non-allodynic patients with CTTH and CM. Severe CA is associated with decreased response to treatment with OTES in patients with CM and CTTH. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Headache In Children

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Srinivasa R

2002-01-01

Full Text Available Headaches are common in children. The presentation of headache in children is varied and hence the characterization of headache is more challenging. This situation is worsened further by inadequacies in the history and the effect of maturational factors. Relevant epidemiological and limitations in the applicability of International Headache Society criteria in childhood headache and the rationale for newer criteria are discussed. Migraine and tension-type headache are the common primary headache seen in children. Although there is a paucity of clinical trials the management of childhood migraine, the important role of correct pharmacological approach has been delineated. The pivotal role of non-pharmacological treatment is emphasized.

Are headache and temporomandibular disorders related? A blinded study.

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Ballegaard, V; Thede-Schmidt-Hansen, P; Svensson, P; Jensen, R

2008-08-01

To investigate overlaps between headache and temporomandibular disorders (TMD) in a clinical headache population and to describe the prevalence of TMD in headache patients, 99 patients referred to a specialized headache centre were diagnosed according to Research Diagnostic Criteria for TMD (RDC/TMD) and classified in headache groups according to the International Classification of Headache Disorders, second edition for headache diagnoses in a blinded design. The prevalence of TMD in the headache population was 56.1%. Psychosocial dysfunction caused by TMD pain was observed in 40.4%. No significant differences in TMD prevalence were revealed between headache groups, although TMD prevalence tended to be higher in patients with combined migraine and tension-type headache. Moderate to severe depression was experienced by 54.5% of patients. Patients with coexistent TMD had a significantly higher prevalence of depression-most markedly in patients with combined migraine and tension-type headache. Our studies indicate that a high proportion of headache patients have significant disability because of ongoing chronic TMD pain. The trend to a higher prevalence of TMD in patients with combined migraine and tension-type headache suggests that this could be a risk factor for TMD development. A need for screening procedures and treatment strategies concerning depression in headache patients with coexistent TMD is underlined by the overrepresentation of depression in this group. Our findings emphasize the importance of examination of the masticatory system in headache sufferers and underline the necessity of a multidimensional approach in chronic headache patients.

Use of the International Classification of Headache Disorders, Second Edition, criteria in the diagnosis of primary headache in schoolchildren: epidemiology study from eastern Turkey.

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Alp, Recep; Alp, Selen Ilhan; Palanci, Yilmaz; Sur, Haydar; Boru, Ulku Turk; Ozge, Aynur; Yapici, Zuhal

2010-07-01

We aimed to determine the prevalence of primary headache among schoolchildren in the city of Agri, located in eastern Turkey, where geographical, climatic and socio-economic conditions differ greatly from those of other regions of Turkey. A cross-sectional school-based (ages ranging from 11 to 18) study was conducted from January to April 2006. Diagnosis was based on the second edition of the International Classification of Headache Disorders. This population was evaluated by a two-stage clustered sampling procedure. In the first phase, 1385 children were asked whether they had had a headache within the past year. For the second-step interview, 540 children (38.9%) with a complaint of headache were selected. Five children who had complained of headaches in the first interview did not agree to participate in the second stage. Of the remaining 535, 473 were identified as having primary headache and 62 as having secondary headache. Overall, one-year prevalence of headache subtypes was 14.3% for migraine, 3.5% for probable migraine, 8.6% for pure tension-type headache, 4.6% for migraine plus tension-type headache, and 3.0% for probable migraine plus tension-type headache. The prevalence of migraine was higher in our study than in previous studies.

Sleep-related headache and its management.

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Singh, Niranjan N; Sahota, Pradeep

2013-12-01

Sleep and headache have both generated curiosity within the human mind for centuries. The relationship between headache and sleep disorders is very complex. While Lieving in 1873 first observed that headaches were linked to sleep, Dexter and Weitzman in 1970 described the relationship between headache and sleep stages. Though our understanding of sleep and headache relationship has improved over the years with expanding knowledge in both fields and assessment tools such as polysomnography, it is still poorly understood. Headache and sleep have an interdependent relationship. Headache may be intrinsically related to sleep (migraine with and without aura, cluster headache, hypnic headache, and paroxysmal hemicrania), may cause sleep disturbance (chronic migraine, chronic tension-type headache, and medication overuse headache) or a manifestation of a sleep disorder like obstructive sleep apnea. Headache and sleep disorder may be a common manifestation of systemic dysfunction-like anemia and hypoxemia. Headaches may occur during sleep, after sleep, and in relation to different sleep stages. Lack of sleep and excessive sleep are both considered triggers for migraine. Insomnia is more common among chronic headache patients. Experimental data suggest that there is a common anatomic and physiologic substrate. There is overwhelming evidence that cluster headache and hypnic headaches are chronobiological disorders with strong association with sleep and involvement of hypothalamus. Cluster headache shows a circadian and circannual rhythmicity while hypnic headache shows an alarm clock pattern. There is also a preferential occurrence of cluster headache, hypnic headache, and paroxysmal hemicrania during REM sleep. Silencing of anti-nociceptive network of periaqueductal grey (PAG), locus ceruleus and dorsal raphe nucleus doing REM sleep may explain the preferential pattern. Sleep related headaches can be classified into (1) headaches with high association with obstructive sleep

Specific strength training compared with interdisciplinary counseling for girls with tension-type headache: a randomized controlled trial

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Tornøe B

2016-05-01

Full Text Available Birte Tornøe,1–4 Lars L Andersen,5,6 Jørgen H Skotte,5 Rigmor Jensen,7 Claus Jensen,8 Bjarne K Madsen,7 Gunvor Gard,1 Liselotte Skov,2 Inger Hallström,11Department of Health Sciences, Lund University, Lund, Sweden; 2Department of Pediatrics E, Children’s Headache Clinic, University of Copenhagen, Herlev and Gentofte Hospitals, Copenhagen, Denmark; 3Department of Physiotherapy and Occupational Therapy, University of Copenhagen, Glostrup Hospital, Copenhagen, Denmark; 4Department of Physiotherapy, University of Copenhagen, Herlev and Gentofte Hospitals, Copenhagen, Denmark; 5National Research Centre for the Working Environment, Copenhagen, Denmark; 6Physical Activity and Human Performance group, SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark; 7Department of Neurology, Danish Headache Centre, University of Copenhagen, Glostrup Hospital, Copenhagen, Denmark; 8Huge Consulting, ApS, Haslev, Denmark Background: Childhood tension-type headache (TTH is a prevalent and debilitating condition for the child and family. Low-cost nonpharmacological treatments are usually the first choice of professionals and parents. This study examined the outcomes of specific strength training for girls with TTH. Methods: Forty-nine girls aged 9–18 years with TTH were randomized to patient education programs with 10 weeks of strength training and compared with those who were counseled by a nurse and physical therapist. Primary outcomes were headache frequency, intensity, and duration; secondary outcomes were neck–shoulder muscle strength, aerobic power, and pericranial tenderness, measured at baseline, after 10 weeks intervention, and at 12 weeks follow-up. Health-related quality of life (HRQOL questionnaires were assessed at baseline and after 24 months. Results: For both groups, headache frequency decreased significantly, P=0.001, as did duration, P=0.022, with no significant between-group differences. The odds of having

Prevalence and impact of headache in undergraduate students in Southern Brazil

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Asdrubal Falavigna

2010-12-01

Full Text Available OBJECTIVE: To determine the prevalence, characteristics and impact of headache among university students. METHOD: The criteria established by the International Headache Society were used to define the primary headache subtypes and the Migraine Disability Assessment Questionnaire (MIDAS, to assess the disability. The students were then grouped into six categories: [1] migraine; [2] probable migraine; [3] tension-type headache; [4] probable tension-type headache; [5] non-classifiable headache; [6] no headache. RESULTS: Of all undergraduate students interviewed, 74.5% had at least one headache episode in the last three months. Regarding disability, there was a significant difference between the headache types (p<0.0001. In the post-hoc analysis, migraine was the headache type with most reported disability. CONCLUSION: Headache is a highly prevalent condition among the students at the University of Caxias do Sul. This disease may have a major impact on the students' lives and in some cases, ultimately lead to educational failure.

Drug therapy in headache.

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Weatherall, Mark W

2015-06-01

All physicians will encounter patients with headaches. Primary headache disorders are common, and often disabling. This paper reviews the principles of drug therapy in headache in adults, focusing on the three commonest disorders presenting in both primary and secondary care: tension-type headache, migraine and cluster headache. The clinical evidence on the basis of which choices can be made between the currently available drug therapies for acute and preventive treatment of these disorders is presented, and information given on the options available for the emergency parenteral treatment of refractory migraine attacks and cluster headache. © Royal College of Physicians 2015. All rights reserved.

Prevalence of neck pain in migraine and tension-type headache

DEFF Research Database (Denmark)

Ashina, Sait; Bendtsen, Lars; Lyngberg, Ann C

2015-01-01

BACKGROUND: We assessed the prevalence of neck pain in the population in relation to headache. METHODS: In a cross-sectional study, a total of 797 individuals completed a headache interview and provided self-reported data on neck pain. We identified migraine, TTH or both migraine and TTH (M......+TTH) groups. Pericranial tenderness was recorded in 496 individuals. A total tenderness score (TTS) was calculated as the sum of local scores with a maximum score of 48. RESULTS: The one-year prevalence of neck pain was 68.4% and higher in those with vs. without primary headache (85.7% vs. 56.7%; adjusted...... OR 3.0, 95% CI 2.0-4.4, pneck pain (56.7%) was significantly higher in those with M+TTH (89.3%), pure TTH (88.4%) and pure migraine (76.2%) (p

A COMPARATIVE STUDY OF EFFICACY OF EMG BIO-FEEDBACK AND PROGRESSIVE MUSCULAR RELAXATION IN TENSION HEADACHE1

Science.gov (United States)

Gada, M.T.

1984-01-01

SUMMARY The aim of the present study was to find out efficacy of frontalis EMG Biofeedback therapy, deep muscular relaxation therapy and compare the efficacy of both in cases of tension headache. During two week basal-data recording period all patients were taught deep muscular relaxation by Jacobson′s technique. Simultaneously patients were instructed to keep headache diary. Headache diary yielded three different parameters a) number of headache-free days per week, b) peak headache intensity (or each week and c) average daily headache activity score per week. These parameters were used to find out therapeutic efficacy of each treatment. Patients were randomly divided in two groups. EMG Biofeedback group was given frontalis EMG feedback through EMG J 33 muscle trainer of Cyborg Corporation (U.S.A.). Patients in each group were given 20 sessions (two sessions per week); each session lasting 30 minutes. Patients were instructed to practice at least one 30 minute session of relaxation at home. The data were subjected to statistical calculation. The results indicate that frontalis EMG Biofeedback therapy and deep muscle relaxation therapy are significantly effective in cases of tension headache. Both treatments are equally effective. The findings are discussed in relation to Indian situation. PMID:21965970

Epidemiology and comorbidity of headache

DEFF Research Database (Denmark)

Stovner, L.J.; Jensen, Rigmor Højland

2008-01-01

The burden associated with headache is a major public health problem, the true magnitude of which has not been fully acknowledged until now. Globally, the percentage of the adult population with an active headache disorder is 47% for headache in general, 10% for migraine, 38% for tension-type...... headache, and 3% for chronic headache that lasts for more than 15 days per month. The large costs of headache to society, which are mostly indirect through loss of work time, have been reported. On the individual level, headaches cause disability, suffering, and loss of quality of life that is on a par...

Primary headaches in children

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Ajay Kumar Pan

2015-01-01

Full Text Available Headache is a widespread clinical problem; the prevalence is high in all age groups, from which children and teenagers are not spared. It has been reported that, as many as 75% of school-age children may experience headache infrequently, among them 10% have recurrent headaches. [1],[2] The vast majority of headaches are primary and classified as migraine, tension-type headache (TTH, cluster headache, and other trigeminal autonomic cephalgias. The type of primary headaches could usually be diagnosed by a thorough and careful history taking, and physical examination. Once the diagnosis of migraine is established and appropriate reassurance provided, a balanced and individually tailored treatment plan can be instituted. The goal of treatment includes abortive or acute pain treatment, preventive long-term treatment, and biobehavioral therapy. Knowledge of precise impact of primary headaches on child′s quality of life helps to design a proper comprehensive treatment plan.

Effect of autogenic training on drug consumption in patients with primary headache: an 8-month follow-up study.

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Zsombok, Terezia; Juhasz, Gabriella; Budavari, Agota; Vitrai, Jozsef; Bagdy, Gyorgy

2003-03-01

To examine the effects of Schultz-type autogenic training on headache-related drug consumption and headache frequency in patients with migraine, tension-type, or mixed (migraine plus tension-type) headache over an 8-month period. Behavioral treatments often are used alone or adjunctively for different types of headache. There are, however, only a few studies that have compared the efficacy and durability of the same treatment in different types of primary headache, and the effects of treatment on headache-related drug consumption rarely have been assessed even in these studies. Twenty-five women with primary headache (11 with mixed headache, 8 with migraine, and 6 with tension-type headache) were evaluated via an open-label, self-controlled, 8-month, follow-up study design. After an initial 4 months of observation, patients began learning Schultz-type autogenic training as modified for patients with headache. They practiced autogenic training on a regular basis for 4 months. Based on data from headache diaries and daily medication records, headache frequencies and the amounts of analgesics, "migraine-specific" drugs (ergots and triptans), and anxiolytics taken by the patients were compared in the three subgroups over the 8-month period. Results.-From the first month of implementation of autogenic training, headache frequencies were significantly reduced in patients with tension-type and mixed headache. Significant reduction in frequency was achieved in patients with migraine only from the third month of autogenic training. Decreases in headache frequencies were accompanied by decreases in consumption of migraine drugs and analgesics resulting in significant correlations among these parameters. Reduction in consumption of anxiolytic drugs was more rapid and robust in patients with tension-type headache compared to patients with migraine, and this outcome failed to show any correlation with change in headache frequency. Schultz-type autogenic training is an effective

A COMPARISOM BETWEEN THE EFFECTTIVENESS OF RELAXATION TRAINING AND PHARMACOTHERAPY IN TREATMENT OF PATIENTS WITH TENSION HEADACHE

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R BAGHERIAN

2003-12-01

Full Text Available

Introduction: Headaches are the common cause of refferals to physicians, and among them, tension headache is the most prevalent. There is not consens us on the effectiveness of a specific therapeutic procedure. However, the purpose of this study was to identify the effects of relaxation training in comparison to pharmacotherapy in treatment of tension headache.
Procedures: The study employed an experiment design with two treatment group (N=12 One treatment group gaticipated in a relaxation training program over an 8-week period. A second treatment group was only given Amitriptyline. Data collected over a 2 - week period before and after treatment by using a dialy headache scale used by patients and visual analog scale used by one of the patient";s relatives. Back depression scale and zung Anxietys scale were used for evaluating levels of depression and Anxiety in patients.
Results: Mean score of improvement in relaxation training was significantly higher than that of Amitriptyline group (t=3.85 , P < 0.01 Also the relaxation group demonstrated lower mean score of headache peak than that of peak than that of Amitriptyline  group (t=2.6, p < 0.01. However, regarding to visual analog scale there was no statistically significant difference between two groups.in respect of distribution of patients among different improvement levels, the relaxation training group was significantly better than Amitriptyline group (x₂=6.66, df=2, p < 0.01
Discussion: The relaxation training was more effective than Amitriptuline in decreasing headach for patients with tension headache.

Test-retest repeatability of strength capacity, aerobic power and pericranial tenderness of neck and shoulder muscles in children - relevant for tension-type headache

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Tornøe B

2013-08-01

Full Text Available Birte Tornøe,1,2,5,6 Lars L Andersen,3 Jørgen H Skotte,3 Rigmor Jensen,4 Gunvor Gard,1 Liselotte Skov,2 Inger Hallström1 1Department of Health Sciences, Lund University, Scania, Sweden; 2Children's Headache Clinic, Department of Pediatrics, University of Copenhagen, Herlev Hospital, Herlev, Denmark; 3National Research Centre for the Working Environment, Copenhagen, Denmark; 4Danish Headache Center, Department of Neurology, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark; 5Department of Physiotherapy and Occupational Therapy, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark; 6Department of Physiotherapy, Medical Department, University of Copenhagen, Herlev Hospital, Herlev, Denmark Background: Frequent or chronic tension-type headache in children is a prevalent and debilitating condition for the child, often leading to medication overuse. To explore the relationship between physical factors and tension-type headache in children, the quality of repeated measures was examined. The aim of the present study was to determine the test-retest repeatability of parameters determining isometric neck and shoulder strength and stability, aerobic power, and pericranial tenderness in children. Methods: Twenty-five healthy children, 9 to 18 years of age, participated in test-retest procedures within a 1-week interval. A computerized padded force transducer was used for testing. The tests included the isometric maximal voluntary contraction and force steadiness of neck flexion and extension, and the isometric maximal voluntary contraction and rate of force of the dominant shoulder. Pericranial tenderness was recorded by means of standardized manual palpation, and a submaximal cycle ergometer test predicted maximal oxygen uptake (VO2 max. The measurements were evaluated in steps, using the intraclass correlation coefficient (ICC; changes in the mean between the two test occasions; the levels of agreement, visualized in Bland

Effects of mindfulness-based stress reduction on perceived stress and psychological health in patients with tension headache

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Abdollah Omidi

2015-01-01

Full Text Available Background: Programs for improving health status of patients with illness related to pain, such as headache, are often still in their infancy. Mindfulness-based stress reduction (MBSR is a new psychotherapy that appears to be effective in treating chronic pain and stress. This study evaluated efficacy of MBSR in treatment of perceived stress and mental health of client who has tension headache. Materials and Methods: This study is a randomized clinical trial. Sixty patients with tension type headache according to the International Headache Classification Subcommittee were randomly assigned to the Treatment As Usual (TAU group or experimental group (MBSR. The MBSR group received eight weekly classmates with 12-min sessions. The sessions were based on MBSR protocol. The Brief Symptom Inventory (BSI and Perceived Stress Scale (PSS were administered in the pre- and posttreatment period and at 3 months follow-up for both the groups. Results: The mean of total score of the BSI (global severity index; GSI in MBSR group was 1.63 ± 0.56 before the intervention that was significantly reduced to 0.73 ± 0.46 and 0.93 ± 0.34 after the intervention and at the follow-up sessions, respectively (P < 0.001. In addition, the MBSR group showed lower scores in perceived stress in comparison with the control group at posttest evaluation. The mean of perceived stress before the intervention was 16.96 ± 2.53 and was changed to 12.7 ± 2.69 and 13.5 ± 2.33 after the intervention and at the follow-up sessions, respectively (P < 0.001. On the other hand, the mean of GSI in the TAU group was 1.77 ± 0.50 at pretest that was significantly reduced to 1.59 ± 0.52 and 1.78 ± 0.47 at posttest and follow-up, respectively (P < 0.001. Also, the mean of perceived stress in the TAU group at pretest was 15.9 ± 2.86 and that was changed to 16.13 ± 2.44 and 15.76 ± 2.22 at posttest and follow-up, respectively (P < 0.001. Conclusion: MBSR could reduce stress and improve

Increased Risk of Dementia in Patients with Tension-Type Headache: A Nationwide Retrospective Population-Based Cohort Study.

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Fu-Chi Yang

Full Text Available The association between primary headaches, including tension-type headache (TTH as one of the most common primary headache disorders, and dementia remains controversial. In this nationwide, population-based, retrospective, cohort study, we explored the potential association between TTH and dementia and examined sex, age, and comorbidities as risk factors for dementia.Using the Taiwan National Health Insurance Research Database (NHIRD claims data, the sample included 13908 subjects aged ≥20 years with newly-diagnosed TTH in 2000-2006. The non-TTH group included 55632 randomly selected sex- and age-matched TTH-free individuals. All subjects were followed until dementia diagnosis, death, or the end of 2011. Patients with dementia, including vascular and non-vascular (including Alzheimer's subtypes, were identified using International Classification of Diseases Ninth Revision, Clinical Modification codes. Multivariate Cox proportional hazards regression models were used to assess the risk of dementia and dementia-associated risk factors, such as migraine and other medical comorbidities.During the average follow-up of 8.14 years, the incidence density rates of dementia were 5.30 and 3.68/1,000 person-years in the TTH and non-TTH groups, respectively. Compared with the non-TTH group, the risks of dementia were 1.25 (95% confidence interval [CI], 1.11-1.42 and 1.13 (95% CI, 1.01-1.27 times higher in the women and >65-year-old TTH group, respectively. TTH patients with comorbidities had a higher risk of dementia. TTH patients had a greater risk of non-vascular dementia (hazard ratio, 1.21; 95% CI, 1.09-1.34 than the non-TTH group.TTH patients have a future risk of dementia, indicating a potentially linked disease pathophysiology that warrants further study. The association between TTH and dementia is greater in women, older adults, and with comorbidities. Clinicians should be aware of potential dementia comorbidity in TTH patients.

Temporomandibular dysfunction and headache disorder.

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Speciali, José G; Dach, Fabíola

2015-02-01

It has been well established that primary headaches (especially migraine, chronic migraine, and tension-type headache) and temporomandibular dysfunction (TMD) are comorbid diseases, with the presence of one of them in a patient increasing the prevalence of the others. The relationship between the 2 diseases may involve the sharing of common physiopathological aspects. Studies about the treatment of this disease association have shown that a simultaneous therapeutic approach to the 2 diseases is more effective than the separate treatment of each. As a consequence, specialists in orofacial pain are now required to know the criteria for the diagnosis of headaches, and headache physicians are required to know the semiologic aspects of orofacial pain. Nevertheless, a headache may be attributed to TMD, instead be an association of 2 problems - TMD and primary headaches - in these cases a secondary headache, described in item 11.7 of the International Classification of Headache Disorders, is still a controversial topic. Attempts to determine the existence of this secondary headache with a specific or suggestive phenotype have been frustrated. The conclusion that can be reached based on the few studies published thus far is that this headache has a preferential unilateral or bilateral temporal location and migraine-like or tension-type headache-like clinical characteristics. In the present review, we will consider the main aspects of the TMD-headache relationship, that is, comorbidity of primary headaches and TMD and clinical aspects of the headaches attributed to TMD from the viewpoint of the International Headache Society and of a group of specialists in orofacial pain. This paper aims to explore our understanding of the association between TMD and headaches in general and migraine in particular. © 2015 American Headache Society.

Tension headache

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... are chronic, they can interfere with life and work. When to Contact a Medical Professional Call 911 if: You are experiencing "the worst headache of your life" You have speech, vision, or movement problems or loss of balance, especially if you have not had these symptoms ...

An epidemiological study of headache among the Monks of Athos (Greece).

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Mitsikostas, D D; Thomas, A; Gatzonis, S; Ilias, A; Papageorgiou, C

1994-10-01

The Monks of Athos in Greece constitute a particular group with unusual sleep schedule and specific diet. In order to study the frequency of headache among them, a special questionnaire was designed. Four hundred forty-nine monks below the age of 50 were approached, 39 of whom suffered from frequent (more than one episode per month, in the last 6 months) headaches (8.68%). The prevalence of migraine was 1.78% (0.66% with aura and 1.11% without) and of tension-type headache 3.34% (1.33% chronic and 2% episodic). Furthermore, 1.87% of monks suffered from mixed headaches (tension-type and migraine attacks as well). Cluster headache was not traced.

A basic diagnostic headache diary (BDHD) is well accepted and useful in the diagnosis of headache. a multicentre European and Latin American study

DEFF Research Database (Denmark)

Jensen, Rigmor Højland; Tassorelli, C; Rossi, P

2011-01-01

Aims: We tested the usability and usefulness of the basic diagnostic headache diary (BDHD) for the diagnosis of migraine, tension-type headache and medication-overuse headache in European and Latin American countries. Methods: Patients were subdivided into two groups according to a 1...

Nitric oxide-related drug targets in headache

DEFF Research Database (Denmark)

Olesen, Jes

2010-01-01

SUMMARY: Nitric oxide (NO) is a very important molecule in the regulation of cerebral and extra cerebral cranial blood flow and arterial diameters. It is also involved in nociceptive processing. Glyceryl trinitrate (GTN), a pro-drug for NO, causes headache in normal volunteers and a so-called del......SUMMARY: Nitric oxide (NO) is a very important molecule in the regulation of cerebral and extra cerebral cranial blood flow and arterial diameters. It is also involved in nociceptive processing. Glyceryl trinitrate (GTN), a pro-drug for NO, causes headache in normal volunteers and a so......-called delayed headache that fulfils criteria for migraine without aura in migraine sufferers. Blockade of nitric oxide synthases (NOS) by L-nitromonomethylarginine effectively treats attacks of migraine without aura. Similar results have been obtained for chronic the tension-type headache and cluster headache....... Inhibition of the breakdown of cyclic guanylate phosphate (cGMP) also provokes migraine in sufferers, indicating that cGMP is the effector of NO-induced migraine. Similar evidence suggests an important role of NO in the tension-type headache and cluster headache. These very strong data from human...

New daily persistent headache

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Alok Tyagi

2012-01-01

Full Text Available New daily persistent headache (NDPH is a chronic headache developing in a person who does not have a past history of headaches. The headache begins acutely and reaches its peak within 3 days. It is important to exclude secondary causes, particularly headaches due to alterations in cerebrospinal fluid (CSF pressure and volume. A significant proportion of NDPH sufferers may have intractable headaches that are refractory to treatment. The condition is best viewed as a syndrome rather than a diagnosis. The headache can mimic chronic migraine and chronic tension-type headache, and it is also important to exclude secondary causes, particularly headaches due to alterations in CSF pressure and volume. A large proportion of NDPH sufferers have migrainous features to their headache and should be managed with treatments used for treating migraine. A small group of NDPH sufferers may have intractable headaches that are refractory to treatment.

Relación entre cefalea tensional y disfunción familiar en una unidad de medicina familiar Relation of tension headache and family dysfunction in a family medicine unit

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Jorge Octavio Carvajal Rivera

2009-03-01

Full Text Available La cefalea tensional es la forma más frecuente de cefalea primaria. Este trabajo se realizó con el objetivo de estimar si existe asociación entre cefalea tensional y disfunción familiar. 60 pacientes evaluaron sus familias a través del cuestionario FF-SIL de funcionamiento familiar. La cefalea tensional fue más frecuente en miembros de familias disfuncionales que en aquellos que provenían de familias funcionales (p=.028. Fueron frecuentes las manifestaciones clínicas relacionadas con estrés postraumático en el paciente problema, existe un complejo y conflictual ambiente familiar que incluye a estos enfermos, lo que nos sugiere el uso de los recursos de la familia como opción terapéutica aún pobremente explorada.Tension headache is the more frequent presentation of primary cephalagia. Aim of this paper is to estimate if there is an association between tension headache and familial dysfunction. Sixty patients evaluated their families by through FF-SIL questionnaire of familial performance. Tension headache was more frequent in members of dysfunctional families than in those from functional families (p = .028. Clinical manifestations related to post-traumatic stress were frequent, there is a familial complex and difficult environment including these sick persons, suggesting us the use of family resources as therapeutical option not very explored yet.

Referred pain from myofascial trigger points in head and neck-shoulder muscles reproduces head pain features in children with chronic tension type headache.

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Fernández-de-las-Peñas, César; Fernández-Mayoralas, Daniel M; Ortega-Santiago, Ricardo; Ambite-Quesada, Silvia; Palacios-Ceña, Domingo; Pareja, Juan A

2011-02-01

Our aim was to describe the referred pain pattern and areas from trigger points (TrPs) in head, neck, and shoulder muscles in children with chronic tension type headache (CTTH). Fifty children (14 boys, 36 girls, mean age: 8 ± 2) with CTTH and 50 age- and sex- matched children participated. Bilateral temporalis, masseter, superior oblique, upper trapezius, sternocleidomastoid, suboccipital, and levator scapula muscles were examined for TrPs by an assessor blinded to the children's condition. TrPs were identified with palpation and considered active when local and referred pains reproduce headache pain attacks. The referred pain areas were drawn on anatomical maps, digitalized, and also measured. The total number of TrPs was significantly greater in children with CTTH as compared to healthy children (P < 0.001). Active TrPs were only present in children with CTTH (P < 0.001). Within children with CTTH, a significant positive association between the number of active TrPs and headache duration (r (s) = 0.315; P = 0.026) was observed: the greater the number of active TrPs, the longer the duration of headache attack. Significant differences in referred pain areas between groups (P < 0.001) and muscles (P < 0.001) were found: the referred pain areas were larger in CTTH children (P < 0.001), and the referred pain area elicited by suboccipital TrPs was larger than the referred pain from the remaining TrPs (P < 0.001). Significant positive correlations between some headache clinical parameters and the size of the referred pain area were found. Our results showed that the local and referred pains elicited from active TrPs in head, neck and shoulder shared similar pain pattern as spontaneous CTTH in children, supporting a relevant role of active TrPs in CTTH in children.

The headache to subjects with multiple sclerosis: clinical and imaging study

International Nuclear Information System (INIS)

Moldovanu, Ion; Voiticovschi-Iosob, Cristina

2011-01-01

The present study showed clinical and imaging particularities of primary headache to subjects with multiple sclerosis. From the total number of 28 patients included in this study 22 (78,57%) had headache accuses (3 men and 19 women). Was observed a high prevalence of tension type headache, present to 10 of the 22 patients (45.45%). Migraine was diagnosed to 8 respondents (36.36 %). In 4 cases was found a combination of migraine and tension type headache (8.1%). Headache was more common to women with multiple sclerosis (MS) than to men. Neuroimaging of MS patients indicates the fact that the presence of demyelinating disease in the brainstem, midbrain, periaqueductal gray substance is associated with an increased risk of headache, migraine characteristics (migraine-like). Psychometric test have revealed a high level of depression and anxiety in patients with MS and chronic headache. (authors)

Two Studies of the Long-Term Follow-up of Minimal Therapist Contact Treatments of Vascular and Tension Headache.

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Blanchard, Edward B.; And Others

1988-01-01

Followed up on tension and vascular headache patients, intially treated with biofeedback and/or relaxation training in either a minimal therapist contact or an intensive individual protocol, where one-half of patients continued keeping headache diaries and were seen monthly; others had minimal contact. Demonstrated equally good maintenance from…

Botulinum toxin a in the treatment of chronic tension-type headache with cervical myofascial trigger points: a randomized, double-blind, placebo-controlled pilot study.

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Harden, R Norman; Cottrill, Jerod; Gagnon, Christine M; Smitherman, Todd A; Weinland, Stephan R; Tann, Beverley; Joseph, Petra; Lee, Thomas S; Houle, Timothy T

2009-05-01

To evaluate the efficacy of botulinum toxin A (BT-A) as a prophylactic treatment for chronic tension-type headache (CTTH) with myofascial trigger points (MTPs) producing referred head pain. Although BT-A has received mixed support for the treatment of TTH, deliberate injection directly into the cervical MTPs very often found in this population has not been formally evaluated. Patients with CTTH and specific MTPs producing referred head pain were assigned randomly to receive intramuscular injections of BT-A or isotonic saline (placebo) in a double-blind design. Daily headache diaries, pill counts, trigger point pressure algometry, range of motion assessment, and responses to standardized pain and psychological questionnaires were used as outcome measures; patients returned for follow-up assessment at 2 weeks, 1 month, 2 months, and 3 months post injection. After 3 months, all patients were offered participation in an open-label extension of the study. Effect sizes were calculated to index treatment effects among the intent-to-treat population; individual time series models were computed for average pain intensity. The 23 participants reported experiencing headache on a near-daily basis (average of 27 days/month). Compared with placebo, patients in the BT-A group reported greater reductions in headache frequency during the first part of the study (P = .013), but these effects dissipated by week 12. Reductions in headache intensity over time did not differ significantly between groups (P = .80; maximum d = 0.13), although a larger proportion of BT-A patients showed evidence of statistically significant improvements in headache intensity in the time series analyses (62.5% for BT-A vs 30% for placebo). There were no differences between the groups on any of the secondary outcome measures. The evidence for BT-A in headache is mixed, and even more so in CTTH. However, the putative technique of injecting BT-A directly into the ubiquitous MTPs in CTTH is partially supported

Characteristics of Elderly-Onset (≥65 years) Headache Diagnosed Using the International Classification of Headache Disorders, Third Edition Beta Version.

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Song, Tae Jin; Kim, Yong Jae; Kim, Byung Kun; Kim, Byung Su; Kim, Jae Moon; Kim, Soo Kyoung; Moon, Heui Soo; Cha, Myoung Jin; Park, Kwang Yeol; Sohn, Jong Hee; Chu, Min Kyung; Cho, Soo Jin

2016-10-01

New-onset headache in elderly patients is generally suggestive of a high probability of secondary headache, and the subtypes of primary headache diagnoses are still unclear in the elderly. This study investigated the characteristics of headache with an older age at onset (≥65 years) and compared the characteristics between younger and older age groups. We prospectively collected demographic and clinical data of 1,627 patients who first visited 11 tertiary hospitals in Korea due to headache between August 2014 and February 2015. Headache subtype was categorized according to the International Classification of Headache Disorders, Third Edition Beta Version. In total, 152 patients (9.3%, 106 women and 46 men) experienced headache that began from 65 years of age [elderly-onset group (EOG)], while the remaining 1,475 patients who first experienced headache before the age of 65 years were classified as the younger-age-at-onset group (YOG). Among the primary headache types, tension-type headache (55.6% vs. 28.8%) and other primary headache disorders (OPH, 31.0% vs. 17.3%) were more common in the EOG than in the YOG, while migraine was less frequent (13.5% vs. 52.2%) (p=0.001) in the EOG. Among OPH, primary stabbing headache (87.2%) was more frequent in the EOG than in the YOG (p=0.032). The pain was significantly less severe (p=0.026) and the frequency of medication overuse headache was higher in EOG than in YOG (23.5% vs. 7.6%, p=0.040). Tension-type headache and OPH headaches, primarily stabbing headache, were more common in EOG patients than in YOG patients. The pain intensity, distribution of headache diagnoses, and frequency of medication overuse differed according to the age at headache onset.

A Comparison of Paraprofessionally Trained and Self-Instructed Relaxation Training for the Reduction in Frequency of Tension Headaches.

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Hartman, Bruce W.; Utz, Patrick W.

Previous research has demonstrated the effectiveness of using paraprofessional trainers in teaching students with tension headaches to relax, thus reducing the frequency of their headaches. A technique for automated self-instructed relaxation training was compared to a paraprofessionally trained group and a no-treatment control group over a 3-week…

Prevalence, characteristics and management of headache experienced by people with schizophrenia and schizoaffective disorder: a cross sectional cohort study.

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Connaughton, Joanne; Wand, Benedict

2017-08-01

Headache is the most common type of pain reported by people with schizophrenia. This study aimed to establish prevalence, characteristics and management of these headaches. One hundred participants with schizophrenia/schizoaffective disorder completed a reliable and valid headache questionnaire. Two clinicians independently classified each headache as migraine, tension-type, cervicogenic or other. The 12-month prevalence of headache (57%) was higher than the general population (46%) with no evidence of a relationship between psychiatric clinical characteristics and presence of headache. Prevalence of cervicogenic (5%) and migraine (18%) was comparable to the general population. Tension-type (16%) had a lower prevalence and 19% of participants experienced other headache. No one with migraine was prescribed migraine specific medication; no one with cervicogenic and tension-type received best-practice treatment. Headache is a common complaint in people with schizophrenia/schizoaffective disorder with most fitting recognised diagnostic criteria for which effective interventions are available. No one in this sample was receiving best-practice care for their headache.

Common primary headaches in pregnancy

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Anuradha Mitra

2015-01-01

Full Text Available Headache is a very common problem in pregnancy. Evaluation of a complaint of headache requires categorizing it as primary or secondary. Migrainous headaches are known to be influenced by fluctuation of estrogen levels with high levels improving it and low levels deteriorating the symptoms. Tension-type Headaches (TTHs are the most common and usually less severe types of headache with female to male ratio 3:1. Women known to have primary headache before conception who present with a headache that is different from their usual headache, or women not known to have primary headache before conception who present with new-onset of headache during pregnancy need neurologic assessments for potential secondary cause for their headache. In addition to proper history and physical examination, both non-contrast computed tomography (CT and Magnetic Resonance Imaging (MRI are considered safe to be performed in pregnant women when indicated. Treatment of abortive and prophylactic therapy should include non-pharmacologic tools, judicious use of drugs which are safe for mother and fetus.

Headaches - danger signs

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Migraine headache - danger signs; Tension headache - danger signs; Cluster headache - danger signs; Vascular headache - danger signs ... and other head pain. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: ...

Can headache impair intellectual abilities in children? An observational study

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Esposito M

2012-11-01

Full Text Available Maria Esposito,1 Antonio Pascotto,1 Beatrice Gallai,3 Lucia Parisi,2 Michele Roccella,2 Rosa Marotta,4 Serena Marianna Lavano,4 Antonella Gritti,5 Giovanni Mazzotta,6 Marco Carotenuto11Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Second University of Naples, Naples, 2Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, 3Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, 4Department of Psychiatry, “Magna Graecia” University of Catanzaro, Catanzaro, 5Suor Orsola Benincasa University, Napoli, 6Unit of Child and Adolescent Neuropsychiatry, Azienda Sanitaria Locale 4, Terni, ItalyBackground: The purpose of this study was to assess the cognitive functioning of children affected by headache, pinpointing the differences in intelligence style between subjects affected by migraine without aura and subjects with tension-type headache.Methods: The study population consisted of 147 children (mean age 10.82 ± 2.17 years with headache, recruited from the Headache Center for Developmental Age, Child and Adolescent Neuropsychiatry Clinic, Second University of Naples. Cognitive profiling was performed using Weschler Intelligence Scale for Children Third Edition throughout the sample. According to the International Classification of Headache Disorders II criteria for pediatric age, subjects were divided into a migraine without aura group (n = 75; 43 boys, 32 girls and a tension-type headache group (n = 72; 49 boys, 23 girls. The results were compared with the findings obtained from a sample of 137 healthy control subjects recruited from schools in the Campania region, matched for age and gender.Results: No difference in full intelligence quotient was found between the groups, but the children with tension-type headache had a lower verbal intelligence quotient and a higher performance intelligence quotient than the healthy controls and children with migraine. Factor

[Primary headache and depression].

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Gesztelyi, Gyöngyi

2004-11-28

Primary headaches--mainly tension-type headache and migraine--affect a significant portion of the population. Depression is also highly prevalent. The co-existence of a primary headache and depression in the same patient therefore might be a coincidence due to the high prevalence of these conditions, but there might be a causal relationship between them, or headaches and depression might have a common background. This review of the literature summarizes the features of the relationship between primary headaches and depression. Depression is more prevalent in headache patients than in the headache-free population. Prospective epidemiological studies suggest a common genetic, biochemical or environmental background behind primary headaches and depression. This theory is supported by the role of the same neurotransmitter systems (mostly serotonin and dopamine) in headaches as well as in depression. Comorbid depression is associated with female gender, higher age, and higher frequency of headaches. Most depression inventories--questionnaires used to screen for the severity of depressive symptoms--contain transdiagnostic items, therefore their use in their original form is limited in organic diseases: due to the somatic items they might overestimate the severity of depression. When examining a headache patient special attention should be paid to the recognition of comorbid depression. The diagnosis of suspected mood disorder could be supported by using simple screening methods, such as the original or the abbreviated versions of standard depression inventories, but the final diagnosis of major depression needs psychiatric evaluation. Quality of life of the headache patient is affected not only by the characteristics of pain (frequency, duration, severity) but also by the disability caused by headache and the associating mood disorder. Recognizing coexisting mood disorder and disability helps to make the best treatment choice for the acute and preventive treatment of

A Randomized Controlled Trial on the Effectiveness of Court-Type Traditional Thai Massage versus Amitriptyline in Patients with Chronic Tension-Type Headache

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Peerada Damapong

2015-01-01

Full Text Available This study aimed to evaluate the effectiveness of the court-type traditional Thai massage (CTTM to treat patients with chronic tension-type headaches (CTTHs comparing with amitriptyline taking. A randomized controlled trial was conducted. Sixty patients diagnosed with CTTH were equally divided into a treatment and a control group. The treatment group received a 45-minute course of CTTM twice per week lasting 4 weeks while the control group was prescribed 25 mg of amitriptyline once a day before bedtime lasting 4 weeks. Outcome measures were evaluated in week 2, week 4 and followed up in week 6 consisting of visual analog scale (VAS, tissue hardness, pressure pain threshold (PPT, and heart rate variability (HRV. The results demonstrated a significant decrease in VAS pain intensity for the CTTM group at different assessment time points while a significant difference occurred in within-group and between-group comparison (P < 0.05 for each evaluated measure. Moreover, the tissue hardness of the CTTM group was significantly lower than the control group at week 4 (P < 0.05. The PPT and HRV of the CTTM group were significantly increased (P < 0.05. CTTM could be an alternative therapy for treatment of patients with CTTHs.

[Prevalence and indirect costs of headache in a Brazilian Company].

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Vincent, M; Rodrigues, A de J; De Oliveira, G V; De Souza, K F; Doi, L M; Rocha, M B; Saporta, M A; Orleans, R B; Kotecki, R; Estrela, V V; De Medeiros, V A; Borges, W I

1998-12-01

Employees from a Brazilian oil company research centre (n = 993) were interviewed on the occurrence of headache during a 30 days period. Headache prevalence was 49.8%, with a mean frequency of 4.3 +/- 7.0 attacks per month, lasting 12.2 +/- 21.4 hours each. According to the International Headache Society diagnostic criteria, migraine (5.5%), episodic tension-type headache (26.4%), chronic tension-type headache (1.7%) and headaches not fulfilling the criteria for such disorders (16.2%) were observed. Women suffered comparatively more headache and specifically migraine than men. The pain interfered with work productivity in 10% of the subjects, corresponding to 538.75 hours off. According to an indirect costs estimation for each headache, the company may loose up to US$125.98 per employee annually. Since among headaches migraine has the highest indirect cost, migraine prevention and treatment is particularly important at the working environment. Migraine frequency may be prevented to a large extent, resulting on positive effects in both the quality of life and productivity. The cost-benefit ratio clearly favours therapeutic and preventive programs against chronic headaches.

[A role of treatment of autonomic syndrome in patients with tension-type headache].

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Duma, S N

2015-01-01

The study aims to evaluate the effect of correction of psycho-vegetative violations anxiolitikami on the frequency and intensity of headache. the study included 50 women (average age - 37,4 years) with confirmed diagnosis: frequent episodic headache and chronic headache no factor abuses. Patients of the main group received ibuprofen to 200-400 mg/day for headaches in combination with tizanidine (2-4 mg/day) and anvifen 750 mg a day for 8 weeks. Patients in the comparison group received ibuprofen and tizanidine in the same mode, but did not take anvifen. Evaluated the severity of headaches by visual analogue scale, the level of anxiety on the Hamilton depression rating scale, vegetative disorders on questionnaire ( Wayne), the quality of sleep before treatment and 60 days. In addition, 60 day therapy was conducted subjective assessment of the General state on a scale GGI. The conclusion about expediency of inclusion of, anvifen in the complex treatment of the condition.

Alexithymia in juvenile primary headache sufferers: a pilot study.

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Gatta, Michela; Canetta, Elisabetta; Zordan, Maria; Spoto, Andrea; Ferruzza, Emilia; Manco, Irene; Addis, Alessandra; Dal Zotto, Lara; Toldo, Irene; Sartori, Stefano; Battistella, Pier Antonio

2011-02-01

Starting in the 1990s, there has been accumulating evidence of alexithymic characteristics in adult patients with primary headache. Little research has been conducted, however, on the relationship between alexithymia and primary headache in developmental age. In their research on alexithymia in the formative years, the authors identified one of the most promising prospects for research, as discussed here. The aim of this study was to verify whether there is: (a) a link between tension-type headache and alexithymia in childhood and early adolescence; and (b) a correlation between alexithymia in children/preadolescents and their mothers. This study was based on an experimental group of 32 patients (26 females and 6 males, aged from 8 to 15 years, mean 11.2 ± 2.0) suffering from tension-type headache and 32 control subjects (26 females and 6 males, aged from 8 to 15 years, mean 11.8 ± 1.6). Tension-type headache was diagnosed by applying the International Headache Classification (ICHD-II, 2004). The alexithymic construct was measured using an Italian version of the Alexithymia Questionnaire for Children in the case of the juvenile patients and the Toronto Alexithymia Scale (TAS-20) for their mothers. Higher rates of alexithymia were observed in the children/preadolescents in the experimental group (EG) than in the control group; in the EG there was no significant correlation between the alexithymia rates in the children/preadolescents and in their mothers.

Temporomandibular disorders, sleep bruxism, and primary headaches are mutually associated.

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Fernandes, Giovana; Franco, Ana Lúcia; Gonçalves, Daniela Aparecida; Speciali, José Geraldo; Bigal, Marcelo Eduardo; Camparis, Cinara Maria

2013-01-01

To investigate the association among temporomandibular disorders (TMD), sleep bruxism, and primary headaches, assessing the risk of occurrence of primary headaches in patients with or without painful TMD and sleep bruxism. The sample consisted of 301 individuals (253 women and 48 men) with ages varying from 18 to 76 years old (average age of 37.5 years). The Research Diagnostic Criteria for Temporomandibular Disorders were used to classify TMD. Sleep bruxism was diagnosed by clinical criteria proposed by the American Academy of Sleep Medicine, and primary headaches were diagnosed according to the International Classification of Headache Disorders-II. Data were analyzed by chi-square and odds ratio tests with a 95% confidence interval, and the significance level adopted was .05. An association was found among painful TMD, migraine, and tension-type headache (P headache (3.7; 1.59-8.75). With regard to sleep bruxism, the association was significant only for chronic migraine (3.8; 1.83-7.84). When the sample was stratified by the presence of sleep bruxism and painful TMD, only the presence of sleep bruxism did not increase the risk for any type of headache. The presence of painful TMD without sleep bruxism significantly increased the risk in particular for chronic migraine (30.1; 3.58-252.81), followed by episodic migraine (3.7; 1.46-9.16). The association between painful TMD and sleep bruxism significantly increased the risk for chronic migraine (87.1; 10.79-702.18), followed by episodic migraine (6.7; 2.79-15.98) and episodic tension-type headache (3.8; 1.38-10.69). The association of sleep bruxism and painful TMD greatly increased the risk for episodic migraine, episodic tension-type headache, and especially for chronic migraine.

Characterization of headaches in the premenstrual tension syndrome Caracterização das cefaléias na síndrome da tensão pré-menstrual

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Yara Dadalti Fragoso

2009-03-01

Full Text Available OBJECTIVE: Characterization of headaches in premenstrual syndrome (PMS. Although headache is one of the symptoms for PMS, no details on this headache are given by the American College of Obstetrics and Gynecology (ACOG criteria. METHOD: A group of 45 fertile age women presenting PMS were invited to complete a registration diary for headache and PMS symptoms for three consecutive months. The diary included details of each headache attack, allowing for classification according to the International Headache Society criteria (IHS-2004. RESULTS: Migraine without aura was the most common type of headache in PMS (n=27, 60%, followed by tension type headache (n=15, 30%. Only in two cases the type of headache varied among the observed months, and only in one case the diagnosis could not be concluded by the IHS-2004 criteria. CONCLUSION: Better clinical and therapeutic approach to headache in PMS can be achieved if the patient's type of headache could be properly characterized.OBJETIVO: Caracterização das cefaléias na síndrome da tensão pré-menstrual (TPM. Embora cefaléia seja um dos sintomas associados à TPM, não são fornecidos detalhes sobre esta dor pelos critérios do American College of Obstetrics and Gynecology (ACOG. MÉTODO: Um grupo de 45 mulheres em idade fértil apresentando TPM foi convidado a preencher um diário de registro de cefaléia e dos sintomas de TPM por três meses consecutivos. O diário incluía detalhes de cada crise de cefaléia, permitindo classificação de acordo com os critérios da International Headache Society (IHS-2004. RESULTADOS: Enxaqueca sem aura foi a forma mais freqüente de cefaléia na TPM (n=27, 60%, seguida de cefaléia tipo tensional (n=15, 30%. Em apenas dois casos a cefaléia variou entre os meses observados e em apenas um caso o diagnóstico não pôde ser conclusivo pelos critérios da IHS-2004. CONCLUSÃO: Melhor manejo clínico e terapêutico pode ser obtido na cefaléia da TPM se o tipo de

Differential Effectiveness of Electromyograph Feedback, Verbal Relaxation Instructions, and Medication Placebo with Tension Headaches

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Cox, Daniel J.; And Others

1975-01-01

Adults with chronic tension headaches were assigned to auditory electromyograph (EMG) feedback (N=9), to progressive relaxation (N=9), and to placebo treatment (N=9). Data indicated that biofeedback and verbal relaxation instructions were equally superior to the medicine placebo on all measured variables in the direction of clinical improvement,…

Cluster Headache

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... a role. Unlike migraine and tension headache, cluster headache generally isn't associated with triggers, such as foods, hormonal changes or stress. Once a cluster period begins, however, drinking alcohol ...

Possíveis etapas na patogênese da cefaléia tensional e indicações de tratamento Tension headache: possible pathogenic stages and its relations with therapeutic agents

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Ceme Ferreira Jordy

1995-09-01

Full Text Available Análise de resultados obtidos no estudo de uma série de 100 pacientes com diagnóstico de cefaléia tensional permitem sugerir 5 etapas de um processo fisiopatogênico implicado. Com base nesta sugestão, a indicação para o tratamento e respectiva eficácia, dependerão da etapa patogênica sobre a qual se pretenda fazer incidir a ação terapêutica.Five steps in the pathogenic process involved in the tension headache pathogenesis are suggested from a 100 patients clinical study. Therapeutic efficacy in the treatment of the tension headache is considered to be linked to the relation between the therapeutic agent and the stage in which it has focused its effect, in the pathogenic process.

Predicting the level of job satisfaction based on hardiness and its components among nurses with tension headache.

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Mahdavi, A; Nikmanesh, E; AghaeI, M; Kamran, F; Zahra Tavakoli, Z; Khaki Seddigh, F

2015-01-01

Nurses are the most significant part of human resources in a sanitary and health system. Job satisfaction results in the enhancement of organizational productivity, employee commitment to the organization and ensuring his/ her physical and mental health. The present research was conducted with the aim of predicting the level of job satisfaction based on hardiness and its components among the nurses with tension headache. The research method was correlational. The population consisted of all the nurses with tension headache who referred to the relevant specialists in Tehran. The sample size consisted of 50 individuals who were chosen by using the convenience sampling method and were measured and investigated by using the research tools of "Job Satisfaction Test" of Davis, Lofkvist and Weiss and "Personal Views Survey" of Kobasa. The data analysis was carried out by using the Pearson Correlation Coefficient and the Regression Analysis. The research findings demonstrated that the correlation coefficient obtained for "hardiness", "job satisfaction" was 0.506, and this coefficient was significant at the 0.01 level. Moreover, it was specified that the sense of commitment and challenge were stronger predictors for job satisfaction of nurses with tension headache among the components of hardiness, and, about 16% of the variance of "job satisfaction" could be explained by the two components (sense of commitment and challenge).

Effect of Flunarizine on Serum Glutamate Levels and its Correlation with Headache Intensity in Chronic Tension-Type Headache Patients

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Khairul Putra Surbakti

2017-10-01

CONCLUSION: Since there was no significant correlation found between serum glutamate and headache intensity after treatment with flunarizine, it is suggested that decreasing of headache intensity after flunarizine treatment occurred not through glutamate pathways in CTTH patients.

The working mechanism of manual therapy in participants with chronic tension-type headache

NARCIS (Netherlands)

Castien, R.F.; Blankenstein, A.H.; van der Windt, D.; Heijmans, M.W.; Dekker, J.

2013-01-01

STUDY DESIGN: Prospective longitudinal study.OBJECTIVE: To explore the working mechanism of manual therapy, we investigated whether 3 cervical spine variables were mediators of the effect of manual therapy on headache frequency.BACKGROUND: Manual therapy has been shown to reduce headache frequency

Prevalence of headache in adolescents and association with use of computer and videogames.

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Xavier, Michelle Katherine Andrade; Pitangui, Ana Carolina Rodarti; Silva, Georgia Rodrigues Reis; Oliveira, Valéria Mayaly Alves de; Beltrão, Natália Barros; Araújo, Rodrigo Cappato de

2015-11-01

The aim of this study was to determine the prevalence of headache in adolescents and its association with excessive use of electronic devices and games. The sample comprised 954 adolescents of both sexes (14 to 19 years) who answered a questionnaire about use of computers and electronic games, presence of headache and physical activity. The binary and multinomial logistic regression, with significance level of 5% was used for inferential analysis. The prevalence of headache was 80.6%. The excessive use of electronics devices proved to be a risk factor (OR = 1.21) for headache. Subjects aged between 14 and 16 years were less likely to report headache (OR = 0.64). Regarding classification, 17.9% of adolescents had tension-type headache, 19.3% had migraine and 43.4% other types of headache. The adolescents aged form 14 to 16 years had lower chance (OR ≤ 0.68) to report the tension-type headache and other types of headache. The excessive use of digital equipment, electronic games and attending the third year of high school proved to be risk factors for migraine-type development (OR ≥ 1.84). There was a high prevalence of headache in adolescents and high-time use of electronic devices. We observed an association between excessive use of electronic devices and the presence of headache, and this habit is considered a risk factor, especially for the development of migraine-type.

Prevalence of neck pain in migraine and tension-type headache: a population study.

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Ashina, Sait; Bendtsen, Lars; Lyngberg, Ann C; Lipton, Richard B; Hajiyeva, Nazrin; Jensen, Rigmor

2015-03-01

We assessed the prevalence of neck pain in the population in relation to headache. In a cross-sectional study, a total of 797 individuals completed a headache interview and provided self-reported data on neck pain. We identified migraine, TTH or both migraine and TTH (M+TTH) groups. Pericranial tenderness was recorded in 496 individuals. A total tenderness score (TTS) was calculated as the sum of local scores with a maximum score of 48. The one-year prevalence of neck pain was 68.4% and higher in those with vs. without primary headache (85.7% vs. 56.7%; adjusted OR 3.0, 95% CI 2.0-4.4, pneck pain (56.7%) was significantly higher in those with M+TTH (89.3%), pure TTH (88.4%) and pure migraine (76.2%) (pneck pain had higher TTS than individuals without neck pain (15.1±10.5 vs. 8.4±8.0, pNeck pain is highly prevalent in the general population and even more prevalent in individuals with primary headaches. Prevalence is highest in coexistent M+TTH, followed by pure TTH and migraine. Myofascial tenderness is significantly increased in individuals with neck pain. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Tinnitus Patients with Comorbid Headaches: The Influence of Headache Type and Laterality on Tinnitus Characteristics

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Berthold Langguth

2017-08-01

Full Text Available BackgroundBoth clinical experience and clinical studies suggest a relationship between tinnitus and headache. Here, we aimed to investigate the influence of comorbid headache type and headache laterality on tinnitus characteristics.MethodThe Tinnitus Research Initiative database was screened for patients of the Tinnitus Center of the University Regensburg who reported comorbid headaches. These patients were contacted to complete additional validated questionnaires. Based on these data, patients were categorized according to headache type and headache laterality, and their clinical characteristics were compared with tinnitus patients, who did not report comorbid headaches.ResultsData from 193 patients with tinnitus and comorbid headaches were compared with those from 765 tinnitus patients without comorbid headaches. Tinnitus patients with comorbid headache have higher scores in tinnitus questionnaires, a lower quality of life and more frequently comorbidities such as painful sensation to loud sounds, vertigo, pain (neck, temporomandibular, and general, and depressive symptoms when compared with tinnitus patients without headaches. Both headache laterality and headache type interact with the degree of comorbidity with higher impairment in patients with left-sided and bilateral headaches as well as in patients with migraine or cluster headache.ConclusionThe observed increased impairment in tinnitus patients with comorbid headache can be explained as an additive effect of both disorders on health-related quality of life. The more frequent occurrence of further comorbidities suggests a generally increased amplification of sensory signals in a subset of tinnitus patients with comorbid headaches.

Clinical effectiveness of primary and secondary headache treatment by transcranial direct current stimulation

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Dmitry ePinchuk

2013-03-01

Full Text Available The clinical effectiveness of headache treatment by transcranial direct current stimulation with various locations of stimulating electrodes on the scalp was analyzed retrospectively. The results of the treatment were analyzed in 90 patients aged from 19 to 54 years (48 patients had migraine without aura, 32 – frequent episodic tension-type headaches, 10 – chronic tension-type headaches and in 44 adolescents aged 11 – 16 years with chronic posttraumatic headaches after a mild head injury. Clinical effectiveness of tDCS with 70 – 150 µA current for 30 – 45 minutes via 6.25 cm2 stimulating electrodes is comparable to that of modern pharmacological drugs, with no negative side effects. The obtained result has been maintained on average from 5 to 9 months. It has been demonstrated that effectiveness depends on localization of stimulating electrodes used for different types of headaches.

An examination of Gestalt contact styles, anger and anxiety levels of headache and non headache groups (Turkish

Directory of Open Access Journals (Sweden)

Çiğdem Kudiaki

2018-03-01

Full Text Available Object: In migraine and tension type headaches, which constitute the largest part of primary headache disorders, the importance of psychological factors and psychotherapy applications are reported consistently. In the gestalt therapy approach, studies on physical disorders and body have a special precaution and it is assumed that the physical disorders that are highly related to psychological factors such as headache may be related to Gestalt contact patterns. This study was conducted to investigate Gestalt contact patterns, anger and anxiety levels, and to identify variables that predict contact patterns in the groups with and without headache. Methods: In the first group, migrain and tension type headache, there were 161 (141 female/20 male participants and in the group without headache there were 126 participants (94 female/32 male. There were 287 participants in total. Data was collected through Personal Information Form, Gestalt Contact Styles Scale – Revised Form, Multidimensional Anger Scale and Beck Anxiety Inventory. Results: The comparisons of groups in terms contact styles, anger and anxiety yields that the individuals in headache group engage in retroflection, deflection and desensitization contact styles more than individuals who do not have headaches and they have higher anger and anxiety levels. Similarly, the results of the regression analysis show that the negative attitudes towards oneself, others and the world are an important predictor of retroflection and deflection contacts styles. Also, the attitude of desensitization seems to play a role in decreasing anxious reactions and decreasing quiet responses. Discussion: The results indicate that unhealthy contact styles, anger and anxiety experiences have negative effects on headache. Thus, Gestalt therapy based psychotherapy techniques can me recommended to be an important foundation for treatment of headaches.

Other primary headaches

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Anish Bahra

2012-01-01

Full Text Available The ′Other Primary Headaches′ include eight recognised benign headache disorders. Primary stabbing headache is a generally benign disorder which often co-exists with other primary headache disorders such as migraine and cluster headache. Primary cough headache is headache precipitated by valsalva; secondary cough has been reported particularly in association with posterior fossa pathology. Primary exertional headache can occur with sudden or gradual onset during, or immediately after, exercise. Similarly headache associated with sexual activity can occur with gradual evolution or sudden onset. Secondary headache is more likely with both exertional and sexual headache of sudden onset. Sudden onset headache, with maximum intensity reached within a minute, is termed thunderclap headache. A benign form of thunderclap headache exists. However, isolated primary and secondary thunderclap headache cannot be clinically differentiated. Therefore all headache of thunderclap onset should be investigated. The primary forms of the aforementioned paroxysmal headaches appear to be Indomethacin sensitive disorders. Hypnic headache is a rare disorder which is termed ′alarm clock headache′, exclusively waking patients from sleep. The disorder can be Indomethacin responsive, but can also respond to Lithium and caffeine. New daily persistent headache is a rare and often intractable headache which starts one day and persists daily thereafter for at least 3 months. The clinical syndrome more often has migrainous features or is otherwise has a chronic tension-type headache phenotype. Management is that of the clinical syndrome. Hemicrania continua straddles the disorders of migraine and the trigeminal autonomic cephalalgias and is not dealt with in this review.

Headache and facial pain: differential diagnosis and treatment.

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Bernstein, Jonathan A; Fox, Roger W; Martin, Vincent T; Lockey, Richard F

2013-01-01

Headaches affect 90% of the population sometime during their life. Most are benign and fleeting, some are serious and life-threatening, and others require ongoing medical consultation and treatment. A careful history and physical is necessary to establish a differential diagnosis and to guide the choice of testing to make an accurate diagnosis. The most common types of headaches are discussed in this review. They are divided into primary and secondary headache disorders as classified by the International Headache Society. Primary headache disorders include migraine without and with aura, cluster and tension-type headaches. Secondary headaches are those that occur as a result of some other disorder and include brain tumors, rhinosinusitis, diseases of intracranial and extracranial vasculature, and temporomandibular joint disease. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Headache during airplane travel ("airplane headache"): first case in Greece.

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Kararizou, Evangelia; Anagnostou, Evangelos; Paraskevas, George P; Vassilopoulou, Sofia D; Naoumis, Dimitrios; Kararizos, Grigoris; Spengos, Konstantinos

2011-08-01

Headache related to airplane flights is rare. We describe a 37-year-old female patient with multiple intense, jabbing headache episodes over the last 3 years that occur exclusively during airplane flights. The pain manifests during take-off and landing, and is located always in the left retro-orbital and frontotemporal area. It is occasionally accompanied by dizziness, but no additional symptoms occur. Pain intensity diminishes and disappears after 15-20 min. Apart from occasional dizziness, no other symptoms occur. The patient has a history of tension-type headache and polycystic ovaries. Blood tests and imaging revealed no abnormalities. Here, we present the first case in Greece. We review the current literature on this rare syndrome and discuss on possible pathophysiology and the investigation of possible co-factors such as anxiety and depression.

Obesity and headache: part I--a systematic review of the epidemiology of obesity and headache.

Science.gov (United States)

Chai, Nu Cindy; Scher, Ann I; Moghekar, Abhay; Bond, Dale S; Peterlin, B Lee

2014-02-01

Individually, both obesity and headache are conditions associated with a substantial personal and societal impact. Recent data support that obesity is comorbid with headache in general and migraine specifically, as well as with certain secondary headache conditions such as idiopathic intracranial hypertension. In the current manuscript, we first briefly review the epidemiology of obesity and common primary and secondary headache disorders individually. This is followed by a systematic review of the general population data evaluating the association between obesity and headache in general, and then obesity and migraine and tension-type headache disorders. Finally, we briefly discuss the data on the association between obesity and a common secondary headache disorder that is associated with obesity, idiopathic intracranial hypertension. Taken together, these data suggest that it is important for clinicians and patients to be aware of the headache/migraine-obesity association, given that it is potentially modifiable. Hypotheses for mechanisms of the obesity-migraine association and treatment considerations for overweight and obese headache sufferers are discussed in the companion manuscript, as part II of this topic. © 2014 American Headache Society.

Traumatic-event headaches

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Haas David C

2004-10-01

Full Text Available Abstract Background Chronic headaches from head trauma and whiplash injury are well-known and common, but chronic headaches from other sorts of physical traumas are not recognized. Methods Specific information was obtained from the medical records of 15 consecutive patients with chronic headaches related to physically injurious traumatic events that did not include either head trauma or whiplash injury. The events and the physical injuries produced by them were noted. The headaches' development, characteristics, duration, frequency, and accompaniments were recorded, as were the patients' use of pain-alleviative drugs. From this latter information, the headaches were classified by the diagnostic criteria of the International Headache Society as though they were naturally-occurring headaches. The presence of other post-traumatic symptoms and litigation were also recorded. Results The intervals between the events and the onset of the headaches resembled those between head traumas or whiplash injuries and their subsequent headaches. The headaches themselves were, as a group, similar to those after head trauma and whiplash injury. Thirteen of the patients had chronic tension-type headache, two had migraine. The sustained bodily injuries were trivial or unidentifiable in nine patients. Fabrication of symptoms for financial remuneration was not evident in these patients of whom seven were not even seeking payments of any kind. Conclusions This study suggests that these hitherto unrecognized post-traumatic headaches constitute a class of headaches characterized by a relation to traumatic events affecting the body but not including head or whiplash traumas. The bodily injuries per se can be discounted as the cause of the headaches. So can fabrication of symptoms for financial remuneration. Altered mental states, not systematically evaluated here, were a possible cause of the headaches. The overall resemblance of these headaches to the headaches after

Quality of life and clinical features of chronic exertion headache in men and women

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Slyusar T.A.

2012-12-01

Full Text Available The research goal was to study quality of life and clinical features of chronic headache in men and women. Materials and Methods. The comprehensive survey was conducted. 162 people (75 men and 87 women aged 35-54 years, average age 45,6±2,6 years with tension headache (TH, corresponding to the criteria of tension-type headache under international classification of headaches (2003 were examined. The results of studies of quality of life among the patients with chronic tension headache allowed to estimate the impact of disease on various components of QOL in men and women. Conclusions. Monitoring of physical, psychological and social functioning of patients to obtain differential and integral quantitative indicators enabled a doctor to correct treatment at various stages and to develop a set of practical recommendations for treatment of patients with poor quality of life.

Headache as an Aura of Epilepsy: Video-EEG Monitoring Study.

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Kim, Dong Wook; Sunwoo, Jun-Sang; Lee, Sang Kun

2016-04-01

Headache can be associated with epilepsy as a pre-ictal, ictal, or post-ictal phenomenon; however, studies of patients with headache as an epileptic aura are scarce. We performed the present study to investigate the incidence and characteristics of headache as an epileptic aura, via confirmation of electroencephalography (EEG) changes by video-EEG monitoring. Data of aura and clinical seizure episodes of 831 consecutive patients who undertook video-EEG monitoring were analyzed retrospectively. For patients who had headache as an aura, information on the detailed features of headache was acquired, including location, nature, duration, and the presence of accompanying symptoms. Video-recorded clinical seizures, EEG findings, and neuroimaging data were used to determine the ictal onset areas in the patients. Six out of 831 (0.7%) patients experienced headache as aura (age range, 25-52 years), all of whom had partial seizures. The incidence of pre-ictal headache was 6.3% (25/831), and post-ictal headache was 30.9% (257/831). In patients with headache as aura, five patients described headache as the most frequent aura, and headache was the second most frequent aura in one patient. The characteristics of headache were hemicrania epileptica in two patients, tension-type headache in another two patients, and migraine-like headache in the remaining two patients. No patient met the diagnostic criteria of ictal epileptic headache or migraine aura-triggered seizure. Our study showed that headache as an aura is uncommon in adult patients with epilepsy, and that headache can present as diverse features, including hemicrania epileptica, tension-type headache, and migraine-like headache. Further studies are necessary to characterize the features of headache as an epileptic aura in adult patients with epilepsy. © 2016 American Headache Society.

The local and referred pain from myofascial trigger points in the temporalis muscle contributes to pain profile in chronic tension-type headache.

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Fernández-de-Las-Peñas, César; Ge, Hong-You; Arendt-Nielsen, Lars; Cuadrado, Maria Luz; Pareja, Juan A

2007-01-01

To assess the local and referred pain areas and pain characteristics evoked from temporalis muscle trigger points (TrPs) in chronic tension-type headache (CTTH). Thirty CTTH patients and 30 age and sex-matched controls were studied. A headache diary was kept for 4 weeks to substantiate the diagnosis and record the pain history. Both temporalis muscles were examined for the presence of myofascial TrPs in a blinded fashion. The local and referred pain intensities, referred pain pattern, and pressure pain threshold were recorded. Referred pain was evoked in 87% and 54% on the dominant and nondominant sides in CTTH patients, which was significantly higher (P<0.001) than in controls (10% vs. 17%, respectively). Referred pain spread to the temple ipsilateral to the stimulated muscle in both patients and controls, with additional referral behind the eyes in most patients, but none in controls. CTTH patients reported a higher local [visual analog scale (VAS): 5.6+/-1.2 right side, 5.3+/-1.4 left side] and referred pain (VAS: 4.7+/-2 right side, 3.5+/-2.8 left side) intensity than healthy controls (VAS: 0.8+/-0.7 right side, 0.7+/-0.7 left side for local pain; and 0.3+/-0.2 right side, 0.4+/-0.3 left side for referred pain) in both temporalis muscles (both, P<0.001). The local and referred pain areas were larger in patients than in controls (P<0.001). Twenty-three out of 30 CTTH patients (77%) had active TrPs in the temporalis muscle leading to their usual headache (17 patients on the right side; 12 on the left side, whereas 6 with bilateral active TrPs). CTTH patients with active TrPs in either right or left temporalis muscle showed longer headache duration than those with latent TrPs (P=0.004). CTTH patients showed significantly (P<0.001) lower pressure pain threshold (1.1+/-0.2 right side, 1.2+/-0.3 left side) as compared with controls (2.5+/-0.5 right side, 2.6+/-0.4 left side). In CTTH patients, the evoked local and referred pain from active TrPs in the temporalis

Stress and Sleep Duration Predict Headache Severity in Chronic Headache Sufferers

OpenAIRE

Houle, Timothy T.; Butschek, Ross A.; Turner, Dana P.; Smitherman, Todd A.; Rains, Jeanetta C.; Penzien, Donald B.

2012-01-01

The objective of this study was to evaluate the time-series relationships between stress, sleep duration, and headache pain among patients with chronic headaches. Sleep and stress have long been recognized as potential triggers of episodic headache (< 15 headache days/month), though prospective evidence is inconsistent and absent in patients diagnosed with chronic headaches (≥ 15 days/month). We reanalyzed data from a 28-day observational study of chronic migraine (n = 33) and chronic tension...

CGRP in human models of primary headaches

DEFF Research Database (Denmark)

Ashina, Håkan; Schytz, Henrik Winther; Ashina, Messoud

2018-01-01

experiments are likely due to assay variation; therefore, proper validation and standardization of an assay is needed. To what extent CGRP is involved in tension-type headache and cluster headache is unknown. CONCLUSION: Human models of primary headaches have elucidated the role of CGRP in headache...... pathophysiology and sparked great interest in developing new treatment strategies using CGRP antagonists and antibodies. Future studies applying more refined human experimental models should identify biomarkers of CGRP-induced primary headache and reveal whether CGRP provocation experiments could be used......OBJECTIVE: To review the role of CGRP in human models of primary headaches and to discuss methodological aspects and future directions. DISCUSSION: Provocation experiments demonstrated a heterogeneous CGRP migraine response in migraine patients. Conflicting CGRP plasma results in the provocation...

Evidence for efficacy of acute treatment of episodic tension-type headache: methodological critique of randomised trials for oral treatments.

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Moore, R Andrew; Derry, Sheena; Wiffen, Philip J; Straube, Sebastian; Bendtsen, Lars

2014-11-01

The International Headache Society (IHS) provides guidance on the conduct of trials for acute treatment of episodic tension-type headache (TTH), a common disorder with considerable disability. Electronic and other searches identified randomised, double-blind trials of oral drugs treating episodic TTH with moderate or severe pain at baseline, or that tested drugs at first pain onset. The aims were to review methods, quality, and outcomes reported (in particular the IHS-recommended primary efficacy parameter pain-free after 2 hours), and to assess efficacy by meta-analysis. We identified 58 reports: 55 from previous reviews and searches, 2 unpublished reports, and 1 clinical trial report with results. We included 40 reports of 55 randomised trials involving 12,143 patients. Reporting quality was generally good, with potential risk of bias from incomplete outcome reporting and small size; the 23 largest trials involved 82% of patients. Few trials reported IHS outcomes. The number needed to treat values for being pain-free at 2 hours compared with placebo were 8.7 (95% confidence interval [CI] 6.2 to 15) for paracetamol 1000 mg, 8.9 (95% CI 5.9 to 18) for ibuprofen 400mg, and 9.8 (95% CI 5.1 to 146) for ketoprofen 25mg. Lower (better) number needed to treat values were calculated for outcomes of mild or no pain at 2 hours, and patient global assessment. These were similar to values for these drugs in migraine. No other drugs had evaluable results for these patient-centred outcomes. There was no evidence that any one outcome was better than others. The evidence available for treatment efficacy is small in comparison to the size of the clinical problem. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Symptomatic Overlap and Therapeutic Opportunities in Primary Headache.

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Cady, Roger; Garas, Sandy Yacoub; Patel, Ketu; Peterson, Andrew; Wenzel, Richard

2015-08-01

Headache, a nearly universal experience, remains costly, disabling, and often suboptimally managed. The most common presentations in the United States are migraine, tension-type headache (TTH) and "sinus" headache, but their extensive symptomatic overlap suggests that these conditions can be approached as variations in the same underlying pathology and managed accordingly. We use case studies of patients with varying prior diagnoses (none, migraine, TTH, and sinus headache), as well as a 4-question diagnostic screening tool, to illustrate how pharmacists can use this conceptual framework to simplify identification, management, and referral of patients with primary headache conditions of uncertain etiology. © The Author(s) 2014.

Stress and sleep duration predict headache severity in chronic headache sufferers.

Science.gov (United States)

Houle, Timothy T; Butschek, Ross A; Turner, Dana P; Smitherman, Todd A; Rains, Jeanetta C; Penzien, Donald B

2012-12-01

The objective of this study was to evaluate the time-series relationships between stress, sleep duration, and headache pain among patients with chronic headaches. Sleep and stress have long been recognized as potential triggers of episodic headache (headache days/month), though prospective evidence is inconsistent and absent in patients diagnosed with chronic headaches (≥15 days/month). We reanalyzed data from a 28-day observational study of chronic migraine (n=33) and chronic tension-type headache (n=22) sufferers. Patients completed the Daily Stress Inventory and recorded headache and sleep variables using a daily sleep/headache diary. Stress ratings, duration of previous nights' sleep, and headache severity were modeled using a series of linear mixed models with random effects to account for individual differences in observed associations. Models were displayed using contour plots. Two consecutive days of either high stress or low sleep were strongly predictive of headache, whereas 2 days of low stress or adequate sleep were protective. When patterns of stress or sleep were divergent across days, headache risk was increased only when the earlier day was characterized by high stress or poor sleep. As predicted, headache activity in the combined model was highest when high stress and low sleep occurred concurrently during the prior 2 days, denoting an additive effect. Future research is needed to expand on current findings among chronic headache patients and to develop individualized models that account for multiple simultaneous influences of headache trigger factors. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Characteristics of the first 1000 headaches in an outpatient headache clinic registry.

Science.gov (United States)

Guerrero, Ángel L; Rojo, Esther; Herrero, Sonia; Neri, María J; Bautista, Lourdes; Peñas, María L; Cortijo, Elisa; Mulero, Patricia; Fernández, Rosa

2011-02-01

To analyze the incidence and characteristics of the first 1000 headaches in an outpatient clinic. Headache is a common cause of medical consultation, both in primary care and in specialist neurology outpatient clinics. The International Classification of Headache Disorders, 2nd Edition (ICHD-II), enables headaches to be classified in a precise and reproducible manner. In January 2008, an outpatient headache clinic was set up in Hospital Clínico Universitario, a tertiary hospital in Valladolid, Spain. Headaches were classified prospectively in accordance with ICHD-II criteria. In each case we recorded age and sex, duration of headache, ancillary tests required, and previous symptomatic or prophylactic therapies. In January 2010, the registry included 1000 headaches in 682 patients. The women/men ratio was 2.46/1 and the mean age of the patients was 43.19 ± 17.1 years (range: 14-94 years). Patients were referred from primary care (53.4%), general neurology clinics (36.6%), and other specialist clinics (9%). The headaches were grouped (ICHD-II classification) as follows: group 1 (Migraine), 51.4%; group 2 (Tension-type headache), 16%; group 3 (Trigeminal autonomic cephalalgias), 2.6%; group 4 (Other primary headaches) and group 13 (Cranial neuralgias), 3.4%. The diagnostic criteria of chronic migraine were satisfied in 8.5% of migraines. Regarding secondary headaches, 1.1% of all cases were included in group 5 (Headaches attributed to trauma) and 8.3% in group 8 (Headaches attributed to a substance or its withdrawal). Only 3.4% of headaches were classified in group 14 (Unspecified or not elsewhere classified), and 5.2% were included in the groups listed in the ICHD-II research appendix. This registry outlines the characteristics of patients seen in an outpatient headache clinic in a tertiary hospital; our results are similar to those previously reported for this type of outpatient clinic. Migraine was the most common diagnosis. Most headaches can be classified using

Obesity and Headache: Part I – A Systematic Review of the Epidemiology of Obesity and Headache

Science.gov (United States)

Chai, Nu Cindy; Scher, Ann I.; Moghekar, Abhay; Bond, Dale S.; Peterlin, B. Lee

2014-01-01

Individually, both obesity and headache are conditions associated with a substantial personal and societal impact. Recent data support that obesity is comorbid with headache in general and migraine specifically, as well as with certain secondary headache conditions such as idiopathic intracranial hypertension. In the current manuscript, we first briefly review the epidemiology of obesity and common primary and secondary headache disorders individually. This is followed by a systematic review of the general population data evaluating the association between obesity and headache in general, and then obesity and migraine and tension-type headache disorders. Finally, we briefly discuss the data on the association between obesity and a common secondary headache disorder that is associated with obesity, idiopathic intracranial hypertension. Taken together, these data suggest that it is important for clinicians and patients to be aware of the headache/migraine-obesity association, given that it is potentially modifiable. Hypotheses for mechanisms of the obesity-migraine association and treatment considerations for overweight and obese headache sufferers are discussed in the companion manuscript, as part II of this topic. PMID:24512574

The power features of Masseter muscle activity in tension-type and migraine without aura headache during open-close clench cycles

Directory of Open Access Journals (Sweden)

Behrouz Alizadeh Savareh

2017-07-01

Full Text Available Introduction Different types of headaches and TMJ click influence the masseter muscle activity. The aim of this study was to assess the trend of energy level of the electromyography (EMG activity of the masseter muscle during open-close clench cycles in migraine without aura (MOA and tension-type headache (TTH with or without TMJ click. Methods Twenty-five women with MOA and twenty four women with TTH participated in the study. They matched with 25 healthy subjects, in terms of class of occlusion and prevalence of temporomandibular joint (TMJ with click. The EMG of both masseter muscles were recorded during open-close clench cycles at a rate of 80 cycles per minute for 15 seconds. The mouth opening was restricted to two centimeters by mandibular motion frame. Signal processing steps have been done on the EMG as: noise removing, smoothing, feature extraction, and statistical analyzing. The six statistical parameters of energy computed were mean, Variance, Skewness, Kurtosis, and first and second half energy over all signal energy. Results A three-way ANOVA indicated that during all the cycles, the mean of energy was more and there was a delay in showing the peak of energy in the masseter of the left side with clicked TMJ in MOA group compared to the two other groups, while this pattern occurred inversely in the side with no-clicked TMJ (P < 0.009. The variation of energy was significantly less in MOA group compared to the two other groups in the no-clicked TMJ (P < 0.003. However, the proportion of the first or second part of signal energy to all energy showed that TTH group had less energy in the first part and more energy in the second part in comparison to the two other groups (P < 0.05. Conclusion The study showed different changes in the energy distribution of masseter muscle activity during cycles in MOA and TTH. MOA, in contrast to TTH, had lateralization effect on EMG and interacted with TMJ click.

Evaluation and management of "sinus headache" in the otolaryngology practice.

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Patel, Zara M; Setzen, Michael; Poetker, David M; DelGaudio, John M

2014-04-01

Patients, primary care doctors, neurologists and otolaryngologists often have differing views on what is truly causing headache in the sinonasal region. This review discusses common primary headache diagnoses that can masquerade as "sinus headache" or "rhinogenic headache," such as migraine, trigeminal neuralgia, tension-type headache, temporomandibular joint dysfunction, giant cell arteritis (also known as temporal arteritis) and medication overuse headache, as well as the trigeminal autonomic cephalalgias, including cluster headache, paroxysmal hemicrania, and hemicrania continua. Diagnostic criteria are discussed and evidence outlined that allows physicians to make better clinical diagnoses and point patients toward better treatment options. Copyright © 2014 Elsevier Inc. All rights reserved.

[Management of chronic daily headache in children and adolescents].

Science.gov (United States)

Cuvellier, J-C

2009-01-01

Chronic daily headache (CDH) affects 2 to 4% of adolescent females and 0,8 to 2% of adolescent males. CDH is diagnosed when headaches occur more than 4 hours a day, for greater than or equal to 15 headache days per month, over a period of 3 consecutive months, without an underlying pathology. It is manifested by severe intermittent headaches, that are migraine-like, as well as a chronic baseline headache. Silberstein and Lipton divided patients into four diagnostic categories: transformed migraine, chronic tension-type headache, new daily-persistent headache, and hemicrania continua. The second edition of the International Classification of Headache Disorders did not comprise any CDH category as such, but provided criteria for all four types of CDH: chronic migraine, chronic tension-type headache, new daily-persistent headache, and hemicrania continua. Evaluation of CDH needs to include a complete history and physical examination to identify any possibility of the headache representing secondary headaches. Children and adolescents with CDH frequently have sleep disturbance, pain at other sites, dizziness, medication-overuse headache and a psychiatric comorbidity (anxiety and mood disorders). CDH frequently results in school absence. CDH management plan is dictated by CDH subtype, the presence or absence of medication overuse, functional disability and presence of attacks of full-migraine superimposed. Reassuring, explaining, and educating the patient and family, starting prophylactic therapy and limiting aborting medications are the mainstay of treatment. It includes pharmacologic (acute and prophylactic therapy) and nonpharmacologic measures (biobehavioral management, biofeedback-assisted relaxation therapy, and psychologic or psychiatric intervention). Part of the teaching process must incorporate life-style changes, such as regulation of sleep and eating habits, regular exercise, avoidance of identified triggering factors and stress management. Emphasis must be

Therapeutic Strategy for Chronic Headache in Children

Directory of Open Access Journals (Sweden)

H.O. Lezhenko

2016-05-01

Full Text Available The therapeutic efficacy of a combined homeopathic preparation Cefavora, which consists of alcoholic extracts of Ginkgo biloba, hawthorn (Crataegus and white mistletoe (Viscum album, has been studied in the treatment of chronic tension-type headache in children. It has been shown that alongside with elimination of headache manifestations, the use of homeopathic medicine has contributed to the normalization of adaptive mechanisms of autonomic regulation in children indicating its high therapeutic efficacy.

Development and psychometric validation of the headache screening questionnaire – Dutch Version

NARCIS (Netherlands)

van der Meer, Hedwig A.; Visscher, Corine M.; Engelbert, Raoul H.H.; Mulleners, Wim M.; Nijhuis-van der Sanden, Maria W. G.; Speksnijder, Caroline M.

2017-01-01

Background Headache is a common disorder which may lead to substantial socio-economic loss. Treatment options include self-management strategies, medication and physiotherapy. Physiotherapists need to be able to screen for the presence of migraine and tension-type headache (TTH), so they can adjust

Caffeine in the management of patients with headache.

Science.gov (United States)

Lipton, Richard B; Diener, Hans-Christoph; Robbins, Matthew S; Garas, Sandy Yacoub; Patel, Ketu

2017-10-24

Caffeinated headache medications, either alone or in combination with other treatments, are widely used by patients with headache. Clinicians should be familiar with their use as well as the chemistry, pharmacology, dietary and medical sources, clinical benefits, and potential safety issues of caffeine. In this review, we consider the role of caffeine in the over-the-counter treatment of headache. The MEDLINE and Cochrane databases were searched by combining "caffeine" with the terms "headache," "migraine," and "tension-type." Studies that were not placebo-controlled or that involved medications available only with a prescription, as well as those not assessing patients with migraine and/or tension-type headache (TTH), were excluded. Compared with analgesic medication alone, combinations of caffeine with analgesic medications, including acetaminophen, acetylsalicylic acid, and ibuprofen, showed significantly improved efficacy in the treatment of patients with TTH or migraine, with favorable tolerability in the vast majority of patients. The most common adverse events were nervousness (6.5%), nausea (4.3%), abdominal pain/discomfort (4.1%), and dizziness (3.2%). This review provides evidence for the role of caffeine as an analgesic adjuvant in the acute treatment of primary headache with over-the-counter drugs, caffeine doses of 130 mg enhance the efficacy of analgesics in TTH and doses of ≥100 mg enhance benefits in migraine. Additional studies are needed to assess the relationship between caffeine dosing and clinical benefits in patients with TTH and migraine.

Rounding behavior in the reporting of headache frequency complicates headache chronification research.

Science.gov (United States)

Houle, Timothy T; Turner, Dana P; Houle, Thomas A; Smitherman, Todd A; Martin, Vincent; Penzien, Donald B; Lipton, Richard B

2013-06-01

To characterize the extent of measurement error arising from rounding in headache frequency reporting (days per month) in a population sample of headache sufferers. When reporting numerical health information, individuals tend to round their estimates. The tendency to round to the nearest 5 days when reporting headache frequency can distort distributions and engender unreliability in frequency estimates in both clinical and research contexts. This secondary analysis of the 2005 American Migraine Prevalence and Prevention study survey characterized the population distribution of 30-day headache frequency among community headache sufferers and determined the extent of numerical rounding ("heaping") in self-reported data. Headache frequency distributions (days per month) were examined using a simplified version of Wang and Heitjan's approach to heaping to estimate the probability that headache sufferers round to a multiple of 5 when providing frequency reports. Multiple imputation was used to estimate a theoretical "true" headache frequency. Of the 24,000 surveys, headache frequency data were available for 15,976 respondents diagnosed with migraine (68.6%), probable migraine (8.3%), or episodic tension-type headache (10.0%); the remainder had other headache types. The mean number of headaches days/month was 3.7 (standard deviation = 5.6). Examination of the distribution of headache frequency reports revealed a disproportionate number of responses centered on multiples of 5 days. The odds that headache frequency was rounded to 5 increased by 24% with each 1-day increase in headache frequency (odds ratio: 1.24, 95% confidence interval: 1.23 to 1.25), indicating that heaping occurs most commonly at higher headache frequencies. Women were more likely to round than men, and rounding decreased with increasing age and increased with symptoms of depression. Because of the coarsening induced by rounding, caution should be used when distinguishing between episodic and chronic

PTSD, combat injury, and headache in Veterans Returning from Iraq/Afghanistan.

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Afari, Niloofar; Harder, Laura H; Madra, Naju J; Heppner, Pia S; Moeller-Bertram, Tobias; King, Clay; Baker, Dewleen G

2009-10-01

To examine the relationship between posttraumatic stress disorder, combat injury, and headache in Operation Iraqi Freedom and Operation Enduring Freedom veterans at the VA San Diego Healthcare System. Previous investigations suggest that a relationship between posttraumatic stress disorder and primary headache disorders exists and could be complicated by the contribution of physical injury, especially one that results in loss of consciousness. These associations have not been systematically examined in Operation Iraqi Freedom and Operation Enduring Freedom veterans. In this observational cross-sectional study, a battery of self-report, standardized questionnaires was completed by 308 newly registered veterans between March and October 2006. The Davidson Trauma Scale was used to determine the degree of posttraumatic stress disorder symptoms and combat-related physical injury was assessed by self-report. The presence of headache was based on a symptom checklist measure and self-reported doctor diagnoses. Logistic regression analysis was performed to predict presence of headache and determine odds ratios and 95% confidence intervals associated with demographic, military, in-theatre, and mental health characteristics. About 40% of the veterans met the criteria for posttraumatic stress disorder; 40% self-reported current headache, 10% reported a physician diagnosis of migraine, 12% a physician diagnosis of tension-type headache, and 6% reported both types of headache. Results from the logistic regression model indicated that combat-related physical injury (odds ratio: 2.25; 95% confidence interval: 1.17-4.33) and posttraumatic stress disorder (odds ratio: 4.13; 95% confidence interval: 2.44-6.99) were independent predictors of self-reported headache. Additional analyses found that veterans with both tension and migraine headache had higher rates of posttraumatic stress disorder (chi-square [d.f. = 3] = 15.89; P = .001) whereas veterans with migraine headache alone had

Eletromiograma de superfície durante stress experimental como subsídio no diagnóstico da cefaléia tensional: resultados em 100 casos Surface scalp and neck electromyography with stress as diagnostic criterion in chronic tension headache: results in 100 cases

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Ceme Ferreira Jordy

1995-09-01

Full Text Available Eletromiograma de superfície foi realizado no crânio e pescoço, durante stress provocado por frio, em 100 pacientes sofrendo cefaléia crônica isolada. Os resultados de diagnóstico obtidos com a eletromiografia revelaram erro de 24% a 32% na avaliação clínica da cefaléia tensional segundo os critérios anamnésicos referendados pelo Comitê de Classificação das Cefaléias, da Sociedade Internacional de Cefaléia (1988. A eletromiografia durante stress é proposta como novo critério de diagnóstico da Cefaléia tensional.We report the use of surface scalp and neck electromyography during experimental stress state in a series of 100 out-patients suffering from chronic tension headache. Results revealed a 24% to 32% of diagnostic errors in the diagnostic obtained by routine anamnestic procedures and following the criteria recommended by the Headache Classification Commitee of the International Headache Society (1988. The electromyography with stress is proposed as a new diagnostic criterion for tension headache.

Diagnostic and Therapeutic Problems of Geriatric Headache

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Kaviyan Ghandehari

2007-07-01

Full Text Available There is no difference in clinical characteristics of headache between old individuals and younger’s. However, differential diagnosis of migrainous aura and transient ischemic attacks may be difficult in old people who frequently have vascular risk factors. Old people have less headache than the young’s. Chronic tension headache is the most common primary type of headache in the elderly. Chronic paroxismal hemicrania and headache due to giant cell arterities are specified to the elderly, Secondary headaches; e.g headache due to cervical spondylosis and brain tumors is more common in the old people than young. Old people poorly tolerate headache drugs, i.e. Ergotamine, Triptans and Tricyclics. Trigeminal neuralgia is often seen in the elderly and is resistant to medical therapy in the old people. Headache could be the main manifestation of depression in old people. Headaches secondary to disorders of internal medicine; i.e. hypertension and chronic obstructive pulmonary disease have importance in the elderly. Subarachnoid hemorrhage is considered in every old person with sudden onset explosive headache especially in cases with decreased consciousness and neck stiffness. Old individuals use a collection of different drugs due to suffering various diseases and commonly have drug induced headaches. Neuroimaging should be performed in a geriatric patient with new onset sever headache without medical disorder or consumption of drug induced headache. Some of the old people suffer of multiple types of headache.

Association of cross-sectional area of the rectus capitis posterior minor muscle with active trigger points in chronic tension-type headache: a pilot study.

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Fernández-de-Las-Peñas, César; Cuadrado, María Luz; Arendt-Nielsen, Lars; Ge, Hong-You; Pareja, Juan A

2008-03-01

To investigate whether cross-sectional area (CSA) of the suboccipital muscles was associated with active trigger points (TrPs) in chronic tension-type headache (CTTH). Magnetic resonance imaging (MRI) of the cervical spine was performed in 11 females with CTTH aged from 26 to 50 yrs old. CSA for both rectus capitis posterior minor (RCPmin) and rectus capitis posterior major (RCPmaj) muscles were measured from axial T1-weighted images, using axial MRI slices aligned parallel to the C2/3 intervertebral disc. A headache diary was kept for 4 wks to record the pain history. TrPs in the suboccipital muscle were identified by eliciting referred pain to palpation, and increased referred pain with muscle contraction. TrPs were considered active if the elicited referred pain reproduced the head pain pattern and features of the pattern seen during spontaneous headache attacks. Active TrPs were found in six patients (55%), whereas the remaining five patients showed latent TrPs. CSA of the RCPmin was significantly smaller (F = 13.843; P = 0.002) in the patients with active TrPs (right side: 55.9 +/- 4.4 mm; left side: 61.1 +/-: 3.8 mm) than in patients with latent TrPs (right side: 96.9 +/- 14.4 mm; left side: 88.7 +/- 9.7 mm). No significant differences were found for CSA of the RCPmaj between the patients with either active or latent TrP (P > 0.5). It seems that muscle atrophy in the RCPmin, but not in the RCPmaj, was associated with suboccipital active TrPs in CTTH, although studies with larger sample sizes are now required. It may be that nociceptive inputs in active TrPs could lead to muscle atrophy of the involved muscles. Muscle disuse or avoidance behavior can also be involved in atrophy.

CBF patterns in different types of headache using 99mTc HMPAO and high resolution SPECT

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Jones, B.E.; Davies, P.G.; Costa, D.C.; Steiner, T.J.; Rose, F.C.; Jewkes, R.F.; Charing Cross Hospital, London

1988-01-01

High resolution SPECT studies have been performed using 99m Tc HMPAO on patients suffering from migraine, cluster headache or chronic tension headache. Reduced uptake of tracer in the right parieto-occipital cortex was seen in 6/8 patients suffering from classical or hemiplegic migraine and 2/10 patients suffering from common migraine. A high uptake of tracer was seen in the temporal muscle of some patients with chronic tension headache. Extracerebral uptake of radioactivity was also seen in the tissue surrounding the brain in a case injected with the HMPAO 45 minutes after it had been prepared and in metastatic skull lesions in patients suffering from cancer of the breast. It is therefore important to use high resolution instrumentation to avoid artifacts when using this technique. (orig.)

Tension‑Type Headache - Psychiatric Perspective

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João Campos Mendes

2013-11-01

Full Text Available Introduction: The tension‑type headaches (Ctt are the most frequent headaches in the general population and those with higher socio‑economic impact, given the high degree of disability they cause. Objective: The authors propose to conduct a review of the available literature on the subject, from a psychiatric perspective. Discussion: Several studies have identified a higher prevalence of psychiatric disorders, personality traits and ineffective coping mechanisms in patients with Ctt, so it is essential to understand this relationship and the impact of these psychopathological factors on this kind of headaches. Conclusion: Their clinical and therapeutic approach is hampered by these and other factors and multiple strategies of pharmacological and psycho‑behavioral treatment have been used on them, however, scientific evidence is still scarce.

Manual therapy for tension-type headache related to quality of work life and work presenteeism: Secondary analysis of a randomized controlled trial.

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Monzani, Lucas; Espí-López, Gemma Victoria; Zurriaga, Rosario; Andersen, Lars L

2016-04-01

The objective of this research is to evaluate the efficacy of manual therapy for tension-type headache (TTH) in restoring workers quality of work life, and how work presenteeism affects this relation. This study is a secondary analysis of a factorial, randomized clinical trial on manual therapy interventions. Altogether, 80 patients (85% women) with TTH and without current symptoms of any other concomitant disease participated. An experienced therapist delivered the treatment: myofascial inhibitory technique (IT), articulatory technique (AT), combined technique (IT and AT), and control group (no treatment). In general, all treatments as compared to our control group had a large effect (f≥.69) in the improvement of participants' quality of work life. Work presenteeism interacted with TTH treatment type's efficacy on participant's quality of work life. The inhibitory technique lead to higher reports of quality of work life than other treatment options only for participants with very low frequency of work presenteeism. In turn, TTH articulatory treatment techniques resulted in higher reports of quality of work life for a high to very high work presenteeism frequency. Articulatory manipulation technique is the more efficient treatment to improve quality of work life when the frequency of work presenteeism is high. Implications for future research and practice are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Neuromodulation of chronic headaches: position statement from the European Headache Federation

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2013-01-01

The medical treatment of patients with chronic primary headache syndromes (chronic migraine, chronic tension-type headache, chronic cluster headache, hemicrania continua) is challenging as serious side effects frequently complicate the course of medical treatment and some patients may be even medically intractable. When a definitive lack of responsiveness to conservative treatments is ascertained and medication overuse headache is excluded, neuromodulation options can be considered in selected cases. Here, the various invasive and non-invasive approaches, such as hypothalamic deep brain stimulation, occipital nerve stimulation, stimulation of sphenopalatine ganglion, cervical spinal cord stimulation, vagus nerve stimulation, transcranial direct current stimulation, repetitive transcranial magnetic stimulation, and transcutaneous electrical nerve stimulation are extensively published although proper RCT-based evidence is limited. The European Headache Federation herewith provides a consensus statement on the clinical use of neuromodulation in headache, based on theoretical background, clinical data, and side effect of each method. This international consensus further gives recommendations for future studies on these new approaches. In spite of a growing field of stimulation devices in headaches treatment, further controlled studies to validate, strengthen and disseminate the use of neurostimulation are clearly warranted. Consequently, until these data are available any neurostimulation device should only be used in patients with medically intractable syndromes from tertiary headache centers either as part of a valid study or have shown to be effective in such controlled studies with an acceptable side effect profile. PMID:24144382

[The effect of EMG level by EMG biofeedback with progressive muscle relaxation training on tension headache].

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Ro, U J; Kim, N C; Kim, H S

1990-08-01

The purpose of this study is to assess if EMG biofeedback training with progressive muscle relaxation training is effective in reducing the EMG level in patients with tension headaches. This study which lasted from 23 October to 30 December 1989, was conducted on 10 females who were diagnosed as patients with tension headaches and selected from among volunteers at C. University in Seoul. The process of the study was as follows: First, before the treatment, the baseline was measured for two weeks and the level of EMG was measured five times in five minutes. And then EMG biofeedback training was used for six weeks, 12 sessions in all, and progressive muscle relaxation was done at home by audio tape over eight weeks. Each session was composed of a 5-minute baseline, two 5-minute EMG biofeedback training periods and a 5-minute self-control stage. Each stage was followed by a five minute rest period. So each session took a total of 40 minutes. The EMG level was measured by EMG biofeedback (Autogenic-Cyborg: M 130 EMG module). The results were as follows: 1. The average age of the subjects was 44.1 years and the average history of headache was 10.6 years (range: 6 months-20 years). 2. The level of EMG was lowest between the third and the fourth week of the training except in Cases I and IV. 3. The patients began to show a nonconciliatory attitude at the first session of the fifth week of the training.

BOTULINUM TOXIN FOR THE TREATMENT OF CHRONIC HEADACHE

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L. B. Zavaliy

2015-01-01

Full Text Available ABSTRACT. The article deals with the use of botulinum toxin in the treatment of chronic headache. We present four clinical cases of patients who sought treatment in the “Pain Clinic” of N.V. Sklifosovsky Research Institute for Emergency Medicine with a chronic severe cephalgic syndrome of different genesis (migraine, tension headache, dystonia, which had not responded to outpatient treatment for a long time. The paper shows the change of pain in patients with various forms of headache after treatment with botulinum toxin type A, indicating the effectiveness of the method in these patients. 

Cognitive-Behavioral Therapy versus Temporal Pulse Amplitude Biofeedback Training for Recurrent Headache

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Martin, Paul R.; Forsyth, Michael R.; Reece, John

2007-01-01

Sixty-four headache sufferers were allocated randomly to cognitive-behavioral therapy (CBT), temporal pulse amplitude (TPA) biofeedback training, or waiting-list control. Fifty-one participants (14M/37F) completed the study, 30 with migraine and 21 with tension-type headache. Treatment consisted of 8, 1-hour sessions. CBT was highly effective,…

Application of ICHD-II Criteria in a Headache Clinic of China

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Dong, Zhao; Di, Hai; Dai, Wei; Liang, Jingyao; Pan, Meiyan; Zhang, Mingjie; Zhou, Zhibin; Li, Zheng; Liu, Ruozhuo; Yu, Shengyuan

2012-01-01

Background China has the huge map and the largest population in the world. Previous studies on the prevalence and classification of headaches were conducted based on the general population, however, similar studies among the Chinese outpatient population are scarce. This study aimed to analyze the characteristics of 1843 headache patients enrolled in a North China headache clinic of the General Hospital for Chinese People's Liberation Army from October 2011 to May 2012, with the International Classification of Headache Disorders, 2nd Edition (ICHD-II). Methods and Results Personal interviews were carried out and a detailed questionnaire was used to collect medical records including age, sex and headache characteristics. Patients came from 28 regions of China with the median age of 40.9 (9–80) years and the female/male ratio of 1.67/1. The primary headaches (78.4%) were classified as the following: migraine (39.1%), tension-type headache (32.5%), trigeminal autonomic cephalalgias (5.3%) and other primary headache (1.5%). Among the rest patients, 12.9% were secondary headaches, 5.9% were cranial neuralgias and 2.5% were unspecified or not elsewhere classified. Fourteen point nine percent (275/1843) were given an additional diagnosis of chronic daily headache, including medication-overuse headache (MOH, 49.5%), chronic tension-type headache (CTTH, 32.7%) and chronic migraine (CM, 13.5%). The visual analogue scale (VAS) score of TTH with MOH was significantly higher than that of CTTH (6.8±2.0 vs 5.6±2.0, Pheadache clinic outpatients in a tertiary hospital of North China that migraine is the most common diagnosis. Furthermore, most headaches in this patient population can be classified using ICHD-II criteria. PMID:23239993

Efficacy and safety of two fast-absorbing formulations of paracetamol in combination with caffeine for episodic tension-type headache: results from two randomized placebo- and active-controlled trials

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Yue Y

2017-06-01

Full Text Available Yong Yue,1 Kenneth D Reed,1 Lucy Shneyer,2 Dongzhou J Liu3 1GlaxoSmithKline Consumer Healthcare, Parsippany, NJ, 2Shneyer Statistics LLC, Denville, NJ, 3GlaxoSmithKline, Collegeville, PA, USA Objectives: Two randomized placebo-controlled trials evaluated whether combining rapid-acting paracetamol formulations with caffeine resulted in faster/greater relief of episodic tension-type headache (ETTH compared with placebo and over-the-counter (OTC analgesics. Both studies were prematurely terminated. Materials and methods: In the single-blind crossover study 1, adults with ETTH (n=66 received three of the following in random sequence: paracetamol 1,000 mg with sodium bicarbonate 650 mg and caffeine 130 mg; paracetamol 1,000 mg; ibuprofen 400 mg; and placebo. In the double-blind parallel-group study 2, adults with ETTH (n=157 were randomly assigned 2:2:1 to treat up to three headaches with paracetamol with Optizorb technology 1,000 mg plus caffeine 130 mg; ibuprofen 400 mg; and placebo. Results: In study 1, the primary outcome – mean time to perceptible pain relief – was 36.7, 38, 48.9, and 42.7 minutes in the paracetamol–sodium bicarbonate–caffeine, ibuprofen, paracetamol, and placebo groups, respectively; differences were not statistically significant. In study 2, the weighted sum of pain intensity (scale of 0 [no pain] to 4 [severe pain] difference from the time of treatment to hour 4, the primary outcome, showed numerically favorable differences for paracetamol with Optizorb–caffeine compared with ibuprofen (difference in least square means −0.3, 95% confidence interval −1.05 to 0.45 and placebo (−0.47, 95% confidence interval −1.36 to 0.42. In both studies, secondary outcomes suggested faster and greater relief with rapid paracetamol–caffeine compared with placebo and paracetamol; a few of these outcomes achieved statistical significance at ~45–90 minutes in study 1. Adverse events were mostly mild and consistent with known

Epidemiological-based childhood headache natural history study: after an interval of six years.

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Ozge, Aynur; Sasmaz, Tayyar; Cakmak, Sema Erol; Kaleagasi, Hakan; Siva, Aksel

2010-06-01

Headache is a common problem among adolescents, and variations can be observed in headache types and characteristics. The present study aimed to reach 5562 Turkish children who were investigated six years previously in a school-based childhood headache project, and to evaluate their current headache status. Investigators interviewed the available students with structured questionnaires. New and old data were matched and analyzed. The present study included 1155 adolescents (mean age 15.2 +/- 1.1 years), with 582 boys (50.4%) and 573 girls (49.6%). The prevalence of headache was 78.7% (tension-type headache [TTH] 57.5%, migraine 18.6%, unspecified 2.6%). The prevalence of headache was 45.2% six years previously. In the intervening six years, headache prevalence increased and the headache types changed significantly (Kappa: 0.04, p < .01). The most important variation during this time was the significant increase in TTH. Analgesic use was determined in 70.2% of adolescents with headache, with this ratio being higher in migraineurs. In conclusion, there were an increase in headache prevalence and a significant change in headache types over the previous six years. It can also be suggested that new country-based management strategies are required.

[Effect of autogenic training with cognitive and symbol therapy on the treatment of patients with primary headache].

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Zsombók, Terézia; Juhász, Gabriella; Gonda, Xénia; Vitrai, József; Bagdy, György

2005-01-01

Only a minor part of headaches are associated with an organic abnormality in the nervous system. In case of migraine and tension headache, the main provoking factor is psychological stress. Furthermore, these syndromes often occur together with depression and anxiety disorders, and when these comorbid conditions are present headache attacks tend to be more frequent, longer and stronger, causing an increase in the consumption of antimigraine agents, and at the same time increase the consumption of antidepressant and anxiolytic agents. Further to drugs, modified versions of Schultz-type autogenic training is also frequently used for anxiolysis. The aim of our research was to study the effect of the cognitive and symbol therapy enhanced autogenic training on headache and related drug consumption in three different types of primary headaches. Twenty five female patients with migraine, tension-type headache or mixed headache participated in an eight-month follow-up study. Headache frequency, analgesic, antimigraine and anxiolytic consumption were measured by means of a headache diary. During the first four months (observation phase) patients became familiar with using the diary, and in the second four months they participated in autogenic training. The data of the second, third and fourth months were considered as baseline data. Our method decreased headache frequency and drug consumption in all three headache groups. This means that the cognitive and symbol therapy enhanced autogenic training is an effective alternative for medications in the treatment of primary headaches.

A RETROSPECTIVE OBSERVATIONAL STUDY OF PREVALENCE AND OCULAR MANIFESTATIONS IN VARIOUS OCULAR CAUSES FOR HEADACHE DISORDERS

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Srinivasan Shanmugam

2016-10-01

Full Text Available BACKGROUND Headache or cephalgia is one of the commonest symptoms causing pain in head above eyes or the ears, behind the head in the occipital region or in the back of the upper neck causing pain as well as disability to an individual. WHO reports around 47% of adults worldwide will have experienced headache in the last year. Headache maybe primary or secondary. Tension headache is more common type of primary headache. Almost, 90% of adults have tension headache and it is more common in females than males. Migraine headache is third most prevalent disorder worldwide and ranked as seventh highest cause of disability. Migraine headaches are the second most common type of primary headaches, whereas cluster headache, a relatively uncommon type of primary headache affecting less than 1 in every 1000 adults. 1 Many people suffer from mixed headache disorder in which tension headache or secondary headache may trigger migraine. Headache on 15 or more days in every month affects 1.7-4% of the world adult population. Hospital-based studies of migraine shows India is home over 16% of world inhabitants suffering from migraine. MATERIALS AND METHODS In our study, total screening of 1200 cases was done with headache symptomatology reported to Eye OPD directly as well as referred from ENT, Medical, NeuroMedical, Surgical, Neurosurgical, Psychiatry, Orthopaedics and Trauma Ward. A detailed clinical examination and ophthalmological examination was done in 1200 cases. RESULTS Sexual prevalence in our study indicated female with increased prevalence of 46.67% compared to male of 36%. Among 30 cases of migrainous headache with or without aura, the sexual prevalence in our study has female-to-male ratio as 2:1 (female - 20 cases and male - 10 cases. No cluster headache disorder was reported in our study. Among the tension headache presented with ocular manifestations like association of the refractive error, redness, burning sensation, the female prevalence among

Pressure pain and isometric strength of neck flexors are related in chronic tension-type headache.

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Castien, Rene; Blankenstein, Annette; De Hertogh, Willem

2015-01-01

In patients with chronic tension-type headache (CTTH) changes in pressure pain in the cervical region are associated with peripheral or central sensitization. It is hypothesized that an increase of isometric strength of neck flexors would lead to a decrease of pressure pain in CTTH, as an expression of reduced peripheral or central sensitization In this study we aimed to analyze the correlation between change in isometric strength of the neck flexors and change in pressure pain scores (PPS) in patients with CTTH. Comparative analysis of data from previous study. Primary healthcare center. Data from 145 patients with CTTH who underwent a manual therapy program including isometric strength training of the neck flexors were analyzed at 8 and 26 weeks post-treatment. PPS were measured as a total of pain scores on a numeric rating scale (score 0 to 10) on application of a pressure stimulus of 3kg/cm at 8 cervical- and suboccipital muscles. Isometric strength of the neck flexors was measured in seconds. Correlations were computed between changes in PPS and isometric neck flexor strength. Isometric strength of neck flexors scored significantly different compared to baseline measurement (mean 30.0 seconds, sd:25.2), and increased with a mean difference of 17.33 seconds (95%CI: 20.61 to 14.05) at 8 weeks and 19.18 seconds (95%CI: 23.48 to 14.87) at 26 weeks. Similarly, compared to PPS baseline measurement (31.6 points, sd:18.6), mean difference in PPS was significantly decreased at 8 and 26 weeks: -11.3 points (95%CI: -8.77 to -13.83) and -11.15 points (95%CI: -8.31 to -13.99). There is a negative correlation between changes in PPS and changes in isometric strength of neck flexors which is weak at 8 weeks (r = -0.243, P = 0.004) and moderate at 26 weeks (r = -0.318, P isometric strength of neck flexors in patients with CTTH in short- and long-term.

Headache associated with hemodialysis

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Nikić Petar M.

2008-01-01

, serum concentration of hemoglobin, blood urea nitrogen, creatinine, glucose, MCHC, total protein, sodium and potassium. Fourteen patients (34% of those with headaches experienced headache during the HD session and were sub classified as HDH using diagnostic criteria of the International Headache Society. Tension type headache (41% of those with headaches and migraine without aura (10% were most common in the primary headache group and headache due to arterial hypertension (7% was the most prevalent among the secondary headaches. Although there were some common clinical characteristics, we could not find a unifying clinical pattern in the patients with HDH. CONCLUSION Hemodialysis headache is the most common headache in patients undergoing hemodialysis, and despite some common symptoms, it does not appear to be uniform in its clinical characteristics.

Headache at high school: clinical characteristics and impact.

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Tonini, M C; Frediani, F

2012-05-01

Although migraine (MH) and tension type headache (TTH) are the most common and important causes of recurrent headache in adolescents, they are poorly understood and not recognized by parents and teachers, delaying the first physician evaluation for correct diagnosis and management. The purpose of this study is to assess the knowledge about headache impact among the students of a Communication Private High School in Rimini city, and to evaluate the main different types of headaches interfering with school and social day activities. A self-administered questionnaire interview was given to students of the last 2 years of high school; ten items assessed the headache experience during the prior 12 months, especially during school time: the features and diagnosis of headaches types (based on the 2004 IHS criteria), precipitating factors, disability measured using the migraine disability assessment (MIDAS); therapeutic intervention. Out of the 60 students, 84 % experienced recurrent headache during the last 12 months. 79 % were females, aged 17-20 years; a family history was present in 74 % of headache students, in the maternal line; 45 % of subjects were identified as having MH and 27 % TTH; 25 % had morning headache and 20 % in the afternoon; fatigue, emotional stress and lack of sleep were the main trigger factors for headache, respectively in 86, 50 and 50 % of students; 92 % of headache students could not follow the lessons, could not participate in exercises and physical activity because of the headache; none had consulted a medical doctor and the 90 % of all students had never read, listened or watched television about headache. This study remarks on the need to promote headache educational programs, starting from high school, to increase communication between teachers-family-physician and patient-adolescents, with the goal to have an early appropriate therapeutic intervention, improvement of the quality of life and to prevent long-term headache disease in the

Types of headache and those remedies in traditional persian medicine.

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Zarshenas, Mohammad M; Petramfar, Peyman; Firoozabadi, Ali; Moein, Mahmood Reza; Mohagheghzadeh, Abdolali

2013-01-01

The history of headache, as a common neurological complication, goes back to almost 9000 years ago. Many ancient civilizations present references to headaches and the coherent treatment strategies. Accordingly, several documents comprising headache complications embodying precise medical information stem from Traditional Persian Medicine (TPM) that can provide useful opportunities for more comprehensive treatment. We conducted a survey on headache through original important pharmacopeias and other important medical manuscripts of TPM which were written during 9(th) to 19(th) centuries and have derived all headache categories and herbal remedies. An extensive search of scientific data banks, such as Medline and Scopus, has also been exercised to find results relating to the anti-inflammatory, anti-nociceptive, and analgesic effects of denoted medicinal herbs. The concept of headache and treatments in TPM covers over 20 various types of headache and more than 160 different medicinal plants administered for oral, topical, and nasal application according to 1000 years of the subject documents. Nearly, 60% of remarked medicinal herbs have related anti-inflammatory or analgesic effects and some current headache types have similarities and conformities to those of traditional types. Beside historical approaches, there are many possible and available strategies that can lead to development of new and effective headache treatment from medicinal plants so that this study can provide beneficial information on clinical remedies based on centuries of experience in the field of headache which can stand as a new candidate for further investigations.

Specific strength training compared with interdisciplinary counseling for girls with tension-type headache

DEFF Research Database (Denmark)

Tornøe, Birte; Andersen, Lars L; Skotte, Jørgen H

2016-01-01

an increase in [Formula: see text] >5%. For the counseling group, this was the case for 29%. A 24-month follow-up on HRQOL for the pooled sample revealed statistically significant improvements. Fifty-five percent of the girls reported little to none disability. CONCLUSION: The results indicate that both....... METHODS: Forty-nine girls aged 9-18 years with TTH were randomized to patient education programs with 10 weeks of strength training and compared with those who were counseled by a nurse and physical therapist. Primary outcomes were headache frequency, intensity, and duration; secondary outcomes were neck......-shoulder muscle strength, aerobic power, and pericranial tenderness, measured at baseline, after 10 weeks intervention, and at 12 weeks follow-up. Health-related quality of life (HRQOL) questionnaires were assessed at baseline and after 24 months. RESULTS: For both groups, headache frequency decreased...

Avaliação da utilização do placebo nas crises agudas de migrânea sem aura, migrânea com aura e cefaléia do tipo tensional episódica Evaluation of placebo use in migraine without aura, migraine with aura and episodic tension-type headache acute attacks

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Marcelo Eduardo Bigal

2001-09-01

Full Text Available O presente estudo apresenta a avaliação do efeito placebo no tratamento agudo da migrânea sem aura, migrânea com aura e cefaléia do tipo tensional episódica. Foram estudados pacientes que deram entrada entre 1 de março de 1997 a 31 de novembro de 1999 em dois pronto-socorros. Definiram-se três grupos, cada um com 30 pacientes: 1 - migrânea sem aura (MSA; 2 -- migrânea com aura (MCO; 3 -- cefaléia do tipo tensional episódica (CTTE. Os pacientes participavam de estudo randomizado para avaliar a eficácia de 4 drogas; aqueles randomizados para o placebo foram incluídos também. Os parâmetros avaliados foram: 1 -- dor; 2 - sintomas associados. Avaliados uma hora após a administração do placebo, 50% dos pacientes do grupo MSA, 23,3% dos pacientes do grupo MCA e 26,7% dos pacientes do grupo CTTE apresentavam melhora da dor. A melhora, avaliada pela escala numérica da dor foi, em média, de 41,6%, 23,1% e 36%, respectivamente. Houve também redução significativa de todos os sintomas associados. A utilização do placebo é, portanto, essencial na avaliação de drogas utilizadas no tratamento de cefaléias agudas.This study presents an evaluation of placebo response in the acute treatment of migraine with or without aura and episodic tension type headache. We studied patients admitted between March 1st,1997 and November 31st,1999 in two Emergency Room Units. Three groups had been defined, each one with 30 participants: migraine without aura (MWOA, migraine with aura (MWA and episodic tension-type headache (ETTH. Patients were participating of a randomized study to evaluate efficacy of 4 different drugs; those randomized to receive placebo were included. We evaluated pain and associated symptoms. After one hour of placebo administration, 50% of MWOA patients, 23.3% of MWA and 26.7% of ETTH had presented pain relief. The mean of this relief, evaluated by the numerical pain scale, was 41.6%, 23.1% and 36%, respectively. Use of placebo

The quality of diagnosis and management of migraine and tension-type headache in three social groups in Russia

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Lebedeva, Elena R; Kobzeva, Natalia R; Gilev, Denis V

2017-01-01

BACKGROUND: Three successive editions of the International Classification of Headache Disorders and multiple guideline papers on headache care have described evidence based diagnosis and treatment of headache disorders. It remains unknown, however, to which extent this has improved the diagnosis ...

Primary headache disorders in the Republic of Georgia: prevalence and risk factors

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Katsarava, Z; Dzagnidze, A; Kukava, M

2009-01-01

OBJECTIVE: To estimate the 1-year prevalences of migraine and tension-type headache (TTH), and identify their principal risk factors, in the general population of the Republic of Georgia. METHODS: In a community-based door-to-door survey, 4 medical residents interviewed all biologically unrelated......, a remarkably high percentage of the population of Georgia have headache on >/=15 days/month. This study demonstrates the importance of socioeconomic factors in a developing country and unmasks the unmet needs of people with headache disorders....

A retrospective analysis of the headache associated with temporomandibular joint disorder.

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Ungari, C; Quarato, D; Gennaro, P; Riccardi, E; Agrillo, A; Mitro, V; Cascino, F; Reale, G; Rinna, C; Filiaci, F

2012-11-01

Headache is a common symptom, that can be extremely disabling, affecting 26 million of patients only in Italy. ICHD-II has reported two categories: "primary headaches" and "secondary headaches". Temporomandibular joint disorders can lead to a secondary headaches. We want to evaluate the prevalence and clinical features of headache among a series of patients having temporomandibular joint disorders and we illustrate the evolution of headache following medical treatament of temporomandibular joint (TMJ) disorders. This is a retrospective study carried out on chart review of 426 consecutive patients with various degrees of temporomandibular disorders and treated with medical devices from 2007 to 2011. Headache was reported by 73 patients (17.14%). Headache was observed in 36 of 51 patients with lock and in 32 out of 130 patients with mandibular deflections (Table I). The remaining 5 patients with headache had articular noise. Headache is not a rare finding in a population with temporomandibular dysfunctions and is more often a tension-type rather than trigeminal headache.

The comparison of sleep disturbances between the subjects with headache and healthy subjects

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Arash Bostani

2015-11-01

Full Text Available Background: Headache is one of the most common complaints of the patients referring to the treatment centers. Also, some studies have reported the correlation of sleep disturbances with migraine and tension headaches. This study was aimed to analyze the association of sleep disturbances with migraine and tension headaches. Methods: In this cross-sectional study, 1005 students of Kermanshah University of Medical Sciences were selected by stratified random sampling during the academic year 2013-2014. Having attracted the participation and cooperation of the participants, sleep disorder and symptoms of headache (migraine and tension tests were administered. Results: The overall prevalence of headache, migraine headache and tension headache in students of medical science were 73.8 %, 16.7 % and 30.9 %, respectively. 20.3% of medical students had sleep disorder. Difficulty in sleep onset, daytime fatigue, apnea and sadness and anxiety were associated with headache. Total sleep disorder was directly associated with migraine headache (P<0.05.Conclusion: There was a correlation between sleep disorders and headache, especially migraine headache. Considering the importance of sleep in the incidence of headaches, sleep hygiene education and changes in the quality and patterns of sleep are essential for students, which can greatly affect their individual and social life.

Management of chronic daily headache in children and adolescents.

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Mack, Kenneth J; Gladstein, Jack

2008-01-01

Chronic daily headache (CDH) occurs in 1-2% of children and adolescents. It can evolve from either episodic tension-type headache or episodic migraine, or can appear with no previous headache history. As with other primary headache disorders, treatment is based on the level of disability. There are children and adolescents who cope well, but there are others who are markedly disabled by their chronic headaches. As in adults, children and adolescents with CDH are at risk for medication overuse. CDH is a diagnosis of exclusion, based on a thorough history, normal physical examination, and negative neuroimaging findings. Along with the chronic headaches, children with this condition may have co-morbid sleep problems, autonomic dysfunction, anxiety, and/or depression. Principles of treatment include identifying migrainous components, stopping medication overuse, stressing normalcy, using rational pharmacotherapy, and addressing co-morbid conditions. Successful outcomes often involve identifying an appropriate headache preventative, reintegration into school, and family participation in resetting realistic expectations.

[PRIMARY HEADACHE IN CHILDREN AND ADOLESCENTS--DIAGNOSIS AND TREATMENT].

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Matar, Amal Khourieh; Kerem, Nogah C; Srugo, Isaac; Genizi, Jacob

2015-12-01

Primary headaches are one of the most common disorders of childhood, with migraine and tension type headaches (TTHs) being the most frequent ones. In spite of their prevalence, there is paucity of knowledge regarding the underlying pathophysiological mechanisms that cause headaches and regarding the unique aspects of headaches in children and adolescents. To review the literature and summarize the knowledge regarding clinical features, diagnosis and management of primary headache in children and adolescents, mainly migraine and TTH. Most of our current knowledge regarding primary headaches in children and adolescents is driven from extrapolations from studies that were conducted with adult patients. Therefore, it needs to be validated for the different age groups. Migraines may be diagnosed effectively based on the 2nd edition of the International Classification of Headache Disorders (ICHD-II), however, TTH is diagnosed mainly by the absence of features found in other headache types. Treatment strategies for primary headaches vary according to patient's age, family structure, culture and beliefs, headache diagnosis, and based on the disability the headache imposes on the patient's daily living. It was shown that a multidisciplinary approach, that includes continuing counseling, education, and reassurance, in combination with pharmacological and non-pharmacological treatment, is an effective strategy for children and adolescents suffering from primary headaches. Further studies are needed to enrich our knowledge about the pathophysiological mechanisms that cause headaches in children and adolescents and to develop efficient strategies to alleviate their burden.

Frequency, character and predisposing factor of headache among students of medical college of Karachi.

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Noor, Tooba; Sajjad, Ali; Asma, Anoosha

2016-02-01

To evaluate the frequency, predisposing factors and symptomatology of headache among medical students. The cross-sectional study was conducted from September to December 2013 and comprised students of two medical colleges of Karachi. International Classification of Headache Disorder-II criterion was used to diagnose and classify headache. SPSS 17 was used for statistical analysis. Of the 413 medical students studies, 326(79%) had tension type headache, and 87 (21%) had migraine. Headache was more frequent among females than males, with a ratio of 6.5:1. Both types of headache were significantly associated with self-reported disturbed sleep pattern, stress and various triggering factors (p<0.05 each). Both types greatly influenced individual's daily life with significant association with avoiding academics, extra-curricular activities, family and friends (p<0.05 each). High self-medication rate of 400(96.9%) was observed. The prevalence of headache among medical students was high with female predominance. Infrequent consultation needs to be addressed through awareness programmes.

Fibromyalgia and headache: an epidemiological study supporting migraine as part of the fibromyalgia syndrome.

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Marcus, Dawn A; Bernstein, Cheryl; Rudy, Thomas E

2005-11-01

Fibromyalgia is defined by widespread body pain, tenderness to palpation of tender point areas, and constitutional symptoms. The literature reports headache in about half of fibromyalgia patients. The current epidemiological study was designed to determine the prevalence and characteristics of headache in fibromyalgia patients. Treatment-seeking fibromyalgia patients were evaluated with measures for fibromyalgia, chronic headache, quality of life, and psychological distress. Multivariate analysis of variance (MANOVA) and t-tests were used to identify significant differences, as appropriate. A total of 100 fibromyalgia patients were screened (24 fibromyalgia without headache and 76 fibromyalgia with headache). International Headache Society diagnoses included: migraine alone (n = 15 with aura, n = 17 without aura), tension-type alone (n = 18), combined migraine and tension-type (n = 16), post-traumatic (n = 4), and probable analgesic overuse headache (n = 6). Fibromyalgia tender point scores and counts and most measures of pain severity, sleep disruption, or psychological distress were not significantly different between fibromyalgia patients with and without headache. As expected, the fibromyalgia patients with headache scored higher on the Headache Impact Test (HIT-6) (62.1 +/- 0.9 vs 48.3 +/- 1.6, p 60 in 80% of fibromyalgia plus headache patients, representing severe impact from headache, and 56-58 in 4%, representing substantial impact. In summary, chronic headache was endorsed by 76% of treatment-seeking fibromyalgia patients, with 84% reporting substantial or severe impact from their headaches. Migraine was diagnosed in 63% of fibromyalgia plus headache patients, with probable analgesic overuse headache in only 8%. General measures of pain, pain-related disability, sleep quality, and psychological distress were similar in fibromyalgia patients with and without headache. Therefore, fibromyalgia patients with headache do not appear to represent a significantly

Post procedure headache in patients treated for neurovascular arteriovenous malformations and aneurysms using endovascular therapy.

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Khan, Sabrina; Amin, Faisal Mohammad; Hauerberg, John; Holtmannspötter, Markus; Petersen, Julie Falkenberg; Fakhril-Din, Zainab; Gaist, David; Ashina, Messoud

2016-12-01

Though endovascular therapy (EVT) is increasingly applied in the treatment of intracranial vascular lesions, little is known about the effect of EVT on post-procedure headache. We aimed to investigate the prevalence of headache in patients who have undergone EVT for cerebral arteriovenous malformations (AVMs) and aneurysms. A total of 324 patients underwent EVT treatment for aneurysms and AVMs at the Danish National Hospital from January 2012 to December 2014. We applied strict exclusion criteria in order to minimize the effect of other factors on headache occurrence, e.g., craniotomy. Eligible subjects were phone-interviewed using a purpose-developed semi-structured questionnaire. Headaches were classified according to ICHD-III beta criteria. The 59 patients underwent treatment of aneurysms (n = 43), cranial dural fistulas (n = 11), and AVMs (n = 5). There was a significant increase in overall headache (p = 0.017) and tension-type headache (TTH) (p = 0.012) within the first 3 months after EVT compared to 1 month before EVT. However, at interview time (median 2.5 years post-EVT), the increase in overall headache, migraine, and tension-type headache was not statistically significant. A minority of patients experienced headaches for the first time within 3 months of their EVT (migraine 4, TTH 10). At interview time, 50 % of these new headaches still persisted. Our results suggest a temporary increase in headache in the first 3 months after EVT, which normalizes over time. Clinicians may use this knowledge to better inform their patients of functional outcomes after their EVT procedure.

Myofascial trigger points in cluster headache patients: a case series

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Rico-Villademoros Fernando

2008-12-01

Full Text Available Abstract Active myofascial trigger points (MTrPs have been found to contribute to chronic tension-type headache and migraine. The purpose of this case series was to examine if active trigger points (TrPs provoking cluster-type referred pain could be found in cluster headache patients and, if so, to evaluate the effectiveness of active TrPs anaesthetic injections both in the acute and preventive headache's treatment. Twelve patients, 4 experiencing episodic and 8 chronic cluster headache, were studied. TrPs were found in all of them. Abortive infiltrations could be done in 2 episodic and 4 chronic patients, and preemptive infiltrations could be done in 2 episodic and 5 chronic patients, both kind of interventions being successful in 5 (83.3% and in 6 (85.7% of the cases respectively. When combined with prophylactic drug therapy, injections were associated with significant improvement in 7 of the 8 chronic cluster patients. Our data suggest that peripheral sensitization may play a role in cluster headache pathophysiology and that first neuron afferent blockade can be useful in cluster headache management.

Implementation of effective, self-sustaining headache services in the Republic of Georgia: Evaluation of their impact on headache-related disability and quality of life of people with headache.

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Giorgadze, Gvantsa; Mania, Maka; Kukava, Maka; Dzagnidze, Ana; Mirvelashvili, Ekaterine; Steiner, Timothy J; Katsarava, Zaza

2018-04-01

Background Headache disorders are widespread and disabling. They are common in Georgia, especially headache on ≥15 days/month (HA ≥ 15), but there are no headache services. Objective We established headache services meeting local needs, investigating feasibility, consumer uptake and satisfaction, and cost, with an exit strategy bequeathing effective, self-sustaining services that could be rolled out nationwide. Methods We created headache centres in Tbilisi and Gori offering free expert care for three visits over three months, and affordable medication thereafter. The primary outcome measure was the percentage of patients using the service beyond the free period - a measure of both satisfaction and sustainability. Results Of 1,445 patients (age 43.7 ± 12.4 years; 10.5% male), 49.8% had episodic migraine, 22.5% episodic tension-type headache, 25.7% HA ≥ 15 (24.5% overusing medication) and 2.0% trigeminal autonomic cephalalgias. Only 454 (31.4%) and 51 (3.5%) returned for second and third visits; in these, headache improved and treatment costs decreased. As information about the service spread, five other headache clinics opened in Tbilisi and Kutaisi (western Georgia). Pharmaceutical companies reduced prices (sumatriptan 100 mg from US$7 to US$1). Conclusion The study failed to achieve its primary outcome, but sustainable headache services operating to international standards were successfully implemented nonetheless, with demand increasing.

[Individual medical relevance of headaches. Comorbidities and quality of life].

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Haag, G

2014-08-01

In a multitude of cases, very frequent primary headaches lead to a clear deterioration in quality of life. Particularly in patients with chronic migraine, chronic tension headache, and cluster headache, quality of life is limited. This contradicts the preconception still encountered today that headaches are not a serious illness. Comorbidities with somatic and above all mental disorders are also very frequently observed in headache patients. In the foreground are the cardiovascular diseases of arterial hypertension, stroke, and coronary heart disease, as well as the mental disorders of depression, anxiety disorders, posttraumatic stress disorders, and sleep disorders. When such comorbidities are present, the quality of life of the sufferers is significantly reduced. Therefore, headache disorders should be taken seriously and sufferers should be provided with a consistent therapy. In cases of severe types of headache and in the presence of comorbidities, it is imperative that therapy is also prophylactic and multimodal in nature.

Intravenous chlorpromazine in the acute treatment of episodic tension-type headache: a randomized, placebo controlled, double-blind study Clorpromazina parenteral no tratamento agudo da cefaléia do tipo tensional episódica: estudo randomizado, com mascaramento duplo, controlado por placebo

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Marcelo Eduardo Bigal

2002-09-01

Full Text Available Acute headache is a very frequent symptom, responsible for a significant percentage of caseload at primary care units and emergency rooms. Chlorpromazine is easily available in such settings. The aim of this study is to conduct a randomized, placebo-controlled, double-blind study to assess the efficacy of chlorpromazine on the acute treatment of episodic tension-type headache. We randomized 30 patients to receive placebo (10 ml of saline intravenous injections and 30 patients to receive 0.1 mg/Kg chlorpromazine intravenously. We used 7 parameters of analgesic evaluation. Patients receiving chlorpromazine showed a statistically significant improvement (p Cefaléia aguda é queixa frequente, responsável por percentual significativo dos casos atendidos em unidades básicas de saúde e unidades de emergência. A clorpromazina é droga usualmente disponível nessas unidades. Apresentamos dados de estudo randomizado, controlado por placebo e com mascaramento duplo, que avaliou a eficácia da clorpromazina no tratamento agudo da cefaléia do tipo tensional episódica. Trinta pacientes foram randomizados para receber placebo (10 ml de solução salina endovenosa e 30 pacientes para receber clorpromazina endovenosa, na dose de 0,1 mg/Kg. Foram usados 7 parâmetros de avaliação analgésica. Pacientes que receberam clorpromazina mostraram significativa redução da dor quando comparados com o grupo placebo (p < 0,05 and p < 0,01, 30 minutos após a administração da droga. O ganho terapêutico foi de 36,7% em 30 minutos e 56,6 % em 60 minutos. O número que se necessita tratar (NNT, a recíproca do ganho terapêutico foi 2,7 em 30 minutos e 1,8 em 60 minutos. Houve redução nos índices de recorrência e de utilização de medicação de resgate no grupo que recebeu clorpromazina. Podemos concluir que clorpromazina em administração parenteral é droga efetiva para o alívio da dor de pacientes com cefaléia do tipo tensional, seu uso sendo

Application of ICHD-II criteria in a headache clinic of China.

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Zhao Dong

Full Text Available China has the huge map and the largest population in the world. Previous studies on the prevalence and classification of headaches were conducted based on the general population, however, similar studies among the Chinese outpatient population are scarce. This study aimed to analyze the characteristics of 1843 headache patients enrolled in a North China headache clinic of the General Hospital for Chinese People's Liberation Army from October 2011 to May 2012, with the International Classification of Headache Disorders, 2nd Edition (ICHD-II.Personal interviews were carried out and a detailed questionnaire was used to collect medical records including age, sex and headache characteristics. Patients came from 28 regions of China with the median age of 40.9 (9-80 years and the female/male ratio of 1.67/1. The primary headaches (78.4% were classified as the following: migraine (39.1%, tension-type headache (32.5%, trigeminal autonomic cephalalgias (5.3% and other primary headache (1.5%. Among the rest patients, 12.9% were secondary headaches, 5.9% were cranial neuralgias and 2.5% were unspecified or not elsewhere classified. Fourteen point nine percent (275/1843 were given an additional diagnosis of chronic daily headache, including medication-overuse headache (MOH, 49.5%, chronic tension-type headache (CTTH, 32.7% and chronic migraine (CM, 13.5%. The visual analogue scale (VAS score of TTH with MOH was significantly higher than that of CTTH (6.8±2.0 vs 5.6±2.0, P<0.001. The similar result was also observed in VAS score between migraine with MOH and CM (8.0±1.5 vs 7.0±1.5, P = 0.004. The peak age at onset of TTH for male and female were both in the 3(rd decade of life. However, the age distribution at onset of migraine shows an obvious sex difference, i.e. the 2(nd decade for females and the 1(st decade for males.This study revealed the characteristics of the headache clinic outpatients in a tertiary hospital of North China that migraine is

The Potential Impact of Internet and Mobile Use on Headache and Other Somatic Symptoms in Adolescence. A Population-Based Cross-Sectional Study.

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Cerutti, Rita; Presaghi, Fabio; Spensieri, Valentina; Valastro, Carmela; Guidetti, Vincenzo

2016-07-01

The purpose of this cross-sectional study was to determine whether migraine or tension-type headaches are associated with abuse of the internet and/or mobile phones and to explore whether headache and the abuse of the two technologies are associated with sleep disturbances and other self-reported somatic symptoms. In the last several years, estimates indicate the increasing pervasiveness of the internet and other technologies in the lives of young people, highlighting the impact on well-being. A population-based cross-sectional study was conducted between February 2013 and June 2014. The initial sample was composed of 1004 Italian students (aged 10-16 years) recruited within public middle schools not randomly selected in central Italy. The final convenience sample consisted of 841 students (Males = 51.1%; Females = 48.9%) who were included in the analysis. Data were collected using self-reported measures. Headache was reported by 28.0% of the total sample. A significant relationship was determined with gender (χ(2) (1) = 7.78, P phone categories (headache was, respectively, the 26% in no abusers, the 30% in internet abusers, the 29% in mobile abusers, and the 29% in internet and mobile abusers, P = .86). Additionally, also by excluding the no headache group, the relationship between the two groups of headache (migraine and tension type headache) and the abuse of media (tension type headache was the 31% in no abusers, the 43% in internet abusers, the 49% in mobile abusers, and the 29% in internet and mobile abusers) is not statistically significant (P = .06). No significant relationship emerged between headache and the internet and mobile phone addiction groups (headache was the 28% in no addiction group, the 35% in mobile addiction group, the 25% of internet addiction group, and the 28% in mobile and internet addiction group, P = .57) as well as no significant relationship was found when only the different headache types were considered

Headache Associated with Myasthenia Gravis: The Impact of Mild Ocular Symptoms

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Yoshinori Nishimoto

2011-01-01

Full Text Available Myasthenia gravis (MG patients visiting outpatient clinics frequently complain of headache. However, there have been few reports on the relation between chronic headache and myasthenia gravis (MG. We aimed to investigate whether MG symptoms affect the development or worsening of chronic headache. Among the 184 MG patients who were followed at the MG clinics, tension-type headache was observed in 71 (38.6% patients and 9 (4.9% complained of migraine. Twenty-five (13.6% complained that headache appeared or was exacerbated after the MG onset. The investigation into differences in the clinical characteristics of the MG patients showed that women tended to suffer from MG-associated headache more often than men. Logistic regression analyses revealed that female gender and mild ocular symptoms were independently predictive of headache associated with MG. Our results suggest that treatment of chronic headache should be required to improve the quality of life in MG patients.

Headache-like Subarachnoid Hemorrhage After Digital Subtraction Angiography: A Case Report

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Fettah Eren

2018-03-01

Full Text Available Subarachnoid hemorrhage (SAH is a clinical condition with acute-onset, sudden, and severe headache. In addition to headache, severe nausea, vomiting, dizziness, confusion, agitation, focal neurologic deficits, and hypertension can be detected. Findings of meningeal irritation may accompany to these clinical features, 6-24 hours after the hemorrhage. Digital subtraction angiography (DSA is used for surgical or endovascular treatment planning in order to identify vascular abnormalities, in addition to other imaging studies. After DSA, the frequency of all neurologic complications is between 0.2% and 4.5%. Headache may occur after DSA in an average 50% of patients. This rate is especially higher in female patients. Headache types are usually classified as migraine, tension or postoperative atypical headaches The incidence of severe headache after DSA is low. Vascular wall rupture should be considered first in severe headache after the procedure. It should also be kept in mind that after all other secondary causes are excluded; SAH-like headaches after DSA can be detected

Association of mobile phone radiation with fatigue, headache, dizziness, tension and sleep disturbance in Saudi population

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Al-Khlaiwi, Thamir; Meo, Sultan A.

2004-01-01

The widespread use of mobile phones has been increased over the past decade; they are now an essential part of business, commerce and society. The use of mobile phones can cause health problems. Therefore, the aim of the present study is to investigate the association of using mobile phones with fatigue, headache, dizziness, tension and sleep disturbance in the Saudi population and provide health and social awareness in using these devices. This study was conducted in the Department of Physiology, College of Medicine, King Saudi University, Riyadh, Kingdom of Saudi Arabia during the year 2002 to 2003. In the present study, a total of 437 subjects (55.1% male and 39.9% female) were invited, they have and had been using mobile phones. A questionnaire was distributed regarding detailed history and association of mobile phones with health hazards. The results of the present study showed an association between the use of mobile phones and health hazards. The overall mean percentage for these clinical findings in all groups were headache (21.6%), sleep disturbance (4.%), tension (3.9%), fatigue (3%) and dizziness (2.4%). Based on the results of the present study, we conclude that the use of mobile phones is a risk factor for health hazards and suggest that long term or excessive use of mobile phones should be avoided by health promotion activities such as group discussions, public presentations and through electronic and print media sources. (author)

Comprehensive Headache Experience in Collegiate Student-Athletes: An Initial Report From the NCAA Headache Task Force.

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Seifert, Tad; Sufrinko, Alicia; Cowan, Robert; Scott Black, W; Watson, Dave; Edwards, Bill; Livingston, Scott; Webster, Keith; Akers, David; Lively, Mathew; Kontos, Anthony P

2017-06-01

The prevalence of primary headache disorders in the general population provides a unique challenge in the evaluation of headache occurring in the context of sport. Despite a wealth of studies exploring the epidemiology of headache in the layperson, little is known about the prevalence and nature of headaches in collegiate student-athletes. These scenarios are challenging in the return to play context, as it is often unclear whether an athlete has an exacerbation of a primary headache disorder, new onset headache unrelated to trauma, or has suffered a concussive injury. To establish the prevalence and nature of headaches in collegiate student-athletes. Retrospective cross-sectional survey. This cross-sectional survey evaluated the characteristics and prevalence of headache in 834 student-athletes from four NCAA Division-I institutions. Because headache occurrence may vary by sport (collision, contact, non-contact), by sex, and medical history, our sample included male and female athletes in a variety of sports, with differing degrees of contact exposure. The 20 question survey collected data on personal and family history of headache, as well as concussion history. A total of 23.7% (n = 198) of participants reported having a personal history of migraine, 25.2% (n = 210) history of sinus headache, and 12.3% (n = 103) history of tension type headache. Among athletes with a prior history of concussion, 46.3% (n = 25) of females reported a history of migraine, while only 32.2% of males reported history of migraine (χ 2  = 3.421, P = .064). The etiology of increased prevalence of migraine in our study is unclear. Whether this is due to increased awareness of headache disorders, a consequence of contact exposure, or a predisposition for migraine development in this age group remains unclear. Further studies are indicated. © 2017 American Headache Society.

Update of Inpatient Treatment for Refractory Chronic Daily Headache.

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Lai, Tzu-Hsien; Wang, Shuu-Jiun

2016-01-01

Chronic daily headache (CDH) is a group of headache disorders, in which headaches occur daily or near-daily (>15 days per month) and last for more than 3 months. Important CDH subtypes include chronic migraine, chronic tension-type headache, hemicrania continua, and new daily persistent headache. Other headaches with shorter durations (headache and various psychiatric disorders, such as depression and anxiety. Indications of inpatient treatment for CDH patients include poor responses to outpatient management, need for detoxification for overuse of specific medications (particularly opioids and barbiturates), and severe psychiatric comorbidities. Inpatient treatment usually involves stopping acute pain, preventing future attacks, and detoxifying medication overuse if present. Multidisciplinary integrated care that includes medical staff from different disciplines (e.g., psychiatry, clinical psychology, and physical therapy) has been recommended. The outcomes of inpatient treatment are satisfactory in terms of decreasing headache intensity or frequency, withdrawal from medication overuse, reducing disability, and improving life quality, although long-term relapse is not uncommon. In conclusion, inpatient treatment may be useful for select patients with refractory CDH and should be incorporated in a holistic headache care program.

Association between stress at work and primary headache among nursing staff in Taiwan.

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Lin, Kao-Chang; Huang, Chin-Chang; Wu, Chiou-Chuen

2007-04-01

Stress, one of the most commonly identified triggers for primary headache in the workplace, usually leads to inefficient work during attacks. Stress-related primary headaches in the nursing staff of hospitals have received little attention. To realize the association between stress and headache, and the means of coping with this kind of headache. A cross-sectional, hospital-based study using a semi-structured questionnaire was administered to 900 nursing staffers in a tertiary medical center in southern Taiwan. Thirty-two items, including basic information, headache- and stress-related questions, work satisfaction, and coping strategies were measured. Headache sufferers with either migraine or episodic tension headache (attacks Headache Society (IHS) criteria were enrolled for analysis. The Student's t-test, one-way analysis of variance (ANOVA), and chi-square test were used for statistical analysis. Three hundred eighty-six out of 779 responders (49.6%) had experienced primary headaches in the previous year, and 374 (48.1%) had had episodic-type headaches (headache, 37 (4.8%) had mixed migraine and tension headache, and 11 (1.4%) had other causes of headache. There were no demographic differences between the sufferers and nonsufferers, although a statistically significant difference was noted in self-reported sources of stress (individual P values ranged from .021 to Headache sufferers had more stress at work than non-headache sufferers (P stress. The methods used to deal with headaches were sleep, taking medicine, taking a rest, visiting the doctor, and seeking psychological help. Nurses commonly used acetaminophen (panadol--500 mg) to relieve their pain. These results indicate that stress at work is associated with primary headaches among nursing staff, and that nurses rarely seek help in the beginning. Therefore, nursing staff education aimed at ameliorating the stress and coping with the headaches, thus allowing the nurses to provide better patient care, may

Classification and clinical features of headache patients: an outpatient clinic study from China.

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Wang, Yunfeng; Zhou, Jiying; Fan, Xiaoping; Li, Xuelian; Ran, Li; Tan, Ge; Chen, Lixue; Wang, Kuiyun; Liu, Bowen

2011-10-01

This study aimed to analyze and classify the clinical features of headache in neurological outpatients. A cross-sectional study was conducted consecutively from March to May 2010 for headache among general neurological outpatients attending the First Affiliated Hospital of Chongqing Medical University. Personal interviews were carried out and a questionnaire was used to collect medical records. Diagnosis of headache was according to the International classification of headache disorders, 2nd edition (ICHD-II). Headache patients accounted for 19.5% of the general neurology clinic outpatients. A total of 843 (50.1%) patients were defined as having primary headache, 454 (27%) secondary headache, and 386 (23%) headache not otherwise specified (headache NOS). For primary headache, 401 (23.8%) had migraine, 399 (23.7%) tension-type headache (TTH), 8 (0.5%) cluster headache and 35 (2.1%) other headache types. Overall, migraine patients suffered (1) more severe headache intensity, (2) longer than 6 years of headache history and (3) more common analgesic medications use than TTH ones (p headaches than migraine patients, and typically headache frequency exceeded 15 days/month (p headache patients were defined as chronic daily headache. Almost 20% of outpatient visits to the general neurology department were of headache patients, predominantly primary headache of migraine and TTH. In outpatient headaches, more attention should be given to headache intensity and duration of headache history for migraine patients, while more attention to headache frequency should be given for the TTH ones.

Do manual therapy techniques have a positive effect on quality of life in people with tension-type headache? A randomized controlled trial.

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Espí-López, Gemma V; Rodríguez-Blanco, Cleofás; Oliva-Pascual-Vaca, Angel; Molina-Martínez, Francisco; Falla, Deborah

2016-08-01

Controversy exists regarding the effectiveness of manual therapy for the relief of tension-type headache (TTH). However most studies have addressed the impact of therapy on the frequency and intensity of pain. No studies have evaluated the potentially significant effect on the patient's quality of life. To assess the quality of life of patients suffering from TTH treated for 4 weeks with different manual therapy techniques. Factorial, randomized, single-blinded, controlled clinical trial. Specialized center for the treatment of headache. Seventy-six (62 women) patients aged between 18 and 65 years (age: 39.9±10.9) with either episodic or chronic TTH. Patients were divided into four groups: suboccipital inhibitory pressure; suboccipital spinal manipulation; a combination of the two treatments; control. Quality of life was assessed using the SF-12 questionnaire (considering both the overall score and the different dimensions) at the beginning and end of treatment, and after a one month follow-up. Compared to baseline, the suboccipital inhibition treatment group showed a significant improvement in their overall quality of life at the one month follow-up and also showed specific improvement in the dimensions related to moderate physical activities, and in their emotional role. All the treatment groups, but not the control group, showed improvements in their physical role, bodily pain, and social functioning at the one month follow-up. Post treatment and at the one month follow-up, the combined treatment group showed improved vitality and the two treatment groups that involved manipulation showed improved mental health. All three treatments were effective at changing different dimensions of quality of life, but the combined treatment showed the most change. The results support the effectiveness of treatments applied to the suboccipital region for patients with TTH. Manual therapy techniques applied to the suboccipital region, for as little as four weeks, offered a

Influence of headache frequency on clinical signs and symptoms of TMD in subjects with temple headache and TMD pain.

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Anderson, Gary C; John, Mike T; Ohrbach, Richard; Nixdorf, Donald R; Schiffman, Eric L; Truelove, Edmond S; List, Thomas

2011-04-01

The relationship of the frequency of temple headache to signs and symptoms of temporomandibular joint (TMJ) disorders (TMD) was investigated in a subset of a larger convenience sample of community TMD cases. The study sample included 86 painful TMD, nonheadache subjects; 309 painful TMD subjects with varied frequency of temple headaches; and 149 subjects without painful TMD or headache for descriptive comparison. Painful TMD included Research Diagnostic Criteria for Temporomandibular Disorders diagnoses of myofascial pain, TMJ arthralgia, and TMJ osteoarthritis. Mild to moderate-intensity temple headaches were classified by frequency using criteria based on the International Classification of Headache Disorder, 2nd edition, classification of tension-type headache. Outcomes included TMD signs and symptoms (pain duration, pain intensity, number of painful masticatory sites on palpation, mandibular range of motion), pressure pain thresholds, and temple headache resulting from masticatory provocation tests. Trend analyses across the painful TMD groups showed a substantial trend for aggravation of all of the TMD signs and symptoms associated with increased frequency of the temple headaches. In addition, increased headache frequency showed significant trends associated with reduced PPTs and reported temple headache with masticatory provocation tests. In conclusion, these findings suggest that these headaches may be TMD related, as well as suggesting a possible role for peripheral and central sensitization in TMD patients. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

A new type of headache, headache associated with airplane travel: preliminary diagnostic criteria and possible mechanisms of aetiopathogenesis.

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Berilgen, M Said; Müngen, Bulent

2011-09-01

In recent years, there has been an increase in the reports indicating a form of headache that occurs during commercial aircraft travel. This headache, called airplane headache by some authors, is believed to be a new type of headache. The headache has very specific characteristics and all of the cases exhibited very stereotypical symptoms. The headache starts suddenly during the ascent and/or descent of the commercial aircraft. It has a mean duration of 20 minutes, which is usually unilateral and commonly localized to periorbital region. The headache is described to be severe, and has a stabbing or jabbing nature, and generally subsides in a short time. In some cases, an organic cause can be identified whereas in others no organic pathology could be found. We described the clinical features of 22 cases who suffered from a headache that occurred during airplane travel. We examined other cases with similar features reported in the literature and proposed preliminary diagnostic criteria for this new form of headache. We also discussed the possible patholophysiological mechanisms that may cause this headache.

The effect of myofascial release and microwave diathermy combined with acupuncture versus acupuncture therapy in tension-type headache patients: A pragmatic randomized controlled trial.

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Georgoudis, George; Felah, Bledjana; Nikolaidis, Pantelis; Damigos, Dimitrios

2018-04-01

Nonpharmacological therapies for tension-type headache (TTH) and cervicogenic cephalalgia are often a treatment choice, despite the weak to moderate evidence. The aim of this study was to compare the effectiveness of an acupuncture/stretching protocol versus acupuncture/stretching plus physiotherapy techniques, in patients with TTH cephalalgia. A single-blind, prospective, multicentre, randomized controlled trial was designed considering the pragmatic situation of administering such protocols and treating the 44 headache patients participating in this study. The patients were randomly assigned in 2 treatment groups (control group, n = 20, acupuncture/stretching; experimental group, n = 24, acupuncture/stretching plus physiotherapy) and completed 10 treatment sessions within 4 weeks with measurements taking place before treatment, after the fifth treatment and after the 10th treatment. The mechanical pressure pain threshold (PPT) was considered as the main outcome measure, using a mechanical algometer to measure 7 bilateral somatic points. Acupuncture in both groups included 17-20 acupuncture points, whereas stretching was initially taught and subsequently self-administered (self-stretches), following a standardized set of movements of the cervical spine. Physiotherapy consisted of microwave diathermy and myofascial release with hands-on techniques. An improvement was noted in both groups/treatments regarding the main outcome measure PPT, all the way from the first to fifth and the 10th treatment, at all measuring sites and at all measurements in both groups (p acupuncture and stretching but further PPT improvements were evidenced when physiotherapy hands-on techniques were added. In clinical terms, the combination of physiotherapy in the form of myofascial release and microwave diathermy with acupuncture and stretching in order to improve the analgesic effect (PPT) is strongly recommended. Copyright © 2017 John Wiley & Sons, Ltd.

Evaluating integrated headache care: a one-year follow-up observational study in patients treated at the Essen headache centre

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Diener Hans C

2011-10-01

Full Text Available Abstract Background Outpatient integrated headache care was established in 2005 at the Essen Headache Centre in Germany. This paper reports outcome data for this approach. Methods Patients were seen by a neurologist for headache diagnosis and recommendation for drug treatment. Depending on clinical needs, patients were seen by a psychologist and/or physical therapist. A 5-day headache-specific multidisciplinary treatment programme (MTP was provided for patients with frequent or chronic migraine, tension type headache (TTH and medication overuse headache (MOH. Subsequent outpatient treatment was provided by neurologists in private practice. Results Follow-up data on headache frequency and burden of disease were prospectively obtained in 841 patients (mean age 41.5 years after 3, 6 and 12 months. At baseline mean headache frequency was 18.1 (SD = 1.6 days per month, compared to measurement at 1 year follow-up a mean reduction of 5.8 (SD = 11.9 headache days per month was observed in 486 patients (57.8% after one year (TTH patients mean: -8.5 days per month; migraine mean: -3.2 days per month, patients with migraine and TTH mean: -5.9 days per month. A reduction in headache days ≥ 50% was observed in 306 patients (36.4% independent of diagnosis, while headache frequency remains unchanged in 20.9% and increase in 21.3% of the patient. Conclusion Multidisciplinary outpatient headache centres offer an effective way to establish a three-tier treatment offer for difficult headache patients depending on clinical needs.

Avaliação clínica da eficácia da combinação paracetamol e cafeína no tratamento da cefaléia tipo tensão Clinical evaluation of the efficacy of the acetaminophen and caffeine combination in the treatment of tension headache

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GETÚLIO DARÉ RABELLO

2000-03-01

Full Text Available A cefaléia tipo tensão em suas duas modalidades, episódica e crônica, é a forma mais comum de dor de cabeça na população. O tratamento é feito com medidas não farmacológicas e farmacológicas, tanto para o ataque como profilaxia das crises. Este estudo foi realizado com 5490 pacientes, que procuraram ambulatórios e consultórios médicos em várias regiões do Brasil. Cerca de 95% apresentavam cefaléia tipo tensão episódica e 5% cefaléia tipo tensão crônica. A maioria dos pacientes apresentou crises de intensidade moderada (62,19%. Em 5419 pacientes uma crise de cefaléia tipo tensão foi tratada com 1000 mg de paracetamol e 130 mg de cafeína. Em 93,98% início de melhora foi observado em até 2 horas após a ingestão da medicação. Em 77,61% houve reversão completa da crise em até 2 horas. Avaliação da eficácia boa/excelente foi observada em 51,93%/37,80% dos casos quando feita pelos médicos e em 48,51%/40,29 quando pelos pacientes. Efeitos adversos, em geral manifestações gastrointestinais, foram observados em 5,57%. Este estudo representa uma experiência brasileira no tratamento de ataque da cefaléia tipo tensão, demonstrando eficácia e segurança no uso da combinação paracetamol-cafeína.Tension type headache in both its forms, episodic and chronic, is the most common type of headache experienced by the population. The headache attack or the prevention of new crises may be treated with pharmacological as well as non-pharmacological measures. This study included 5,490 patients from out-patient clinics and medical offices covering various regions of Brazil. Approximately 95% of the subjects had episodic tension type headache, while 5% had chronic tension type headache. The majority of the patients presented with crisis of moderate intensity (62.19%. In 5,419 patients a tension type headache crisis was treated with acetaminophen 1000 mg and caffeine 130 mg. In 93.98%, onset of relief occurred within 2 hours of

Headache and temporomandibular disorders: evidence for diagnostic and behavioural overlap.

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Glaros, A G; Urban, D; Locke, J

2007-06-01

To assess the diagnostic and behavioural overlap of headache patients with temporomandibular disorders (TMD), individuals recruited from the general population with self-described headaches were compared with non-headache controls. The examination and diagnostic procedures in the Research Diagnostic Criteria (RDC) for TMD were applied to both sets of subjects by a blinded examiner. Following their examination, subjects used experience sampling methods to obtain data on pain, tooth contact, masticatory muscle tension, emotional states and stress. Results showed that a significantly higher proportion of the headache patients received an RDC/TMD diagnosis of myofascial pain than non-headache controls. Headache patients also reported significantly more frequent and intense tooth contact, more masticatory muscle tension, more stress and more pain in the face/head and other parts of the body than non-headache controls. These results are similar to those reported for TMD patients and they suggest that headache patients and TMD patients overlap considerably in diagnosis and oral parafunctional behaviours.

Headache-attributed burden and its impact on productivity and quality of life in Russia: structured healthcare for headache is urgently needed.

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Ayzenberg, I; Katsarava, Z; Sborowski, A; Chernysh, M; Osipova, V; Tabeeva, G; Steiner, T J

2014-05-01

The study evaluated headache-attributed burden and its impact on productivity and quality of life (QoL) in Russia. Its purpose was to support recommendations for change. A countrywide population-based random sample of 2725 biologically unrelated adults (aged 18-65 years) in 35 cities and nine rural areas of Russia were interviewed in a door-to-door survey. The structured questionnaire enquired into symptom burden, functional disability, lost productive time and QoL (applying the WHOQoL-8 question set), as well as willingness to pay (WTP) for adequate headache treatment, if it were available. Mean lost paid-work days due to headache in the previous 3 months were 1.9 ± 4.2, and mean lost household work days were 3.4 ± 5.7. The estimated annual indirect cost of primary headache disorders was USD 22.8 billion, accounting for 1.75% of gross domestic product. QoL was reduced by all types of primary headaches. According to WHOQoL-8, it was significantly lower in those with headache on ≥15 days/month than in those with episodic headache (24.7 ± 4.6 vs. 28.1 ± 5.0; P < 0.05) and lower in those with migraine than in those with tension-type headache (TTH) (27.1 ± 4.9 vs. 28.8 ± 5.0; P < 0.05). Average WTP for adequate headache treatment was RUB 455 ± 494 per month (median RUB 300), a sum sufficient in most cases, and correlated with illness severity (higher for headache on ≥15 days/month than for migraine, and for migraine than for TTH). Headache is common, burdensome and costly in Russia and, manifestly, poorly mitigated by existing healthcare. Structured healthcare services for headache need to be urgently put in place. © 2014 The Author(s) European Journal of Neurology © 2014 EFNS.

Mindfulness-based stress reduction for treating chronic headache: A systematic review and meta-analysis.

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Anheyer, Dennis; Leach, Matthew J; Klose, Petra; Dobos, Gustav; Cramer, Holger

2018-01-01

Background Mindfulness-based stress reduction/cognitive therapy are frequently used for pain-related conditions, but their effects on headache remain uncertain. This review aimed to assess the efficacy and safety of mindfulness-based stress reduction/cognitive therapy in reducing the symptoms of chronic headache. Data sources and study selection MEDLINE/PubMed, Scopus, CENTRAL, and PsychINFO were searched to 16 June 2017. Randomized controlled trials comparing mindfulness-based stress reduction/cognitive therapy with usual care or active comparators for migraine and/or tension-type headache, which assessed headache frequency, duration or intensity as a primary outcome, were eligible for inclusion. Risk of bias was assessed using the Cochrane Tool. Results Five randomized controlled trials (two on tension-type headache; one on migraine; two with mixed samples) with a total of 185 participants were included. Compared to usual care, mindfulness-based stress reduction/cognitive therapy did not improve headache frequency (three randomized controlled trials; standardized mean difference = 0.00; 95% confidence interval = -0.33,0.32) or headache duration (three randomized controlled trials; standardized mean difference = -0.08; 95% confidence interval = -1.03,0.87). Similarly, no significant difference between groups was found for pain intensity (five randomized controlled trials; standardized mean difference = -0.78; 95% confidence interval = -1.72,0.16). Conclusions Due to the low number, small scale and often high or unclear risk of bias of included randomized controlled trials, the results are imprecise; this may be consistent with either an important or negligible effect. Therefore, more rigorous trials with larger sample sizes are needed.

Headache in Idiopathic Intracranial Hypertension: Findings From the Idiopathic Intracranial Hypertension Treatment Trial.

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Friedman, Deborah I; Quiros, Peter A; Subramanian, Prem S; Mejico, Luis J; Gao, Shan; McDermott, Michael; Wall, Michael

2017-09-01

To characterize the phenotype, headache-related disability, medical co-morbidities, use of symptomatic headache medications, and headache response to study interventions in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT). Patients with untreated IIH and mild vision loss enrolled in the IIHTT and randomized to acetazolamide (ACZ) and weight loss or placebo (PLB) and weight loss had prospective assessment of headache disability using the Headache Impact Test-6 (HIT-6) questionnaire. Subjects with headache at the baseline visit were assigned a headache phenotype using the International Classification for Headache Disorders version 3 beta (ICHD-3b). Medication overuse was determined using the participants' reported medication use for the preceding month and ICHD-3b thresholds for diagnosing medication overuse headache. We investigated relationships between headache disability and various other clinical characteristics at baseline and at 6 months. Headache was present in 139 (84%) of the 165 enrollees at baseline. The most common headache phenotypes were migraine (52%), tension-type headache (22%), probable migraine (16%), and probable tension-type headache (4%). Fifty-one (37%) participants overused symptomatic medications at baseline, most frequently simple analgesics. A similar amount of improvement in the adjusted mean (± standard error) HIT-6 score occurred in the ACZ (-9.56 ± 1.05) and PLB groups (-9.11 ± 1.14) at 6 months (group difference -0.45, 95% CI -3.50 to 2.60, P = .77). Headache disability did not correlate with any of the studies, variables of interest, which included: the lumbar puncture opening pressure at baseline or at 6 months, body mass index, the amount of weight lost, papilledema grade, perimetric mean deviation, or the use of hormonal contraception. Headache disability was significantly associated with patient-reported quality of life in the physical, mental, and visual domains. Headache was common, of varied

OnabotulinumtoxinA for the treatment of headache.

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Ashkenazi, Avi; Blumenfeld, Andrew

2013-09-01

Botulinum toxin, a potent muscle relaxant, has been found to have analgesic effects in patients with various pain syndromes. Both in vitro and in vivo studies showed the ability of the toxin to block the release of pain neurotransmitters, such as substance P, glutamate, and calcitonin gene-related peptide. The effect of the toxin, and specifically of one of its serotypes, botulinum neurotoxin type A, on headaches, has been extensively studied. This serotype is available in the United States in 3 forms, including as onabotulinumtoxinA. Data from clinical trials confirmed the efficacy, safety, and tolerability of onabotulinumtoxinA in the prophylactic treatment of chronic migraine, the most severe and debilitating type of migraine, in adults. The drug was approved by the Food and Drug Administration for this indication in 2010. The drug was not found to be effective for episodic migraine or tension-type headache. Noncontrolled studies suggest the efficacy of the toxin for headache associated with craniocervical dystonia. Proper injection technique and appropriate patient selection are essential for achieving positive results after treatment with onabotulinumtoxinA. The recommended injection paradigm combines a fixed site/fixed dose and follow the pain approaches, with the toxin injected to multiple sites of the head and neck, at a total dose of 155U-195U. The treatment is given at intervals of 12 weeks on average. The efficacy of onabotulinumtoxinA for some headaches, its long duration of action, and its favorable adverse effect profile make it a viable treatment option for the appropriate headache patients. The drug may be particularly suitable for patients who cannot tolerate, or are not compliant with, the daily intake of oral headache preventive drugs. © 2013 American Headache Society.

Temporo-mandibular disorders are an important comorbidity of migraine and may be clinically difficult to distinguish them from tension-type headache.

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Silva, Ariovaldo Alberto da; Brandão, Karina Viana; Faleiros, Bruno Engler; Tavares, Rafael Mattos; Lara, Rodrigo Pinto; Januzzi, Eduardo; Carvalho, Anísio Bueno de; Carvalho, Eliane Maria Duarte de; Gomes, João Bosco Lima; Leite, Frederico Mota Gonçalves; Alves, Betania Mara Franco; Gómez, Rodrigo Santiago; Teixeira, Antônio Lúcio

2014-02-01

Clinical differentiation between the primary headaches and temporomandibular disorders (TMD) can be challenging. To investigate the relationship between TMD and primary headaches by conducting face to face assessments in patients from an orofacial pain clinic and a headache tertiary center. Sample consists of 289 individuals consecutively identified at a headache center and 78 individuals seen in an orofacial pain clinic because of symptoms suggestive of TMD. Migraine was diagnosed in 79.8% of headache sufferers, in headache tertiary center, and 25.6% of those in orofacial pain clinic (pheadache was present in 20.4% and 46.1%, while the TMD painful occurred in 48.1% and 70.5% respectively (pheadache, and this headache was more frequent in the dental center than at the medical center.

Two-, Three-, and Four-Year Follow-Up on the Self-Regulatory Treatment of Chronic Headache.

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Blanchard, Edward B.; And Others

1987-01-01

Chronic tension and vascular headache patients, initially treated with relaxation and biofeedback, were followed-up on an annual basis at two-, three-, and four-years posttreatment. Tension headache patients generally showed good maintenance of initial headache reduction at Year Four. Vascular patients showed a nonsignificant trend for gradual…

Management of primary headache in emergency services of Santos and surrounding towns

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Yara Dadalti Fragoso

Full Text Available OBJECTIVES: Primary headaches are often seen by Clinicians on duty at Emergency Services. We have investigated the treatment of such patients by 43 medical doctors who have been working at Emergency Services in the city of Santos and surrounding towns for many years. RESULTS: We confirmed the high prevalence of primary headaches in Emergency Services. There seem to be diagnosis difficulties concerning differentiating attacks of migraine and tension type headache. We also observed that IV dipirone was the most frequently prescribed treatment for patients with primary headaches in this study. There is no protocol in the literature which recommends IV dipirone for the treatment of migraine attacks or other primary headaches. CONCLUSION: It would be advisable to perform controlled double blind studies in order to verify the advantages of IV dipirone in the treatment of intense attacks primary headaches. We concluded that headache management recycling programs could be of interest for doctors who regularly work at Emergency Services.

The Role of Melatonin in the Treatment of Primary Headache Disorders

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Gelfand, Amy A.; Goadsby, Peter J.

2016-01-01

Objective To provide a summary of knowledge about the use of melatonin in the treatment of primary headache disorders. Background Melatonin is secreted by the pineal gland; its production is regulated by the hypothalamus and increases during periods of darkness. Methods We undertook a narrative review of the literature on the role of melatonin in the treatment of primary headache disorders. Results There are randomized placebo-controlled trials examining melatonin for preventive treatment of migraine and cluster headache. For cluster headache, melatonin 10 mg was superior to placebo. For migraine, a randomized placebo-controlled trial of melatonin 3 mg (immediate release) was positive, though an underpowered trial of melatonin 2 mg (sustained release) was negative. Uncontrolled studies, case series, and case reports cover melatonin’s role in treating tension-type headache, hypnic headache, hemicrania continua, SUNCT/SUNA and primary stabbing headache. Conclusions Melatonin may be effective in treating several primary headache disorders, particularly cluster headache and migraine. Future research should focus on elucidating the underlying mechanisms of benefit of melatonin in different headache disorders, as well as clarifying optimal dosing and formulation. PMID:27316772

Refractory migraine in a headache clinic population

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Fernandez-Torron Roberto

2011-08-01

Full Text Available Abstract Background Many migraineurs who seek care in headache clinics are refractory to treatment, despite advances in headache therapies. Epidemiology is poorly characterized, because diagnostic criteria for refractory migraine were not available until recently. We aimed to determine the frequency of refractory migraine in patients attended in the Headache Unit in a tertiary care center, according to recently proposed criteria. Methods The study population consisted of a consecutive sample of 370 patients (60.8% females with a mean age of 43 years (range 14-86 evaluated for the first time in our headache unit over a one-year period (between October 2008 and October 2009. We recorded information on clinical features, previous treatments, Migraine Disability Assessment Score (MIDAS, and final diagnosis. Results Overall migraine and tension-type headache were found in 46.4% and 20.5% of patients, respectively. Refractory migraine was found in 5.1% of patients. In refractory migraineurs, the mean MIDAS score was 96, and 36.8% were medication-overusers. Conclusions Refractory migraine is a relatively common and very disabling condition between the patients attended in a headache unit. The proposed operational criteria may be useful in identifying those patients who require care in headache units, the selection of candidates for combinations of prophylactic drugs or invasive treatments such as neurostimulation, but also to facilitate clinical studies in this patient group.

Two reports of flight-related headache.

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Nagatani, Kazuhiko

2013-07-01

Airplane headache is flight-related and appears during airplane landing and/or takeoff without accompanying symptoms. Intracranial and paranasal imaging studies reveal no abnormalities. The etiology is still uncertain, although sinus barotrauma has been proposed as a possible mechanism. 1) A 26-yr-old woman presented with recurring headache during each air travel since she was 22 yr old. Severe bursting pain suddenly manifested in the bilateral orbits and temples during airplane descent, with no accompanying additional symptoms. She had no unusual medical history. X-ray computed tomography (CT) scans showed no abnormalities except thickening of the nasal mucosa. Effective pain relief was obtained with over-the-counter nasal decongestant spray. 2) A 49-yr-old man presented with a 3-yr history of flight-related headache that appeared at airplane touchdown, when he had mental stress, or when he was suffering from a lack of sleep. Pain was of a severe jabbing quality, localized over the forehead with no additional accompanying symptoms. He had a past history of episodic tension-type headache. Intracranial and paranasal CT scan revealed no abnormalities. Headache ceased spontaneously within 40 min of the end of the flight and nonsteroidal anti-inflammatory drug premedication did not prevent the headache. Sinus barotrauma was thought to be a plausible explanation for the headache in Case 1. In Case 2, an anxiety disorder could be considered as an underlying etiology. The etiology of so-called airplane headache is probably protean and this should be taken into account when assessing cases of in-flight cephalalgia.

Chronic daily headache with analgesics overuse in professional women breath-hold divers.

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Choi, Jay Chol; Lee, Jung Seok; Kang, Sa-Yoon; Kang, Ji-Hoon; Bae, Jong-Myon

2008-07-01

The object of this study is to investigate the prevalence and characteristics of headache in Korean professional women breath-hold divers, including their overuse of analgesics. Headache is a common problem encountered in clinical practice, and undersea divers exhibit unique causes of headache in addition to other common primary headaches. Many scuba divers are known to use various types of drugs to overcome dive-related symptoms or to enhance their underwater performance. The target population of this study was women divers in the northern district of Jeju Island who were registered in the divers' union. Data were collected using telephone interviews with a structured questionnaire. Headache was diagnosed and classified according to criteria of the International Headache Society. Nine hundred and eleven (80.3%) divers responded to the telephone interview. The prevalence rates of headache were 21.4% for tension-type headache and 9.1% for migraine. One hundred and four divers (11.4%) fulfilled the criteria for chronic daily headache (CDH). Overuse of combination analgesics was reported by 70.7% of divers. Women divers with CDH were significantly older and they complained more of tinnitus and dizziness, and had a greater history of hypertension than divers without headache. The prevalence of CDH is high in Korean professional women breath-hold divers, with many of them being combination-analgesics overusers.

The prevalence and impact of headache in Brazil.

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Queiroz, Luiz P; Silva Junior, Ariovaldo A

2015-02-01

In Brazil, several epidemiological studies on headache have been produced, most with an emphasis on prevalence and the association of primary headaches with some sociodemographic characteristics of the population. Data on the burden of headache, however, are scarce. The aim of this paper is to review all Brazilian population-based studies on headache, as well as to analyze the Migraine Disability Assessment Score (MIDAS) data collected with the PhD thesis of the senior author (LPQ). A literature review was performed using the keywords ("headache" or "migraine") and ("epidemiology" or "prevalence") and (Brazil). Another part of this paper will look at unpublished data on disability (MIDAS), collected with the prevalence data of the Brazilian nationwide epidemiological study of headache. There are 6 published epidemiological studies of headache in Brazil. The mean 1-year prevalence of headache in Brazil is 70.6%, of migraine 15.8%, of tension-type headache (TTH) 29.5%, and of chronic daily headache (CDH) 6.1%. Disability is significantly higher: in females compared to males; in patients with migraine and CDH compared to patients with TTH; and in those with headaches ≥15 days per month rather than those with episodic headaches. There was also a positive relationship between pain intensity and severity of disability. Patients with higher disability used more both abortive and prophylactic medication. The mean prevalence of headache in Brazil, and some of its subtypes, is similar to the rates described in other countries of the world. Disability is higher in females, in patients with migraine, in individuals with headaches ≥15 days per month, and in those with severe head pain. © 2015 American Headache Society.

Lack of effect of norepinephrine on cranial haemodynamics and headache in healthy volunteers

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Lindholt, M; Petersen, K A; Tvedskov, J F

2009-01-01

Stress is a provoking factor for both tension-type headache and migraine attacks. In the present single-blind study, we investigated if stress induced by norepinephrine (NE) could elicit delayed headache in 10 healthy subjects and recorded the cranial arterial responses. NE at a dose of 0...... no changes in these arterial parameters after NE. In both treatment groups three subjects developed delayed headaches. Thus, stress by NE infusion did not result in delayed headache........025 microg kg(-1) min(-1) or placebo was infused for 90 min and the headache was followed for 14 h. Blood flow velocity in the middle cerebral artery (measured with transcranial Doppler) and diameters of the temporal artery and the radial artery (measured with ultrasound) were followed for 2 h. There were...

The role of fear of pain in headache.

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Black, Anna Katherine; Fulwiler, Joshua C; Smitherman, Todd A

2015-05-01

Recurrent headache sufferers are often fearful of pain, which disrupts thought processes, interferes with daily activities, and may maintain headache-related disability through avoidance and associated negative reinforcement. The aim of this cross-sectional study was to (1) examine differences in fear of pain (FOP) between headache sufferers and non-headache controls; (2) examine differences in FOP across primary headache diagnostic groups; (3) assess the extent to which FOP predicts headache variables (eg., severity, frequency, disability); and (4) determine whether FOP mediates the relationship between pain severity and headache-related disability. The sample consisted of 908 young adults (M age = 19.5 years; 64.9% female). Of those, 237 (26.1%) met the diagnostic criteria for episodic tension-type headache (TTH), 232 (25.6%) for episodic migraine (167 [18.4%] without aura and 65 [7.2%] with aura), 38 (4.2%) for chronic migraine, and 19 (2.1%) for chronic TTH; 382 (42.1%) served as non-headache controls. FOP differed among groups, with headache sufferers reporting greater FOP than those without headache; migraineurs typically endorsed greater FOP than those with TTH. Among those with headache, FOP significantly predicted headache severity (R(2)  = 6.1%) and frequency (R(2)  = 4.5%), and accounted for more variance in disability (R(2)  = 17.5%) than gender, anxiety, and depression combined (13.8%). Pain severity and disability were strongly associated (r = 0.61, P headache and plays a significant role in primary headache, particularly in headache-related disability. Findings build upon and extend those from previous chronic pain studies and highlight the need for longitudinal and experimental studies to further explore this construct in headache. © 2015 American Headache Society.

Development of a clinical prediction rule for identifying women with tension-type headache who are likely to achieve short-term success with joint mobilization and muscle trigger point therapy.

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Fernández-de-las-Peñas, César; Cleland, Joshua A; Palomeque-del-Cerro, Luis; Caminero, Ana Belén; Guillem-Mesado, Amparo; Jiménez-García, Rodrigo

2011-02-01

To identify prognostic factors from the history and physical examination in women with tension-type headache (TTH) who are likely to experience self-perceived clinical improvement following a multimodal physical therapy session including joint mobilization and muscle trigger point (TrP) therapies. No definitive therapeutic intervention is available for TTH. It would be useful for clinicians to have a clinical prediction rule for selecting which TTH patients may experience improved outcomes following a multimodal physical therapy program. Women diagnosed with pure TTH by 3 experienced neurologists according to the International Headache Society criteria from different neurology departments were included. They underwent a standardized examination (neck mobility, pressure pain thresholds, total tenderness score, presence of muscle TrPs, Medical Outcomes Study 36-Item Short Form, the Neck Disability Index [NDI], the Beck Depression Inventory, and the Headache Disability Inventory) and then a multimodal physical therapy session including joint mobilization and TrP therapies. The treatment session included a 30-second grade III or IV central posterior-anterior nonthrust mobilization applied from T4 to T1 thoracic vertebrae, at C7-T1 cervico-thoracic junction and C1-C2 vertebrae for an overall intervention time of 5 minutes Different TrP techniques, particularly soft tissue stroke, pressure release, or muscle energy were applied to head and neck-shoulder muscles (temporalis, suboccipital, upper trapezius, splenius capitis, semispinalis capitis, sternocleidomastoid) to inactivate active muscle TrPs. Participants were classified as having achieved a successful outcome 1 week after the session based on their self-perceived recovery. Potential prognostic variables were entered into a stepwise logistic regression model to determine the most accurate set of variables for prediction of success. Data for 76 subjects were included in the analysis, of which 36 experienced a

Use of Nonsteroidal Anti-Inflammatory Drugs for Symptomatic Treatment of Episodic Headache.

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Affaitati, Giannapia; Martelletti, Paolo; Lopopolo, Mariangela; Tana, Claudio; Massimini, Francesca; Cipollone, Francesco; Lapenna, Domenico; Giamberardino, Maria Adele; Costantini, Raffaele

2017-03-01

Primary headaches have high epidemiologic impact but their symptomatic treatment often remains problematic. Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used, but their modality of employment and efficacy/differential efficacy are highly variable. This study investigated current NSAID use for episodic headache at an Italian headache center (January 2000 to February 2013). A retrospective evaluation was performed on 6,443 patient records: migraine (n = 2,330), tension-type headache (TTH; n = 807), and migraine plus TTH (n = 3,306). Among migraine patients, 80% had used NSAIDs in the past year. Preferences were: nimesulide (57%), ketoprofen (25%), and ibuprofen (24%); complete efficacy was significantly higher than incomplete/absent efficacy (P headache was higher than could be hypothesized based on guidelines, with NSAID preferences not entirely coinciding with international recommendations. This outcome suggests the need for greater awareness of all treatment options in headache by both patients and physicians. © 2016 World Institute of Pain.

Natural very-low-frequency sferics and headache

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Vaitl, D.; Propson, N.; Stark, R.; Schienle, A.

  Very-low-frequency (VLF) atmospherics or sferics are pulse-shaped alternating electric and magnetic fields which originate from atmospheric discharges (lightning). The objective of the study was threefold: (i) to analyse numerous parameters characterizing the sferics activity with regard to their suitability for field studies, (ii) to identify meteorological processes related to the sferics activity and (iii) to investigate the possible association of sferics with pain processes in patients suffering from migraine- and tension-type headaches. Over a period of 6 months (July through December) the sferics activity in the area of Giessen (Germany) was recorded. Three sferics parameters were chosen. The number of sferics impulses per day, the variability of the impulse rate during a day and the variability in comparison to the preceding day were correlated with weather processes (thunderstorm, temperature, vapour pressure, barometric pressure, humidity, wind velocity, warm sector). Significant correlations were obtained during the summer months (July, August) but not during the autumn months (October, November, December). During autumn, however, the sferics activity was correlated with the occurrence of migraine-type headaches (r=0.33, Pheadache diary over a period of 6 months (July-December). While the thunderstorm activity was very intense during July and August, no relationship between sferics and migraine was found. In summer, tension-type headaches were associated with meteorological parameters such as temperature (r=0.42, P<0.01) and vapour pressure (r=0.28, P<0.05). Although the sferics activity can explain a small percentage of the variation in migraine occurrence, a direct influence was more likely exerted by visible or otherwise perceptible weather conditions (thunderstorms, humidity, vapour pressure, warm sector, etc.) than by the sferics activity itself.

Evaluation of prevalence of headache in Multiple Sclerosis patients before & after the disease

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H. Mozhdehipanah

2017-08-01

Full Text Available Background: Multiple Sclerosis disease is a chronic disease of nervous system which causes different symptoms. Although headache is not a major symptom of this disease, but a lot of patients suffer from it. To specify the prevalence of headache and its’ types has an important role in diagnose, treatment and improvement the quality of patients’ life. Objective: Our goal of this study was to determine the prevalence of headache in multiple sclerosis patients, before and after the diagnosis of this disease. Methods: This cross-sectional descriptive epidemiologic study was performed on 150 multiple sclerosis patients referred to the neurology clinic of Qazvin in 2015. Data were recorded by history taking & physical examination the existence of headache before the MS diagnosis and at the time of study was evaluated by the patients’ data. Findings: Among participants, prevalence of headache before the MS diagnosis was 40%, which increased to 64% after that (P<0.001. The most common type of headache, before and after the affection was tension headache, which formed 58.3% and 70.8% of all headaches, respectively. The average rate of headache in the group with headache, before and after the diagnosis of MS was 5.8 and 5.76 days in month, which calculated 2.32 and 3.68 days in month in all patients, respectively. Conclusion: Prevalence of headache increases in multiple sclerosis patients. Patients suffer from headache almost 13% of their life days.

The methodology of population surveys of headache prevalence, burden and cost: Principles and recommendations from the Global Campaign against Headache

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2014-01-01

The global burden of headache is very large, but knowledge of it is far from complete and needs still to be gathered. Published population-based studies have used variable methodology, which has influenced findings and made comparisons difficult. Among the initiatives of the Global Campaign against Headache to improve and standardize methods in use for cross-sectional studies, the most important is the production of consensus-based methodological guidelines. This report describes the development of detailed principles and recommendations. For this purpose we brought together an expert consensus group to include experience and competence in headache epidemiology and/or epidemiology in general and drawn from all six WHO world regions. The recommendations presented are for anyone, of whatever background, with interests in designing, performing, understanding or assessing studies that measure or describe the burden of headache in populations. While aimed principally at researchers whose main interests are in the field of headache, they should also be useful, at least in parts, to those who are expert in public health or epidemiology and wish to extend their interest into the field of headache disorders. Most of all, these recommendations seek to encourage collaborations between specialists in headache disorders and epidemiologists. The focus is on migraine, tension-type headache and medication-overuse headache, but they are not intended to be exclusive to these. The burdens arising from secondary headaches are, in the majority of cases, more correctly attributed to the underlying disorders. Nevertheless, the principles outlined here are relevant for epidemiological studies on secondary headaches, provided that adequate definitions can be not only given but also applied in questionnaires or other survey instruments. PMID:24467862

[Health care activity in a headache-specific clinic].

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Garcia-Escrivà, A; Asensio-Asensio, M; López-Hernández, N; González-Aznar, O J; Oliver-Navarrete, C; Alvarez-Saúco, M; Pampliega-Pérez, A

It is reckoned that headaches affect, at least once a year, around 90% of the population. The socioeconomic repercussion occasioned by this malady justifies the appearance in recent years of headache units. To conduct a descriptive epidemiological and health care study of the activity carried out in a headache-specific clinic. All the relevant points from the histories of patients who visited our surgery over a period of two years were collected prospectively and consecutively. The different types of headaches were classified according to the 1988 IHS criteria. Both the symptomatic and the preventive treatment were analysed. In all, a total of 866 patients were found; 691 (79.8%) were females and the mean age was 39.8 +/- 15.9 years (range: 6-90 years); 208 (24%) had a history of migraine in the family; 399 (49.9%) were diagnosed as suffering from migraine: 256 (64.2%) had migraine without aura, 152 (19%) were diagnosed as having tension-type headache, and 218 (27.3%) presented chronic daily headache (CDH). The most frequently used symptomatic treatments were NSAI drugs (36.7%) and triptanes (28.4%). Amitriptyline (47.7%), beta-blockers (14.5%) and calcium antagonists (11.3%) were the main drugs used as preventive treatment. After several years' operation of our Headache Unit, we thought there was a need to analyse the population seen in the visits. The fact that the majority of our patients were middle-aged females matched our expectations. Although most of the patients were diagnosed as suffering from M, we also want to highlight the high proportion of cases of CDH, above all associated with the abuse of analgesics.

Headache complaints associated with psychiatric comorbidity in a population-based sample

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Benseñor I.M.

2003-01-01

Full Text Available The objective of the present study was to determine the frequency at which people complain of any type of headache, and its relationship with sociodemographic characteristics and psychiatric comorbidity in São Paulo, Brazil. A three-step cluster sampling method was used to select 1,464 subjects aged 18 years or older. They were mainly from families of middle and upper socioeconomic levels living in the catchment area of Instituto de Psiquiatria. However, this area also contains some slums and shantytowns. The subjects were interviewed using the Brazilian version of the Composite International Diagnostic Interview version 1.1. (CIDI 1.1 by a lay trained interviewer. Answers to CIDI 1.1 questions allowed us to classify people according to their psychiatric condition and their headaches based on their own ideas about the nature of their illness. The lifetime prevalence of "a lot of problems with" headache was 37.4% (76.2% of which were attributed to use of medicines, drugs/alcohol, physical illness or trauma, and 23.8% attributed to nervousness, tension or mental illness. The odds ratio (OR for headache among participants with "nervousness, tension or mental illness" was elevated for depressive episodes (OR, 2.1; 95%CI, 1.4-3.4, dysthymia (OR, 3.4; 95%CI, 1.6-7.4 and generalized anxiety disorder (OR, 4.3; 95%CI, 2.1-8.6, when compared with patients without headache. For "a lot of problems with" headaches attributed to medicines, drugs/alcohol, physical illness or trauma, the risk was also increased for dysthymia but not for generalized anxiety disorder. These data show a high association between headache and chronic psychiatric disorders in this Brazilian population sample.

Primary Headache in Yemen: Prevalence and Common Medications Used

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Salah A. Abdo

2014-01-01

Full Text Available Background and Objective. Primary headaches is a major medical concern in certain Arabic countries, for example Oman, Jordan, and Qatar. This study was aimed at increasing understanding of the prevalence of headache in Arabic countries and identifying common medications used for treatment because of the lack of research done in this field in Yemen. Methods. This is a cross-sectional observational study conducted by recruiting case-series of adults and elderly who have primary headache within the age group from 18 to 85 years. 12640 subjects received a simple explanation for the aim of the study as ethical issue. The subjects were allowed to complete a self-conducted screening questionnaire. The data were diagnosed according to the International Headache Society’s diagnostic criteria (2004. Results. The results showed that 76.5% of the primary headache is prevalent at least once per year, 27.1% of the tension type headache (TTH was the maximum percentage of type of headache, and 14.48% of the migraine headache (MH was the minimum percentage. On the other hand, the relationship between the primary headache and age of subjects was statistically significant (P0.05. In addition, 70.15% of the subjects said that headache attacks affected their activity of daily livings (ADL. 62.26% of the subjects used the medications without medical advice regarding their headache. 37.73% of the subjects relied on medical professionals (physicians and pharmacist regarding analgesics use. The most common agent used among the medications was paracetamol (38.4%. Others included ibuprofen, aspirin, diclofenac sodium, naproxen, mefenamic acid, ergotamine and (11.45% were unknown agents. Conclusion. We concluded that absence of health attention from the Yemeni Community and education from the health system in the country regarding analgesics use and their potential risk led to abuse of such medications and could be a reason beyond high prevalence of headache in Yemen.

[Venous angiomas and headache in children. A case report].

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López, Mauricio; Huete, Isidro; Hernández, Marta

2016-01-01

Venous angiomas (VA) are benign entities; however infrequent symptomatic cases may occur. Case report and literature review. A 6 year old girl was referred with a history of bi-frontal, non-pulsatile, headache with no nausea or vomiting. Headache intensity was 4-6/10. The episodes were frequent, 3-4 times per week. Triggers include academic work. Computed tomography showed a small VA in left caudate nucleus, which was confirmed by a brain MRI, with no evidence of inflammatory or ischaemic changes, or another vascular malformation. Psychological and psycho-pedagogic techniques were used, combined with relaxation and cognitive-behavioural techniques to reduce the intensity and frequency. There was a good outcome, and the headache decreased to 10 episodes per year. The patient was monitored for 12 years until graduation from high school. The VA remained without complications. In the study of a headache, a VA usually is an incidental finding. The International Classification of Headache Disorders III provides specific criteria of frequent episodic tension-type headache, and allows us begin specific therapy for it. Monitoring of non-symptomatic VA cases should be clinical. The surgical management of these entities is exceptional. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Central mechanisms of stress-induced headache.

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Cathcart, S; Petkov, J; Winefield, A H; Lushington, K; Rolan, P

2010-03-01

Stress is the most commonly reported trigger of an episode of chronic tension-type headache (CTTH); however, the causal significance has not been experimentally demonstrated to date. Stress may trigger CTTH through hyperalgesic effects on already sensitized pain pathways in CTTH sufferers. This hypothesis could be partially tested by examining pain sensitivity in an experimental model of stress-induced headache in CTTH sufferers. Such examinations have not been reported to date. We measured pericranial muscle tenderness and pain thresholds at the finger, head and shoulder in 23 CTTH sufferers (CTH-S) and 25 healthy control subjects (CNT) exposed to an hour-long stressful mental task, and in 23 CTTH sufferers exposed to an hour-long neutral condition (CTH-N). Headache developed in 91% of CTH-S, 4% of CNT, and 17% of CTH-N subjects. Headache sufferers had increased muscle tenderness and reduced pain thresholds compared with healthy controls. During the task, muscle tenderness increased and pain thresholds decreased in the CTH-S group compared with CTH-N and CNT groups. Pre-task muscle tenderness and reduction in pain threshold during task were predictive of the development and intensity of headache following task. The main findings are that stress induced a headache in CTTH sufferers, and this was associated with pre-task muscle tenderness and stress-induced reduction in pain thresholds. The results support the hypothesis that stress triggers CTTH through hyperalgesic effects on already increased pain sensitivity in CTTH sufferers, reducing the threshold to noxious input from pericranial structures.

Overview of diagnosis and management of paediatric headache. Part I: diagnosis.

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Ozge, Aynur; Termine, Cristiano; Antonaci, Fabio; Natriashvili, Sophia; Guidetti, Vincenzo; Wöber-Bingöl, Ciçek

2011-02-01

Headache is the most common somatic complaint in children and adolescents. The evaluation should include detailed history of children and adolescents completed by detailed general and neurological examinations. Moreover, the possible role of psychological factors, life events and excessively stressful lifestyle in influencing recurrent headache need to be checked. The choice of laboratory tests rests on the differential diagnosis suggested by the history, the character and temporal pattern of the headache, and the physical and neurological examinations. Subjects who have any signs or symptoms of focal/progressive neurological disturbances should be investigated by neuroimaging techniques. The electroencephalogram and other neurophysiological examinations are of limited value in the routine evaluation of headaches. In a primary headache disorder, headache itself is the illness and headache is not attributed to any other disorder (e.g. migraine, tension-type headache, cluster headache and other trigeminal autonomic cephalgias). In secondary headache disorders, headache is the symptom of identifiable structural, metabolic or other abnormality. Red flags include the first or worst headache ever in the life, recent headache onset, increasing severity or frequency, occipital location, awakening from sleep because of headache, headache occurring exclusively in the morning associated with severe vomiting and headache associated with straining. Thus, the differential diagnosis between primary and secondary headaches rests mainly on clinical criteria. A thorough evaluation of headache in children and adolescents is necessary to make the correct diagnosis and initiate treatment, bearing in mind that children with headache are more likely to experience psychosocial adversity and to grow up with an excess of both headache and other physical and psychiatric symptoms and this creates an important healthcare problem for their future life.

Guideline for primary care management of headache in adults

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Becker, Werner J.; Findlay, Ted; Moga, Carmen; Scott, N. Ann; Harstall, Christa; Taenzer, Paul

2015-01-01

Abstract Objective To increase the use of evidence-informed approaches to diagnosis, investigation, and treatment of headache for patients in primary care. Quality of evidence A comprehensive search was conducted for relevant guidelines and systematic reviews published between January 2000 and May 2011. The guidelines were critically appraised using the AGREE (Appraisal of Guidelines for Research and Evaluation) tool, and the 6 highest-quality guidelines were used as seed guidelines for the guideline adaptation process. Main message A multidisciplinary guideline development group of primary care providers and other specialists crafted 91 specific recommendations using a consensus process. The recommendations cover diagnosis, investigation, and management of migraine, tension-type, medication-overuse, and cluster headache. Conclusion A clinical practice guideline for the Canadian health care context was created using a guideline adaptation process to assist multidisciplinary primary care practitioners in providing evidence-informed care for patients with headache. PMID:26273080

Temporomandibular disorder is more prevalent among patients with primary headaches in a tertiary outpatient clinic

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James Felipe Tomaz-Morais

2015-11-01

Full Text Available Objective The aim of this study was to estimate the prevalence of signs and symptoms of temporomandibular disorders (TMD in patients with primary headaches attended in a tertiary neurology ambulatory.Method Authorized by the Ethics Committee, the present cross-sectional study was conducted with a random sample of patients screened for orofacial pain and primary headaches at a tertiary hospital in Northeast of Brazil.Results The sample consisted in 42 patients with primary headache, 59.5% male. The prevalence of > 6 TMD signs and symptoms was 54.8%. In those patients with migraine TMD was present in 71.4% and in tension-type headache in 38.1% (p = 0.030; OR = 4.1. TMD was related to the clinical status of headache associated or attributed to medication overuse (p = 0.001.Conclusion TMD has a high prevalence in patients with primary headaches (54.8%. Special attention must be given to patients with migraine and headache associated or attributed to medication overuse.

Use of complementary and alternative medicine by a sample of Turkish primary headache patients.

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Karakurum Göksel, Başak; Coşkun, Özlem; Ucler, Serap; Karatas, Mehmet; Ozge, Aynur; Ozkan, Secil

2014-01-01

Complementary and alternative medicine (CAM) is increasingly being used as adjunctive treatment in primary headache syndromes in many countries. In the Turkish population, no epidemiologic data have been reported about awareness and usage of these treatments in patients with headache. One hundred and ten primary headache patients attending three headache clinics completed a questionnaire regarding their headaches, the known modalities and the use and effect of CAM procedures for their headaches. The mean age of the patients was 34.7±9.6 years (32.8-36.5). Almost two-thirds of patients had completed high school and university, and one-third of patients were housewives. Migraine without aura (45.5%) was the most frequently diagnosed type of headache followed by migraine with aura (19.1%) and tension-type headache (18.2%). In 43.6% of the patients, headache frequency was 5-10 per month. The most frequently known CAM modalities were massage (74.5%), acupuncture (44.5%), yoga (31.8%), exercise (28.2%), psychotherapy (25.5%), and rosemary (23.6%). The most frequently used CAM treatments were massage (51%) and exercise (11%). Only massage was reported to be beneficial in one-third of the primary headache patients; the other modalities were not. Our findings suggest that the subgroup of primary headache patients in Turkey seek and use alternative treatments, frequently in combination with standard treatments. Neurologists should become more knowledgeable regarding CAM therapies; further randomized and controlled clinical researches with large sample sizes are needed.

Headache in sports.

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Seifert, Tad

2014-09-01

Sports- and exercise-related headaches are not unusual. Despite their frequent occurrence in this context, there are little epidemiologic data concerning sports-related headache. The recent attention of concussive injuries and associated post-traumatic headache has renewed interest in the study of those headaches occurring after head trauma; however, any primary headache type can also occur in the setting of contact and/or collision sports. The nonspecific nature of headaches provides unique challenges to clinicians encountering this complaint. It is, therefore, imperative that physicians treating athletes are able to distinguish the various headache types and presentations often seen in this population.

[Outcome-quality of treatment for headache on primary care conditions].

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Lang, E; Eisele, R; Jankowsky, H; Kastner, S; Bickel, A; Martus, P; Neundörfer, B

2000-12-01

Little is known about the outcome-quality of treatment for headache on primary care conditions in Germany. All physicians (2100) of middle franconia, a bavarian greater district with 1,6 Mio. inhabitants, involved in outpatient management were asked to include consecutively patients in the study which suffer from migraine (at least 2 attacks/month) and/or tension type headache (at least 8 days/month) of at least 4 weeks duration. Before and after a 6 months interval patients documented the following outcome data in a questionnaire: pain intensity during the last attack (numeric rating scale), pain dependent disability (Brief Pain Inventory, German version), health related quality of life (SF-36, German version) and depressivity (Allgemeine Depressionsskala). The pain chronification state (Mainz Pain Staging System) has been assessed by the physician. Therapy was not standardized and included the natural spectrum of medicamental and non-medicamental therapy of headache. Agreement of therapy with recommendations of the "Arzneimittelkommission der Deutschen Aerzteschaft" has been assessed. 24 physicians participated in the study. Pre-post-data of 80 patients (46+/-14 y) could be analysed. Initially 67% were classified in pain chronification state I, 27% in state II and 6% in state III. Medicamental therapy agreed with recommendations in approximately 50% of patients, non-medicamental therapy has been used rarely. The pain intensity, pain dependent disability, depression and quality of life improved significantly. 45% and 55% of patients improved in at least 2 of 6 outcome-parameters by 30% of baseline value or by half standard deviation of the corresponding pre-post-differences, respectively. The latter outcome-measure reflects a medium effect size. On primary care conditions about 50% of patients suffering from migraine and/or tension type headache (predominantly low chronification stae) perceive a therapy effect that corresponds to a medium effect size.

Headache

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... SEARCH Definition Treatment ... visits to the doctor. The International Classification of Headache Disorders, published by the International Headache Society, is used to classify more than 150 types ...

The Nord-Trøndelag Health Study shows increased prevalence of primary recurrent headaches among adolescents over a four-year period.

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Jacobsena, Brit A; Dyb, Grete; Hagen, Knut; Stovner, Lars J; Holmen, Turid L; Zwart, John-Anker

2017-12-29

Objective Earlier epidemiological studies have shown that headaches are frequent among adolescents, especially girls. In particular, recurrent primary headache disorders such as migraine and tension-type headaches are common complaints in this age group. Headaches are increasingly being recognized as a significant health problem in adolescents and can lead to significant disabilities by affecting their lives, their school performance and their social lives. The aim of this study was to compare the prevalence of primary headaches among adolescents aged 16-20 years in Norway in two periods. Very few replicate studies have re-evaluated the prevalence of primary headaches in this age range and it is uncertain whether the prevalence is increasing. Methods Two cross-sectional, population-based studies were conducted in Norway from 1995 to 1997 (Young-HUNT 1) and from 1999 to 2001 (Young-HUNT 2). In Young-HUNT 1, 2594 adolescents in 2nd and 3rd grade in upper secondary school (aged 16-20 years) completed a comprehensive questionnaire including one question regarding headache during the last 12 months. In addition, 1730 of the students were interviewed about their headache complaints. In Young-HUNT 2, 2373 adolescents aged 16-20 years completed the same questionnaire and 1655 were interviewed in the same way as the earlier survey. The interviews were performed by trained nurses, and respondents were asked if they had experienced recurrent headache during the last year. If so, the headache was classified as migraine (MI), tensiontype headache (TTH) or non-classifiable headache (NCH). Headache frequency during the past year was recorded according to the following categories: Less than 1 day per month (less than monthly), 1-3 days per month (monthly), 1-5 days per week (weekly), or more than 5 days per week (daily). Results The participation rate was 88% in Young-HUNT 1 and 81% in Young-HUNT 2. The overall prevalence of having had headaches during the last 12 months did not

How specific are risk factors for headache in adolescents? Results from a cross-sectional study in Germany.

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Lehmann, Steffi; Milde-Busch, Astrid; Straube, Andreas; von Kries, Ruediger; Heinen, Florian

2013-02-01

The identified preventable risk factors for primary headache in adolescents are smoking; consumption of coffee or alcoholic mixed drinks; physical inactivity; muscle pain in the head, neck, or shoulder region; and chronic stress. To investigate the interrelation of headache with other health complaints and the specificity of the above-mentioned risk factors for headache in adolescents. A total of 1,260 students (grades 10 and 11) filled in questionnaires on headache, dietary, and lifestyle factors. The type of headache and health complaints such as dizziness, abdominal pain, musculoskeletal pains, symptoms of possible fatigue syndrome, and psychic complaints were assessed. Isolated headache was found in 18% of the headache sufferers; most frequently isolated tension-type headache (78.2%). Only among adolescents with a combination of headache (mainly migraine) and other health complaints, significant associations for almost all analyzed risk factors were found. The strength of the associations with the considered risk factors was very similar in all three analyzed strata except for considerably lower odds ratios for isolated headache. All analyzed risk factors are nonspecific for headache in adolescents because they also increase the risk for other health complaints. Interventions, therefore, should consider a holistic approach focusing not only on headache but also on a broader spectrum of health complaints. Georg Thieme Verlag KG Stuttgart · New York.

Children's Headache: Drawings in the Diagnostic Work Up.

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Mazzotta, Silvia; Pavlidis, Elena; Cordori, Cecilia; Spagnoli, Carlotta; Pini, Luigi Alberto; Pisani, Francesco

2015-08-01

This study aims to evaluate the drawings effectiveness in childhood headache assessment. Headache is a common cause of pain in children. Although drawings have been used in childhood to recognize psychological insights and pain perception, they were rarely used for headache characterization. We collected drawings from 67 subjects with cephalalgia during a 22-month timeframe. The clinical diagnosis was made according to the 2nd edition of The International Headache Classification. Drawings were independently categorized as migraine or tension-type headache (TTH) by two child neuropsychiatrists blinded to the clinical data. Cohen kappa for interrater agreement, sensitivity, specificity, and positive predictive value (PPV) were calculated. Subjects were also divided into three age groups to assess the influence of age. Finally, a control group of 90 subjects was collected and K-means cluster analysis was performed. The drawings had a sensitivity of 85.71 and 81.48%, a specificity of 81.48 and 85.71%, and a PPV of 85.71 and 81.48%, for migraine and TTH diagnosis, respectively. Drawings by the older age group showed the highest predictability degree. Finally, by mean of cluster analysis, 59 of the 67 patients were correctly classified, whereas control subjects were similarly distributed between the two clusters. Drawings are a useful instrument for migraine and TTH differential diagnosis. Thus, we suggest their inclusion in childhood headache diagnostic assessment. Georg Thieme Verlag KG Stuttgart · New York.

New-onset headache in an elderly man with uremia that improved only after correction of hyperphosphatemia ("uremic headache": a case report

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Chopra Vanilla

2011-02-01

Full Text Available Abstract Introduction New-onset headaches in the elderly are usually secondary and rarely primary. We present the case of an elderly man with recent-onset headache due to uremic hyperphosphatemia and hypocalcemia. To the best of our knowledge, this is the first case report of its kind in the literature. Case presentation We present the case of a 70-year-old Indian man with chronic kidney disease whose new-onset headache improved only when his hyperphosphatemia and hypocalcemia were corrected. He had diffuse, dense calcification of tentorium cerebelli and falx due to hyperphosphatemia. Conclusions This case report reinforces the importance of identifying the cause of a new-onset headache, particularly in the elderly, and treating it before blaming a tension headache or primary headache as the cause.

Headache children with temporomandibular disorders have several types of pain and other symptoms.

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Liljeström, M-R; Le Bell, Y; Anttila, P; Aromaa, M; Jämsä, T; Metsähonkala, L; Helenius, H; Viander, S; Jäppilä, E; Alanen, P; Sillanpää, M

2005-11-01

The aim was to investigate the association between temporomandibular disorders (TMD) and overall muscle tenderness, depressive symptoms, sleep difficulties, headache frequency and related symptoms in children with primary headache in comparison with controls. Based on an unselected population sample of 1135 Finnish schoolchildren classified according to the type of headache at age 12, altogether 297 children aged 13-14 from different headache groups and healthy controls were randomly selected for an interview and clinical examinations. Children with migraine had more TMD signs than children with nonmigrainous headaches or healthy controls. High TMD total scores were associated with palpation tenderness in other parts of the body and with frequent headache attacks. We conclude that children with overall headache, migraine in particular, and high total TMD scores showed an increased overall tenderness to muscle palpation and multiply manifested hypersensitivity pain.

Improvement in headaches with continuous positive airway pressure for obstructive sleep apnea: a retrospective analysis.

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Johnson, Karin G; Ziemba, Alexis M; Garb, Jane L

2013-02-01

We aimed to identify clinical features in patients with severe headaches that predicted obstructive sleep apnea (OSA) and determine clinical and sleep study characteristics that predicted headache improvement with continuous positive airway pressure (CPAP). Many patients with headaches complain of sleep symptoms and have OSA. There is often improvement of headaches with CPAP treatment. We conducted a retrospective chart review of all patients referred to adult neurology clinic for headaches and sent for polysomnography between January 2008 and December 2009. Follow-up ranged from 18 to 42 months. Eighty-two headache patients (70 females, 12 males) were studied. Mean age was 45±13 years (females 45±13, males 43±11) and mean body mass index was 32±9. Headache types included 17% chronic migraine without aura, 22% episodic migraine without aura, 32% migraine with aura, 21% tension-type headache, 6% chronic post-traumatic headache, 11% medication overuse headache, and 7% other types. All patients were receiving standard treatment for their headaches by their neurologist. Fifty-two patients (63%) had OSA. Increasing age, female gender, and chronic migraine without aura were predictive of OSA. Of the patients with OSA, 33 (63%) used CPAP and 27 (82%) were adherent to CPAP. Headache improvement was reported by 40 patients (49%) due to either standard medical therapy or CPAP. Patients with OSA who were CPAP adherent (21/27) were more likely to have improvement in headaches than patients intolerant of CPAP (2/6), those that did not try CPAP (8/19), and those who did not have OSA (16/30) (P=.045). Of the 33 patients who used CPAP, 13 reported improvement in headaches specifically due to CPAP therapy and 10 additional patients noted benefit in sleep symptoms. The presence of witnessed apneas (P=.045) and male gender (P=.021) predicted improvement in headaches due to CPAP. Headache patients should be evaluated for the presence of OSA. Treating OSA improves headaches in some