BACKGROUND: The investigations of personality traits have been the issue of many studies on patients with tension-type headache. However, there was few comparison study of personality traits between the patients with episodic tension-type headache (ETTH) and chronic tension-type headache (CTTH) using Minnesota Multiphasic Personality Inventory (MMPI). METHODS: The study was consecutively made of the personality profiles of two groups with ETTH (137 patients) and CTTH (115 patients) in accordance with the International Headache Society (IHS) criteria, employing the MMPI. RESULTS: The two groups could be classified into three clusters by a multivariate cluster analysis, which are relatively normal profile (cluster I), somatic profile (cluster II, elevated Hs-D-Hy scales), and psychosomatic profile (cluster III, elevated Pa-Pt-Sc-Si and Hs-D-Hy scales). The proportion of the patients with CTTH in the psychosomatic profile group was stastically more significant (59.6%) than that of the patients with ETTH (40.4%) by a chi-square test. CONCLUSIONS: This study shows that the psychosomatic profile might be more common in the CTTH patients than in the ETTH patients.
Headache ; Humans ; MMPI* ; Tension-Type Headache*

Headache is a common symptom, often associated with disability, but rarely life threatening. However, even disabling migraine is under-diagnosed and under-treated. There are no diagnostic tests for migraine or tension-type headaches, and the history is all-important. A headache history requires time to elicit and a simple and helpful stratagem when the patient first presents in a clinic is to request the keeping of a diary over a few weeks. The pattern of attacks is a very helpful indicator of the right diagnosis. It must be ascertained first that a condition requiring more urgent intervention is not present. In this brief review, the crucial elements of a headache history are presented in detail, and key principles of treatment are described.
Diagnostic Tests, Routine ; Headache ; Humans ; Migraine Disorders ; Tension-Type Headache

Headaches are common in children and become more common and increase in frequency during adolescence. There are various causes of headaches. The majority of cases are considered as primary and include migraine and tension headaches. The rational evaluation of headache begins with careful history. Migraine is genetically determined recurrent pain syndrome accompanied by neurological and gastrointestinal features, involving interaction of external triggers and internal pathophysiology and the causes of considerable disability to suffers. Establishing the correct diagnosis is essential for successful treatment. Treatment of pediatric migraine includes an individually tailored regimen of both nonpharmacologic and pharmacologic measures.
Adolescent ; Child* ; Diagnosis ; Headache* ; Humans ; Migraine Disorders ; Tension-Type Headache

BACKGROUND: The treatment for chronic headache is not simple because of the complexity of its cause and etiology. A stellate ganglion block (SGB) is normally used to treat chronic headache. This study compared the effectiveness of SGB in treating tension headache and migraine patients by evaluating its effect on pain alleviation and improving the quality of life after an 8 week treatment duration. METHODS: Forty-six patients, who experienced headache for more than 4 hours a day and more than 15 days a month and were diagnosed with chronic headache, were enrolled in this study. The patients were classified into two groups, the migraine group (MG, n = 26) and the tension headache group (TG, n = 20). The patients were treated with SGB only and the degree of pain was evaluated after 4 and 8 weeks of treatment, and 4 weeks after the end of treatment. The treatment was applied twice a week during 8 weeks. The effects of these treatments in the two groups were analyzed using Visual Analogue Scale (VAS) pain scores and Brief Pain Inventory (BPI). RESULTS: The VAS and BPI after 8 weeks of treatment showed significant differences compared with those of MG and TG before treatment, and there were no differences between the two groups. The VAS and BPI of the two groups, 4 weeks after the end of treatment, showed statistically significant improvement compared with those before treatment. CONCLUSIONS: The above results suggested that SGB might be an useful modality for the alleviating the pain and improving the quality of life in TG and MG patients.
Headache ; Headache Disorders ; Humans ; Migraine Disorders* ; Nerve Block ; Quality of Life ; Stellate Ganglion* ; Tension-Type Headache*

PURPOSE: The purpose of this study was to evaluate the clinical characteristics and efficacy of prophylactic treatment of pediatric chronic daily headache (CDH). METHODS: A retrospective medical-record review of patients who underwent the prophylaxis after a diagnosis of CDH was performed. Response to treatment was assessed by the total number of headache days/month. More than 50% reduction of headache frequency was classified as responders. RESULTS: Eighty patients with the diagnosis of CDH were included in the study. CDH was more prevalent in girls than in boys. It was classified into chronic migraine (81.2%), chronic tension-type headache (15.0%), or new-onset persistent daily headache (3.7%). None of the patient fulfilled the diagnostic criteria of hemicrania continua. The mean age of the patients was 11.8+/-1.2 years. The mean number of monthly headache episodes before treatment was 25.5+/-4.4. After prophylactic treatment, headache episodes were reduced to 8.7+/-9.5 episodes per month. The responder rate of prophylactic treatment was 70.2% (55/80 patients) for either topiramate or flunarizine. CONCLUSION: In our study, the most common type of CDH was chronic migraine. All patients with CDH had frequent, long lasting migraine attacks. This study also suggests that prophylactic treatment is effective in the treatment of pediatric CDH.
Fructose ; Headache ; Headache Disorders ; Humans ; Migraine Disorders ; Retrospective Studies ; Tension-Type Headache

BACKGROUND AND PURPOSE: Chronic tension-type headache (a primary headache disorder) and cervicogenic headache (a secondary headache disorder that is attributable to upper cervical spine pathology) share similar clinical manifestations, but their associated personality traits may differ. We evaluated the personality differences between sufferers of chronic tension-type headache and cervicogenic headache. METHODS: We administered the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ) and the Zuckerman Sensation-Seeking Scale (SSS) to 18 patients suffering from chronic tension-type headache, 19 suffering from cervicogenic headache, and 26 healthy volunteers. Depressive trends were measured with the Plutchik-van-Praag Depression Inventory (PVP). RESULTS: Compared to healthy controls, the chronic tension-type headache group scored significantly higher on ZKPQ Neuroticism-Anxiety and on the PVP, while the cervicogenic headache group scored significantly lower on SSS Thrill and Adventure Seeking. In addition, the total SSS score was significantly lower in the cervicogenic headache group than in both the chronic tension-type headache group and the healthy controls. CONCLUSIONS: The results of this study indicate that higher scores for neuroticism-anxiety and depression were associated with chronic tension-type headache, while lower sensation-seeking scores were associated with cervicogenic headache.
Depression ; Headache ; Headache Disorders, Secondary ; Humans ; Male ; Post-Traumatic Headache ; Spine ; Stress, Psychological ; Tension-Type Headache ; Surveys and Questionnaires

BACKGROUND AND PURPOSE: Cluster headache (CH) is frequently either not diagnosed or the diagnosis is delayed. We addressed this issue by developing the self-administered Cluster Headache Screening Questionnaire (CHSQ). METHODS: Experts selected items from the diagnostic criteria of CH and the characteristics of migraine. The questionnaire was administered to first-visit headache patients at nine headache clinics. The finally developed CHSQ included items based on the differences in responses between CH and non-CH patients, and the accuracy and reliability of the scoring model were assessed. RESULTS: Forty-two patients with CH, 207 migraineurs, 73 with tension-type headache, and 18 with primary stabbing headache were enrolled. The CHSQ item were scored as follows: 3 points for ipsilateral eye symptoms, agitation, and duration; 2 points for clustering patterns; and 1 point for the male sex, unilateral pain, disability, ipsilateral nasal symptoms, and frequency. The total score of the CHSQ ranged from 0 to 16. The mean score was higher in patients with CH than in non-CH patients (12.9 vs. 3.4, p < 0.001). At a cutoff score of >8 points, the CHSQ had a sensitivity, specificity, positive predictive value, and negative predictive value of 95.2%, 96%, 76.9%, and 99.3%, respectively. CONCLUSIONS: The CHSQ is a reliable screening tool for the rapid identification of CH.
Cluster Headache* ; Diagnosis ; Dihydroergotamine ; Headache ; Headache Disorders, Primary ; Humans ; Male ; Mass Screening* ; Migraine Disorders ; Prevalence ; Sensitivity and Specificity ; Tension-Type Headache

PURPOSE: Headache is a notable problem in clinical practice and a frequent symptom in children, but a systemic evaluation of the clinical course in affected patients is uncommon. The main aim of the present study is to investigate the natural course of primary headache in children after two years of diagnosis. METHODS: Based on the international classification of headache disorder(2nd edition), 51 children were diagnosed as migraine or tension-type headache from September, 2003 to October, 2005. They did not received prophylactic treatment. Their symptoms were reassessed in 42 out of 51 children 2 years after the initial diagnosis. We evaluated the condition of the patients with headache by a telephone interview with their parents. RESULTS: The diagnosed group consisted of 25 patients(59.5%) with migraine and 17 patients(40.5%) with tension-type headache. Regarding the location of the headache, the incidence of temporal area was higher in the migraine(52.0%) group than in the tension-type headache(11.8%) group. In the migraine group, 15 cases(60%) had pulsating headache, which was higher than in the tension-type headache group. At the 2-year follow up, headache-free or improvement was observed in 80.0%(20 cases) of the migraine group and 82.3%(14 cases) of the tension-type headache group. Among 14 children with positive headache family history, 12 patients(85.7%) were headache-free or improved. But there was not significant relationship between headache family history and prognosis. CONCLUSION: Primary headache had a high tendency to improve without long-term management by a 2-year follow-up in this study. Therefore, it is the way of reducing the unnecessary treatment to decide prophylactic treatment after investigating the severity or frequency of the headache using the headache diary or questionnaire.
Child ; Follow-Up Studies ; Headache ; Humans ; Incidence ; Interviews as Topic ; Migraine Disorders ; Surveys and Questionnaires ; Tension-Type Headache

BACKGROUND: The purpose of this study was to investigate whether patients with chronic tension-type headache (TTH) have abnormalities of postural control, and to disclose any frequency shift of the centre of gravity while standing upright. METHODS: Thirty patients with chronic TTH diagnosed by the International Headache Society Classification criteria and with tenderness in pericranial muscles were compared with thirty age and sex matched controls. All the subjects underwent static and computerized dynamic posturography. The spectral frequency analysis of body sway while standing upright was investigated. RESULTS: The sway distance and the sway area of center of foot pressure significantly increased in the patients with TTH. Spectral frequency analysis showed a significant increase in spectral power below the 1.00 Hz frequency band. Computerized dynamic posturography showed a decreased somatosensory ratio in the patients with TTH. The patients with good response to medical treatment showed significant improvement in the follow-up posturography. CONCLUSIONS: These findings suggest a significant proprioceptive disturbance in TTH patients. The disturbance is likely related to chronic pericranial muscle contractions causing tenderness.
Classification ; Follow-Up Studies ; Foot ; Gravitation ; Headache ; Humans ; Muscle Contraction ; Muscles ; Tension-Type Headache*

Tension-type headache is now the term used to describe headaches that have previously been grouped under various ill-defined headings, such as 'tension headache', 'stress headache' and 'muscle contraction headache'. Tension-type headaches are characterized by a pain that is mild to moderate in severity, bilateral in distribution, pressing or tightening in quality, and are not accompanied by major systemic disturbances or neurological signs. Tension-type headaches, the most prevalent from of headaches, are differentiated as being either episodic or chronic, Very little research on this disease has actually been carried out, and knowledge about key pathophysiological issues, such as the nature and site of the noxious stimulus, is limited. As a result of this and the lack of scientific interest for this from of headache in the medical field, the treatment is non-specific. However, it is suggested that a peripheral mechanism of tension-type headache be involved in the episodic form, whereas a secondary central sensitization and/or an impaired supraspinal modulation of incoming stimuli be involved in subjects with the chronic from. While most people with tension-type headaches experience mild, infrequent episodes, so that they do not regard the headache as a disease, a monority have chronic and often daily symptoms. The understanding of the balance between peripheral and central components in tension-type headache may lead us to a better prevention and treatment of this most prevalent type of headaches. This article presents a review on the drug therapy of tension-type headaches in adults.
Adult ; Central Nervous System Sensitization ; Drug Therapy* ; Head ; Headache ; Humans ; Tension-Type Headache*