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*

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

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

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

BACKGROUND: Psychosocial factors exert a significant influence on primary headaches. However, little has been known about the agreement concerning the extent and nature of psychological processes on migraine and tension-type headache (TTH). METHODS: Fifty-five patients with primary headache were enrolled to participate in the study and 33 headache-free control subjects. A depression scale (BDI), an anxiety scale (STAI), a psychopathology scale (SCL-90-R), a stress coping scale (MCS), and a quality-of-life scale (WHOQOL-BREF) were administered to all the participants. RESULTS: The headache sufferers turned out to have various emotional problems, used more inefficient stress coping strategies and lead poor quality of life compared with those who had no headache. No distinctive psychological symptom was found between the two diagnosis groups, but the migraine group showed higher obsessive-compulsive symptoms than the TTH group, and the latter group showed higher levels of trait anxiety than the former. CONCLUSIONS: This study shows that the primary headache sufferers have various psychosocial problems. Accordingly, individual treatment approach focusing on the psychological symptoms is needed for the efficient management of headache.
Anxiety ; Depression ; Diagnosis ; Headache ; Humans ; Migraine Disorders* ; Psychology ; Psychopathology ; Quality of Life ; Tension-Type Headache*

BACKGROUND: Quality-of-life measurement represents an important tool for evaluating the management and impact of headache on individuals and society. The Headache Impact Test-6 (HIT-6) is a simple instrument developed to assess headache-related disability in Western countries. The objective of this study was to determine the reliability and validity of the Korean HIT-6. METHODS: Participants were recruited from patients who visited the Neurology Clinic of Hallym University Sacred Heart Hospital due to headache. The survey included the SF-36 and HIT-6. Headache diagnosis was assigned using ICHD-II after completing a semistructured diagnostic interview. RESULTS: A total of 43 patients were recruited, who were aged 35.2+/-13.6 years (mean+/-SD). Thirty-three and three were diagnosed as having migraine and probable migraine, respectively. Eight and two were diagnosed with tension-type and probable tension-type headache, respectively. There was a negative correlation between the total SF-36 and HIT-6 scores (Spearman's correlation coefficient=-0.64, p<0.01). Similar significant negative correlations were also observed between SF-36 physical health summary and HIT-6 scores (Spearman's correlation coefficient=-0.54, p<0.01), and between SF-36 mental summary and HIT-6 scores (Spearman's correlation coefficient=-0.60, p<0.01). The Cronbach's alpha of HIT-6 was 0.85. CONCLUSIONS: The Korean HIT-6 is a valid and reliable instrument for assessing headache-related quality of life.
Aged ; Headache ; Heart ; Humans ; Migraine Disorders ; Neurology ; Quality of Life ; Reproducibility of Results ; Tension-Type Headache

BACKGROUND: We investigated the demographic features and characteristics of headache (HA) in patients visiting a primary care clinic (PCC). METHODS: We prospectively collected the demographic and clinical data of 261 consecutive HA patients in a PCC located in Taejon from Oct. 1996 to Jul. 1998. All patients were interviewed and examined by a single neurologist. The types of HA were classified as migraine, tension-type, mixed, and others. RESULTS: The mean age at the initial visit was 37.2 +/-13.4 years. Women were 3 times more common than men (193 patients vs. 68 patients). More than half of the female patients were housewives (47.5%). Migraine was the most common type of headache (114 patients, 43.7%), followed by mixed type (72 patients, 27.6%) and tension-type headaches (57 patients, 21.8%). 85.7% of patients with HA for more than 1 month had taken medication before their initial visit. Among the 168 patients who reported their attitude toward HA, 55 patients continuously worried about their HA even in the HA-free period. CONCLUSIONS: In a PCC, migraine was the prevailing type of HA. The majority of HA sufferers were housewives.
Daejeon ; Female ; Headache* ; Humans ; Male ; Migraine Disorders ; Neurology* ; Primary Health Care* ; Prospective Studies ; Tension-Type Headache