Tension type headache
- Most common idiopathic headache
- Two types have been distinguished; Episodic and Chronic
Etiology
- Multiple factors
- Psycho-emotional stress situations, anxiety muscles strain and fatigueÆ contraction of pericranial muscles Æ long lasting muscle strains results in ischemia due to blood vessel contraction. This is for Episodic type.
- Chronic type; leading role is the abnormality in the central mechanisms of pain control
Clinical symptoms
- Non pulsating attacks ranging from 30mins to 7 days, involving the head bilaterally
- Pain is pressing or tightening, mild to moderate intensity
- Most often localized in the occipital, temporal or frontal area.
- No nausea
- Frequently accompanied by tingling or stiffness of the paravertebral muscles
Diagnosis
- Episodic; necessary to have at least 10 episodes of the above outlined headache and overall duration of the latter not exceeding 180 days annually or 15 days monthly
- Chronic; these parameters are exceeded.
Treatment
Mild tension headaches do not require treatment. In more severe situations the following therapy is prescribed:
- NSAIDs and analgesics
- Myorelaxants
Chronic tension headache treatment:
- Antidepressants
- Anticonvulsants
- Local therapy with botulinum toxin
- Psychological treatment
- Physiotherapy; muscles relaxation exercises, massages and acupuncture