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September 3, 1994
Tension-type headache is the term designated by the International
Headache Society to describe what was previously called
tension headache, muscle contraction headache, psychomyogenic
headache, stress headache, ordinary headache, and psychogenic
headache. The International Headache Society defines
tension-type headache more precisely, distinguishes between
the episodic and the chronic varieties, and divides them into
two groups, those associated with a disorder of the
pericranial muscles and those not associated with this type of
disorder. Most clinic-based studies of tension-type headache
suffer from selection bias, as they include patients with more
severe headaches, patients with concomitant migraine, and
patients with chronic daily headache. Traditionally, episodic
tension-type headache and migraine have been considered
distinct disorders, and the International Headache Society
continues the separation. Some believe that both migraine and
tension-type headache are recurring benign headaches. Chronic
tension-type headache used to be called chronic daily
headache, but they are not identical. Chronic tension-type
headache must be distinguished from chronic daily headache
even though the International Headache Society has not done
this. Chronic daily headache is a syndrome consisting of a
group of disorders and can be subclassified into primary and
secondary types. The primary chronic daily headache disorders
include transformed migraine, chronic tension-type headache,
new daily persistent headache, and hemicrania continua.
Secondary causes of chronic daily headache include
post-traumatic headache, cervical spine disorders, and
headache associated with vascular disorders and nonvascular
intracranial disorders. Patients with frequent headaches are
prone to overuse analgesics, ergotamine, or both. Most
patients with chronic daily headache overuse symptomatic
medication.
Silberstein SD
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