Tension headache Flashcards

1
Q

Define tension headache

A

Headache generalised through the head with a predilection for involving the frontal and occipital regions
Either episodic or chronic
Rarely disabling or associated with any significant autonomic phenomena
Do not tend to seek medical care as they successfully self-treat

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2
Q

What is the aetiology for tension headaches

A

Often thought to be due to peri-cranial muscle contraction (little evidence to support)

triggered by psychological stress, associated with insomnia and sleep disorders

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3
Q

What are the risk factors for tension headache

A

Mental tension
Stress
Missing meals
Fatigue
Somatisation | female sex | 20-39 |lower socioeconomic status | analgesic overuse

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4
Q

What are the symptoms of tension headache

A

Headache
- Often frontal and occipital regions
- Bilateral
- Gradual or acute onset
- Dull, non-pulsatile, constricting pain - “tight band around the head”
- 3-4 hours
- Exacerbated by stress, exertion, lack of sleep
- Relieved by analgesic
Photophobia/phonophobia

(normal exam)

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5
Q

What is the management for tension headache

A

Clinical diagnosis

Acute: analgesia e.g. paracetamol, aspirin, ibuprofen

Chronic: antidepressants e.g. amitryptilline
- EMG biofeedback
- Relaxation training
- CBT
- Acupuncture
- Physiotherapy
- Hypotherapy

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6
Q

What classifies chronic tension headache

A

> 7-9 headache days/months

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7
Q

What are the complications from treatment of tension headache

A

Peptic ulcer from repeated NSAID use
Medication overuse headache

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