A 3-Year Follow-Up of Headache Diagnoses and Symptoms in Swedish Schoolchildren

Information is sparse concerning the incidence and prognosis of headache in children from the general population, especially of tension-type headache. In this study, headache diagnoses and symptoms were reassessed in 122 out of 130 schoolchildren after 3 years. Nearly 80± of those with headache at first evaluation still reported headache at follow-up. Although the likelihood of experiencing the same headache diagnosis and symptoms was high, about one-fifth of children with tension-type headache developed migraine and vice versa. Female gender predicted migraine and frequent headache episodes predicted overall headache at follow-up. The estimated average annual incidence was 81 and 65 per 1000 children, for tension-type headache and migraine, respectively. We conclude that there is a considerable risk of developing and maintaining headache during childhood. Headache diagnoses should be reassessed regularly and treatment adjusted. Girls and children with frequent headache have a poorer prognosis and therefore intervention is particularly important in these groups.

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Management of Vataja Shirashula with Kusthadi Shirolepa and Goghrita Pratimarsha Nasya - A Case Report

International Journal of Ayurveda and Pharma Research ◽

10.47070/ijapr.v9i6.1924 ◽

2021 ◽

pp. 29-33

Author(s):

Jyothi S ◽

Ashwini M.J

Keyword(s):

Case Report ◽

Side Effects ◽

General Population ◽

Tension Type Headache ◽

Cranial Vault ◽

Classical Correlation ◽

Main Mode ◽

Vital Part ◽

Type Headache

Shiras, also known as Uttamanga is the most vital part of our body. In Ayurveda, Shiro rogas are restricted to pain or discomfort seen around cranial vault and not the disorders of brain as such. Headache is the most frequent and troublesome reason to seek medical help in our day to day life. Tension type headache is the most common, primary, most neglected and difficult to treat occurring in about three-quarters of the general population. They can range from the occasional mild headaches to daily disabling headaches in some cases. Current allopathic approach is highly limited in treating the disease with just pain killers, which again have lot of side effects. Holistic Ayurveda approach practically is found to yield very good results in the patients of headache. Vataja Shiroroga can be an apt classical correlation of Tension-type headache. Atiuccha bhashana, Vegadharana, Ratrijagarana, Upavasa and Shoka are the major causes of Vataja shirashula. Classical books of Ayurveda advocate the use of Snehana, Swedana, Navana nasya, Snaihika dhumapana and local Vatahara kriya like Lepa and Parisheka as main mode of treatment. Nasya is a special therapy in all Shalakya disorders and Goghrita is considered as best Vatahara dravya. Kushtadi Lepa is indicated in Vataja Shiroroga classically. In this study, Kushtadi shirolepa and Goghrita pratimarsha nasya is done in a 19 year old patient having typical symptoms, to access the overall efficacy. After 1 month of therapy, significant improvement was seen in the symptoms. Mild recurrence was seen post follow-up period.

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Change in intraindividual ICHD-II headache diagnosis over time: A follow-up of the DMKG headache study

Cephalalgia ◽

10.1177/0333102412465203 ◽

2012 ◽

Vol 33 (1) ◽

pp. 25-33 ◽

Cited By ~ 9

Author(s):

Laura Khil ◽

Andreas Straube ◽

Stefan Evers ◽

Klaus Berger

Keyword(s):

Adult Population ◽

Epidemiological Studies ◽

Tension Type Headache ◽

Frequent Use ◽

Headache Diagnosis ◽

International Headache Classification ◽

Type Headache ◽

The Individual ◽

Over Time

Background Change in headache diagnoses over time within the same individual is not well studied in the adult population. In this study, we prospectively examined the individual variation of migraine and tension-type headache (TTH) diagnoses over time. Methods As part of the epidemiological Deutsche Migräne und Kopfschmerzgesellschaft (DMKG) headache study, 1312 participants were personally interviewed and 1122 responded to a second mailed questionnaire 2.2 years later. Headaches were assigned to migraine or TTH at two different points in time using the International Headache Classification, ICHD-II. We used broad (definite and probable subtypes) and strict (only definite type) definitions of migraine and TTH. Results Using the broad definition increased the reproducibility of migraine diagnosis from 48.0% to 62.0% and of TTH from 59.0% to 65.0%. A constant TTH diagnosis was related to a higher social status (OR 2.81; 95% CI 1.43–5.53) a higher level of education (OR 1.96; 95% CI 1.00–3.85) and physical inactivity (OR 2.28; 95% CI 1.16–4.49). A constant diagnosis of definite migraine was associated with severe headache (OR 2.64; 95% CI 0.97–7.21) and frequent use of headache medication (OR 4.73; 95% CI 0.95–23.60). The result that coexisting TTH decreased the likelihood of a constant migraine (OR 0.29; 95% CI 0.10–0.85) is assumed to indicate response variability. Conclusions In epidemiological studies, definite and probable subtypes should be included in the diagnosis to increase the diagnostic accuracy.

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Exteroceptive Suppression of Temporalis Muscle Activity: Findings in Headache

Cephalalgia ◽

10.1046/j.1468-2982.1993.1301011.x ◽

1993 ◽

Vol 13 (1) ◽

pp. 11-14 ◽

Cited By ~ 16

Author(s):

Thomas-Martin Wallasch ◽

Hartmut Göbel

Keyword(s):

Muscle Activity ◽

Silent Period ◽

Tension Type Headache ◽

Temporalis Muscle ◽

Pharmacological Agents ◽

Chronic Tension Type Headache ◽

Exteroceptive Suppression ◽

Headache Diagnosis ◽

Secondary Phenomenon ◽

Type Headache

Exteroceptive suppression of temporalis muscle activity was proposed by Schoenen and co-workers in 1987 as a tool in headache diagnosis and research. Their finding of a decreased or abolished second silent period (ES2) in chronic tension-type headache sufferers has been confirmed by several independent laboratories during the last five years. Temporalis silent periods have also been studied in various other types of headaches. Their modulation by neuropsychological factors and pharmacological agents has also been investigated as well as their retest reliability. The pathophysiological concept of muscle contraction in tension-type headache has been challenged by studies using temporalis silent periods. The exterocepfive suppression of temporalis muscle activity points unequivocally towards a central pathogenetic mechanism, although it remains unclear whether the abnormalities of temporalis ES2 represent the primary dysfunction or a secondary phenomenon in chronic tension-type headache.

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Behavioural Management of Headache Triggers: Three Case Examples Illustrating a New Effective Approach (Learning to Cope with Triggers)

Behaviour Change ◽

10.1017/bec.2015.8 ◽

2015 ◽

Vol 32 (3) ◽

pp. 202-208 ◽

Cited By ~ 5

Author(s):

Paul R. Martin ◽

Moira Callan ◽

Archana Kaur ◽

Karen Gregg

Keyword(s):

Traditional Approach ◽

Tension Type Headache ◽

Post Treatment ◽

Case Examples ◽

Medication Consumption ◽

Alternative Approach ◽

Treatment Changes ◽

Type Headache ◽

Behavioural Management

The traditional approach to headache trigger management is to advise avoidance of all triggers, but we have advocated an alternative approach called ‘Learning to Cope with Triggers’ (LCT), in which the objective is to desensitise headache sufferers to some triggers or to build up tolerance for the triggers, using exposure techniques. A recent publication established the efficacy of this approach to trigger management. Reported here are three cases to illustrate how LCT is used in practice. Two cases were male and one was female, with ages ranging from 32 to 67 years. The headache diagnoses were frequent episodic tension-type headache, migraine without aura, and chronic tension-type headache; all had had headaches since childhood/adolescence. The headache triggers that were the focus of the intervention were heat, tiredness, and stress/anger. Post-treatment, changes in the capacity of the triggers to elicit headaches were reported in all three cases. Reductions in headaches from pre- to post-treatment, and from pre- to 4-month follow-up, were: case 1, 69% and 60% respectively; case 2, 76% and 80% respectively; and case 3, 73% and 61% respectively. Decreases in medication consumption, and enhanced self-efficacy were also recorded.

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Population-Based Validation of a German-Language Self-Administered Headache Questionnaire

Cephalalgia ◽

10.1111/j.1468-2982.2008.01560.x ◽

2008 ◽

Vol 28 (6) ◽

pp. 605-608 ◽

Cited By ~ 35

Author(s):

M-S Yoon ◽

M Obermann ◽

G Fritsche ◽

M Slomke ◽

P Dommes ◽

...

Keyword(s):

General Population ◽

Population Sample ◽

Population Based ◽

Tension Type Headache ◽

German Language ◽

General Population Sample ◽

Trigeminal Autonomic Cephalalgia ◽

Screening Questionnaires ◽

Headache Clinic ◽

Type Headache

We validated a German-language self-administered headache questionnaire for migraine (M), tension-type headache (TTH) and trigeminal autonomic cephalalgia (TAC) in a general population sample of people with headache. Randomly selected subjects ( n = 240) diagnosed by the questionnaire as M ( n = 60), TTH ( n = 60), a combination of M and TTH (M+TTH, n = 60) and TAC ( n = 60) were invited for examination by headache specialists. One hundred and ninety-three subjects (80%) were studied. Sensitivity and specificity for M were 0.85 and 0.85, for TTH 0.6 and 0.88, for M+TTH 0.82 and 0.87, respectively. Cohen's κ was 0.6 (95% confidence interval 0.50, 0.71). Of 45 patients with TAC according to the questionnaire, physicians diagnosed cluster headache in two patients only. We conclude: (i) the questionnaire can be used to diagnose M, TTH and M+TTH, but not TAC; (ii) screening questionnaires for epidemiological research should be validated in a general population sample but not in a tertiary headache clinic.

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СОЦІАЛЬНО-ДЕМОГРАФІЧНІ ТА КЛІНІЧНІ ХАРАКТЕРИСТИКИ ПАЦІЄНТІВ З АБУЗУСНИМ ГОЛОВНИМ БОЛЕМ В ПОЄДНАНІ З ХРОНІЧНИМ ГОЛОВНИМ БОЛЕМ НАПРУГИ

The Medical and Ecological Problems ◽

10.31718/mep.2021.25.3-4.01 ◽

2021 ◽

Vol 25 (3-4) ◽

pp. 3-7

Author(s):

М.Ю. Дельва ◽

І.І. Дельва ◽

В.А. Пінчук ◽

Г.Я. Силенко ◽

А.М. Кривчун

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Abdominal Obesity ◽

Medication Overuse Headache ◽

Depression Scale ◽

Female Gender ◽

Tension Type Headache ◽

Primary Headaches ◽

Exact Test ◽

Type Headache

Introduction. A study of medication overuse headache (MOH) can define the risk group for MOH in patients with primary headaches. The aim of the research is to study the socio-demographic, clinical and pharmacotherapeutic characteristics of patients with MOH and chronic tension-type headache (CTTH). Material and methods. We examined 28 patients with MOH in combination with CTTH and 34 patients with CTTH. MOH and CTTH were diagnosed according to the International Classification of Headache Disorders 3rd revision. Anxiety and depressive signs were assessed by the Hospital Anxiety and Depression Scale; abdominal obesity was determined using waist circumference. Quantitative values were presented as the median and the interquartile range. Quantitative samples were analyzed according to Mann-Whitney U-test, qualitative samples - according to Fisher's exact test. Differences at p <0.05 were considered significant. Results. Patients with MOH and CTTH had the following characteristics: female gender - 79%, age - 41.0 (33.0-49.5) years, familyless state - 54%, higher education - 25%, employment - 46%, smoking - 43%, anxiety signs - 71%, depressive signs - 75%, cervicalgia - 36%, lower back pain - 61%, arterial hypertension - 21%, diabetes mellitus - 7%, abdominal obesity - 46%, mild traumatic brain injury - 43%, headache intensity - 5.0 (4.0-6.3) points on a visual analog scale, duration of headache attacks - 7.0 (5.0-8.3) hours, age of CTTH onset - 31,5 (23,0-41,0) years, duration of CTTH - 9.0 (6,8-10,3) years, duration of MOH – 15.5 (8.3-20.8) months. Patients with MOH and CTTH compared to patients with CTTH were significantly younger, had a history of traumatic brain injury, had significantly more headache days per month. Patients with MOH and CTTH overused combined analgesics (47%), nonsteroidal anti-inflammatory drugs (32%), triptans with analgesics (21%). Abortive medications had been used on 23.0 (18.0-28.5) days a month, in form of 32.0 (27.3 -41.8) doses a month.

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Efficacy of Physiotherapy Including a Craniocervical Training Programme for Tension-Type Headache; A Randomized Clinical Trial

Cephalalgia ◽

10.1111/j.1468-2982.2006.01163.x ◽

2006 ◽

Vol 26 (8) ◽

pp. 983-991 ◽

Cited By ~ 73

Author(s):

H van Ettekoven ◽

C Lucas

Keyword(s):

Controlled Trial ◽

Training Group ◽

Training Programme ◽

Time Frame ◽

Primary Outcome Measure ◽

Tension Type Headache ◽

Control Group ◽

Headache Frequency ◽

Type Headache

We conducted a multicentre, randomized controlled trial with blinded outcome assessment. The treatment period was 6 weeks with follow-up assessment immediately thereafter and after 6 months. The objective was to determine the effectiveness of a craniocervical training programme combined with physiotherapy for tension-type headache. Eighty-one participants meeting the diagnostic criteria for tension-type headache were randomly assigned to an exercise group (physiotherapy and an additional craniocervical training programme) and a control group (physiotherapy alone). The primary outcome measure was headache frequency. Secondary outcomes included headache intensity and duration, Quality of Life (SF-36) and the Multidimensional Headache Locus of Control scale (MHLC). At 6 months' follow-up, the craniocervical training group showed significantly reduced headache frequency, intensity and duration ( P < 0.001 for all). Effect sizes were large and clinically relevant. Loss to follow-up amounted to 3.7±. Physiotherapy including craniocervical training reduces symptoms of tension-type headache significantly over a prolonged time frame.

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The Sensitivity and Specificity of the Case Definition Criteria in Diagnosis of Headache: A School-Based Epidemiological Study of 5562 Children in Mersin

Cephalalgia ◽

10.1046/j.1468-2982.2003.00474.x ◽

2003 ◽

Vol 23 (2) ◽

pp. 138-145 ◽

Cited By ~ 48

Author(s):

A Özge ◽

R Buğdayci ◽

T Şaşmaz ◽

H Kaleağasi ◽

Ö Kurt ◽

...

Keyword(s):

Gold Standard ◽

Positive Likelihood Ratio ◽

Tension Type Headache ◽

Case Definition ◽

Recurrent Headache ◽

School Based ◽

Childhood Headache ◽

Stratified Sample ◽

Type Headache ◽

Sensitivity Specificity

The objectives of the present study were to estimate the prevalence of recurrent headaches in schoolchildren (ranging from 2nd to 5th degrees) in Mersin city of Turkey and to determine the sensitivity, specificity, positive predictive value and positive likelihood ratio of the diagnostic headache characteristics in children with migraine and Tension Type Headache (TTH) using neurologist's diagnosis as the gold standard. The stratified sample of study was composed of 5562 children. The prevalence of recurrent headache was 49.2% (2739 of 5562) and the prevalence of current headache was 31.3% (859 of 2739). TTH was more common than migraine (24.7% vs. 10.4%). The most sensitive headache characteristic for migraine was ‘severity of pain’ and the most sensitive definitive symptom is ‘duration of headache’ in children with TTH. IHS-based symptom definition criteria are highly beneficial in diagnosis of childhood headache, if used together with detailed clinical assessment.

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