Ictal neck pain investigated in the interictal state – a search for the origin of pain

Cephalalgia ◽  
2019 ◽  
Vol 40 (6) ◽  
pp. 614-624 ◽  
Author(s):  
Jeppe Hvedstrup ◽  
Lærke Tørring Kolding ◽  
Samaira Younis ◽  
Messoud Ashina ◽  
Henrik Winther Schytz
Keyword(s):  
Neck Pain ◽  
Migraine Attack ◽  
Structured Interview ◽  
Tension Type Headache ◽  
Prospective Data ◽  
Muscle Tenderness ◽  
Local Tenderness ◽  
Treatment Responses ◽  
Type Headache ◽  
Interictal State

Background Neck pain is reported in more than 50% of migraine patients during migraine attacks and may be an important source to migraine pain. Objectives To investigate phenotypical differences between migraine patients with and without ictal neck pain in the interictal phase. Additionally, to prospectively examine the association between pericranial muscle tenderness and the impending migraine attack. Methods Migraine patients (n = 100) and controls (n = 46) underwent a semi-structured interview and sensory testing interictally. Pericranial muscle tenderness was determined using total tenderness score and local tenderness score. The occurrence of migraine attacks was then prospectively recorded for the following seven days. Results Patients with ictal neck pain had increased tenderness of pericranial neck muscles compared to migraine patients without ( p = 0.023). Ictal neck pain was not associated with migraine localization, tension-type headache, or markers of central sensitization. Prospective data of 84 patients showed that tenderness of trigeminal sensory innervated muscles increased the migraine attack rate ( p = 0.035). Conclusion The distinction of migraine patients based on the occurrence of ictal neck pain could indicate migraine subtypes and possible involvement of peripheral tissue in the pathophysiology. Whether treatment responses differ among these groups would be fascinating. Additionally, we found that cephalic muscle tenderness is a risk factor for an impending migraine attack.

scholarly journals Muscle stiffness in tension-type headache patients with pericranial tenderness

2018 ◽  
Vol 1 ◽  
pp. 251581631876029 ◽  
Author(s):  
Lærke Tørring Kolding ◽  
Thien Phu Do ◽  
Caroline Ewertsen ◽  
Henrik Winther Schytz
Keyword(s):  
Healthy Volunteers ◽  
Shear Wave ◽  
Muscle Tone ◽  
Shear Wave Elastography ◽  
Tension Type Headache ◽  
Muscle Stiffness ◽  
Muscle Tenderness ◽  
Local Tenderness ◽  
Type Headache ◽  
Headache Patients

Background: Tension-type headache patients have previously been shown to have increased muscle tone, stiffness and tenderness in the trapezius muscle compared to healthy volunteers. Shear wave elastography is a non-invasive method to measure muscle stiffness. The aim of the study was to use shear wave elastography to investigate if tension-type headache patients had increased pericranial muscle stiffness and whether pericranial muscle stiffness correlated to muscle tenderness. Methods: Seventeen patients with very frequent or chronic tension-type headache associated with pericranial tenderness and 29 healthy volunteers were included. Muscle stiffness was measured using shear wave elastography and muscle tenderness was measured using local tenderness score and total tenderness score. Results: There was no statistically significant difference in muscle stiffness between tension-type headache patients and healthy volunteers. The local tenderness and total tenderness scores were higher in tension-type headache patients compared with healthy volunteers. There was no correlation between muscle stiffness and tenderness. Conclusion: We found no sign of increased pericranial muscle stiffness in tension-type headache patients compared with healthy volunteers using shear wave elastography. Our findings do not suggest a generalized pericranial increase in muscle tone in very frequent and chronic tension-type headache patients.

scholarly journals Study of Sleep Disorders and Polysomnographic Evaluation among Primary Chronic Daily Headache Patients

2016 ◽  
Vol 07 (S 01) ◽  
pp. S072-S075 ◽  
Author(s):  
Rajesh Verma ◽  
Kamal Kumar Nagar ◽  
Ravindra Kumar Garg ◽  
Ravi Uniyal ◽  
Praveen Kumar Sharma ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Sleep Disorder ◽  
Chronic Daily Headache ◽  
Daytime Sleepiness ◽  
Structured Interview ◽  
Tension Type Headache ◽  
Chronic Tension Type Headache ◽  
Daily Headache ◽  
Type Headache ◽  
Headache Patients

ABSTRACT Objective: Studies related to sleep disorders and polysomnography (PSG) among chronic daily headache patients are rare. We studied this and compared chronic migraine (CM) with chronic tension-type headache. Methods: Eighty-three patients were recruited. They were evaluated by semi-structured interview, headache, and sleep diaries along with Epworth Sleepiness Scale score and insomnia symptom score. Overnight PSG was performed and data compared. Results: Chronic tension-type headache was more common than CM, both having female preponderance. Insomnia followed by excessive daytime sleepiness was prevalent sleep disorder. Sleep efficiency and Stage 3 sleep were lower in CM compared to chronic tension-type. ESSS was significantly increased among chronic tension-type patients. No significant correlation was found among PSG parameters in patients with or without sleep disorders. Conclusion: Insomnia being most common sleep disorder among chronic headache population. Chronic tension-type headache had slightly better slow-wave sleep than CM and significantly increased daytime sleepiness.

Muscular Disorders in Tension-Type Headache

Cephalalgia ◽  
1996 ◽  
Vol 16 (2) ◽  
pp. 97-103 ◽  
Author(s):  
R Jensen ◽  
BK Rasmussen
Keyword(s):  
Diagnostic Criteria ◽  
Tension Type Headache ◽  
Receiver Operating Characteristics ◽  
Operating Characteristics ◽  
Pain Thresholds ◽  
Muscular Disorders ◽  
Muscle Tenderness ◽  
Manual Palpation ◽  
Type Headache ◽  
Receiver Operating

In order to evaluate the diagnostic criteria for muscular disorders in tension-type headache, pericranial muscle tenderness and pressure pain thresholds were studied in a random sample population of 735 adults aged 25–64. In addition, quantitative EMGs were recorded in 547 of these subjects. The correlation between the three diagnostic tests was assessed and the discriminality and cut-off points were analysed using Receiver Operating Characteristics analysis. Local tenderness from the temporal muscles was closely related to the total tenderness scores from 14 pairs of muscles. In chronic tension-type headache, tenderness was positively related to EMG and inversely related to pain thresholds. In the episodic form the total tenderness score was inversely related to pain thresholds, whereas no significant relation to EMG was noted. The Receiver Operating Characteristics curves indicated that tenderness recorded by manual palpation was the most specific and sensitive test, whereas EMG and pain thresholds were of limited diagnostic value. Eighty-seven percent of subjects with the chronic, and 66% of subjects with the episodic form were found to have a “muscular disorder” defined as increased tenderness recorded by either manual palpation or pressure algometry and/or increased EMG levels. However, muscle tenderness increased significantly during pain, so the headache state should be considered in future studies. Suggestions for revision of the present diagnostic criteria for muscular disorders are given.

scholarly journals Self-reported neck pain is associated with migraine but not with tension-type headache in adolescents

Cephalalgia ◽  
2014 ◽  
Vol 34 (11) ◽  
pp. 895-903 ◽  
Author(s):  
Astrid Blaschek ◽  
Siona Decke ◽  
Lucia Albers ◽  
Andreas Sebastian Schroeder ◽  
Steffi Lehmann ◽  
...  
Keyword(s):  
Neck Pain ◽  
Neck Region ◽  
Cross Sectional Study ◽  
Lifestyle Factors ◽  
Tension Type Headache ◽  
Descending Inhibition ◽  
School Students ◽  
Sensory Afferents ◽  
Cross Sectional ◽  
Type Headache

Aim The aim of the present analysis is to confirm or refute the association of neck pain to migraine or tension-type headache and to assess whether this association is independent of other risk factors for headache. Methods Secondary school students were invited to complete a questionnaire on headache and lifestyle factors in a cross-sectional study. Neck pain was assessed via (a) a screening question concerning neck pain and (b) denoting affected areas in schematic drawings of the human body. Results Absolute increment in prevalence of headache with pain in the shoulder-neck region was between 7.5% and 9.6%. Gender, grade, stress and lifestyle factors were assessed as potential confounding factors. Nearly all factors were associated with shoulder-neck pain and most with headache. After adjustment for confounders, the association of neck pain with headache was almost completely confined to migraine (OR 2.39; 95% CI 1.48–3.85) and migraine + tension-type headache (OR 2.12; 95% CI 1.50–2.99), whereas the association with isolated tension-type headache was negligible (OR 1.22, 95% CI 0.87–1.69). Conclusion Neck pain is associated with migraine but not with tension-type headache. A possible link between migraine and neck pain may be the cervico-trigeminal convergence of neck and meningeal sensory afferents or a disturbed descending inhibition in migraine.

scholarly journals Headache Attributed to SARS-CoV-2 Infection or COVID-19 Related Headache—Not Migraine-Like Problem-Original Research

2021 ◽  
Vol 11 (11) ◽  
pp. 1406
Author(s):  
Aleksandra Kacprzak ◽  
Daniel Malczewski ◽  
Izabela Domitrz
Keyword(s):  
Laboratory Test ◽  
Migraine Attack ◽  
Tension Type Headache ◽  
Neurological Symptoms ◽  
Questionnaire Study ◽  
Original Research ◽  
Antigen Test ◽  
Type Headache ◽  
Medical Healthcare ◽  
Healthcare Employees

Background: Many studies have confirmed headache as one of the most common COVID-19-related neurological symptoms. There are some reports concerning migraine attacks during SARS-CoV-2 infection with an unusual course of migraine attack. Our aim was to recognize and characterize accurately the features of headaches accompanying this disease. Methods: Research based on questionnaire study gathered 100 randomly chosen medical healthcare employees who experienced symptoms associated with COVID-19 disease, 96 with confirmed COVID-19 (positive SARS-CoV-2 PCR laboratory test or positive rapid COVID-19 antigen test). Conclusion: Headaches reported in the study did not fulfill criteria for migraine with/without aura, tension-type headache according to ICHD-3.

scholarly journals Level of physical activity, well-being, stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Lotte Skytte Krøll ◽  
Catharina Sjödahl Hammarlund ◽  
Maria Lurenda Westergaard ◽  
Trine Nielsen ◽  
Louise Bönsdorff Sloth ◽  
...  
Keyword(s):  
Physical Activity ◽  
Neck Pain ◽  
Well Being ◽  
Tension Type Headache ◽  
Self Rated Health ◽  
Type Headache ◽  
Headache And Neck Pain

Prevalence of neck pain in migraine and tension-type headache: A population study

Cephalalgia ◽  
2014 ◽  
Vol 35 (3) ◽  
pp. 211-219 ◽  
Author(s):  
Sait Ashina ◽  
Lars Bendtsen ◽  
Ann C Lyngberg ◽  
Richard B Lipton ◽  
Nazrin Hajiyeva ◽  
...  
Keyword(s):  
Neck Pain ◽  
Primary Headache ◽  
Cross Sectional Study ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Cross Sectional ◽  
Type Headache ◽  
One Year ◽  
The One ◽  
Reported Data

Background We assessed the prevalence of neck pain in the population in relation to headache. Methods In a cross-sectional study, a total of 797 individuals completed a headache interview and provided self-reported data on neck pain. We identified migraine, TTH or both migraine and TTH (M+TTH) groups. Pericranial tenderness was recorded in 496 individuals. A total tenderness score (TTS) was calculated as the sum of local scores with a maximum score of 48. Results The one-year prevalence of neck pain was 68.4% and higher in those with vs. without primary headache (85.7% vs. 56.7%; adjusted OR 3.0, 95% CI 2.0–4.4, p < 0.001). Adjusting for age, gender, education and poor self-rated health, in comparison with those without headaches, the prevalence of neck pain (56.7%) was significantly higher in those with M+TTH (89.3%), pure TTH (88.4%) and pure migraine (76.2%) ( p < 0.05 for all three group comparisons). Individuals with neck pain had higher TTS than individuals without neck pain (15.1 ± 10.5 vs. 8.4 ± 8.0, p < 0.001). Conclusions Neck pain is highly prevalent in the general population and even more prevalent in individuals with primary headaches. Prevalence is highest in coexistent M+TTH, followed by pure TTH and migraine. Myofascial tenderness is significantly increased in individuals with neck pain.

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