Variables associated with use of symptomatic medication during a headache attack in individuals with tension-type headache: a European study

Background In literature, osmophobia is reported as a specific migrainous symptom with a prevalence of up to 95%. Despite the International Classification of Headache Disorders 2nd edition proposal of including osmophobia among accompanying symptoms, it was no longer mentioned in the ICHD 3rd edition. Methods We conducted a prospective study on 193 patients suffering from migraine without aura, migraine with aura, episodic tension-type headache or a combination of these. After a retrospective interview, each patient was asked to describe in detail osmophobia, when present, in the following four headache attacks. Results In all, 45.7% of migraine without aura attacks were associated with osmophobia, 67.2% of migraineurs reported osmophobia in at least a quarter of the attacks. No episodic tension-type headache attack was associated with osmophobia. It was associated with photophobia or phonophobia in 4.3% of migraine without aura attacks, and it was the only accompanying symptom in 4.7% of migraine without aura attacks. The inclusion of osmophobia in the ICHD-3 diagnostic criteria would enable a 9.0% increased diagnostic sensitivity. Conclusion Osmophobia is a specific clinical marker of migraine, easy to ascertain and able to disentangle the sometimes challenging differential diagnosis between migraine without aura and episodic tension-type headache. We recommend its inclusion among the diagnostic criteria for migraine as it increases sensitivity, showing absolute specificity.

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Association between social JETLAG/chronotype and time preference of headache attack in migraine and tension-type headache

Sleep Medicine ◽

10.1016/j.sleep.2019.11.459 ◽

2019 ◽

Vol 64 ◽

pp. S166

Author(s):

H.-J. Im ◽

C.-H. Yun ◽

M.K. Chu

Keyword(s):

Time Preference ◽

Tension Type Headache ◽

Headache Attack ◽

Social Jetlag ◽

Type Headache

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Evidence Based Migraine Prophylactic Drug Therapy

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100000160 ◽

1999 ◽

Vol 26 (3) ◽

pp. 27-32 ◽

Cited By ~ 19

Author(s):

W.J. Becker

Keyword(s):

Clinical Trials ◽

Drug Therapy ◽

Scientific Evidence ◽

Tension Type Headache ◽

Beneficial Effects ◽

Symptomatic Medication ◽

Prophylactic Drugs ◽

Prophylactic Drug ◽

Patient Will ◽

Type Headache

Prophylactic drug therapy is a major component of overall migraine management. However, because we do not know how currently used prophylactic drugs exert their beneficial effects in migraine, their use is based primarily on clinical trials. In general, prophylactic drugs are indicated when patients have three or more attacks a month and symptomatic medication use alone is not satisfactory. The choice of drug must be individualized, and is influenced by contraindications, potential side effects, the need to treat associated symptoms like tension-type headache and insomnia, and drug cost. Whether an individual patient will respond to a given drug cannot be predicted, but there are varying degrees of scientific evidence supporting the use of each prophylactic drug in migraine. This evidence is best for metoprolol, divalproex, amitriptyline, atenolol, flunarizine and naproxen. Based on placebo-controlled crossover studies, it would appear that at least some prophylactic drugs exert the greater part of their prophylactic effects very quickly, and that these also disappear very quickly once the drug is stopped. This may not apply to all prophylactic drugs and more research is needed. More well designed clinical trials are needed to guide our use of migraine prophylactic drugs. Although clinical experience is useful, placebo responses and variations in the migraine tendency over time can make interpretation of this experience difficult. Major advances will likely only occur once the pathogenesis of migraine and the mode of action of the prophylactic drugs is better understood.

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The burden attributable to headache disorders in children and adolescents in Lithuania: estimates from a national schools-based study

The Journal of Headache and Pain ◽

10.1186/s10194-021-01237-3 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Diana Genc ◽

Nerija Vaičienė-Magistris ◽

Apolinaras Zaborskis ◽

Tayyar Şaşmaz ◽

Aylin Yeniocak Tunç ◽

...

Keyword(s):

Children And Adolescents ◽

Medication Overuse Headache ◽

Symptom Burden ◽

Tension Type Headache ◽

Emotional Impact ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Symptomatic Medication ◽

Nationally Representative ◽

Type Headache

Abstract Background We recently showed headache to be common in children (aged 7–11 years) and adolescents (aged 12–17) in Lithuania. Here we provide evidence from the same study of the headache-attributable burden. Methods Following the generic protocol for Lifting The Burden’s global schools-based study, this cross-sectional survey administered self-completed structured questionnaires to pupils within classes in 24 nationally representative schools selected from seven regions of the country. Headache diagnostic questions were based on ICHD-3 beta criteria but for the inclusion of undifferentiated headache (UdH; defined as mild headache with usual duration < 1 h). Burden enquiry was conducted in multiple domains. Results Questionnaires were completed by 2505 pupils (1382 children, 1123 adolescents; participating proportion 67.4%), of whom 1858 reported headache in the preceding year, with mean frequency (±SD) of 3.7 ± 4.5 days/4 weeks and mean duration of 1.6 ± 1.9 h. Mean proportion of time in ictal state, estimated from these, was 0.9% (migraine 1.5%, probable medication-overuse headache [pMOH] 10.9%). Mean intensity on a scale of 1–3 was 1.6 ± 0.6 (mild-to-moderate). Symptomatic medication was consumed on 1.5 ± 2.8 days/4 weeks. Lost school time was 0.5 ± 1.5 days/4 weeks (migraine 0.7 ± 1.5, pMOH 5.0 ± 7.8) based on recall, but about 50% higher for migraine according to actual absences recorded in association with reported headache on the preceding day. More days were reported with limited activity (overall 1.2 ± 2.4, migraine 1.5 ± 2.2, pMOH 8.4 ± 8.5) than lost from school. One in 30 parents (3.3%) missed work at least once in 4 weeks because of their son’s or daughter’s headache. Emotional impact and quality-of-life scores generally reflected other measures of burden, with pMOH causing greatest detriments, followed by migraine and tension-type headache, and UdH least. Burdens were greater in adolescents than children as UdH differentiated into adult headache types. Conclusions Headache in children and adolescents in Lithuania is mostly associated with modest symptom burden. However, the consequential burdens, in particular lost school days, are far from negligible for migraine (which is prevalent) and very heavy for pMOH (which, while uncommon in children, becomes four-fold more prevalent in adolescents). These findings are of importance to both health and educational policies in Lithuania.

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Time preference of headache attack and chronotype in migraine and tension-type headache

Chronobiology International ◽

10.1080/07420528.2019.1658202 ◽

2019 ◽

Vol 36 (11) ◽

pp. 1528-1536 ◽

Cited By ~ 1

Author(s):

Hee-Jin Im ◽

Seol-Hee Baek ◽

Chang-Ho Yun ◽

Min Kyung Chu

Keyword(s):

Time Preference ◽

Tension Type Headache ◽

Headache Attack ◽

Type Headache

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Characterization of headaches in the premenstrual tension syndrome

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2009000100010 ◽

2009 ◽

Vol 67 (1) ◽

pp. 40-42 ◽

Cited By ~ 5

Author(s):

Yara Dadalti Fragoso ◽

Andrea Cristina Rodrigues Guidoni ◽

Luciana Brites Ribeiro de Castro

Keyword(s):

Premenstrual Syndrome ◽

Migraine Without Aura ◽

International Headache Society ◽

Tension Type Headache ◽

Common Type ◽

Obstetrics And Gynecology ◽

Headache Attack ◽

Premenstrual Tension ◽

Type Headache

OBJECTIVE: Characterization of headaches in premenstrual syndrome (PMS). Although headache is one of the symptoms for PMS, no details on this headache are given by the American College of Obstetrics and Gynecology (ACOG) criteria. METHOD: A group of 45 fertile age women presenting PMS were invited to complete a registration diary for headache and PMS symptoms for three consecutive months. The diary included details of each headache attack, allowing for classification according to the International Headache Society criteria (IHS-2004). RESULTS: Migraine without aura was the most common type of headache in PMS (n=27, 60%), followed by tension type headache (n=15, 30%). Only in two cases the type of headache varied among the observed months, and only in one case the diagnosis could not be concluded by the IHS-2004 criteria. CONCLUSION: Better clinical and therapeutic approach to headache in PMS can be achieved if the patient's type of headache could be properly characterized.

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Yoga Therapy for Chronic Tension-Type Headache

Global Journal of Health Science ◽

10.5539/gjhs.v11n5p94 ◽

2019 ◽

Vol 11 (5) ◽

pp. 94

Author(s):

Neha Sharma ◽

PJ John ◽

Chandra M Sharma ◽

Ram Vaidya

Keyword(s):

Controlled Trial ◽

Preliminary Evidence ◽

Tension Type Headache ◽

Post Intervention ◽

Headache Attack ◽

Yoga Therapy ◽

Chronic Tension Type Headache ◽

Therapy Program ◽

Type Headache ◽

Randomised Controlled

OBJECTIVE: To evaluate the clinical efficacy of yoga therapy for Chronic Tension-Type Headache. METHOD: 68 patients diagnosed with chronic tension-type headache were included in 12- week yoga therapy program. All patients completed baseline assessments before starting the intervention and at 4, 8 and 12 weeks completing the yoga therapy. Headache frequency, duration, intensity and analgesics use were recorded through headache diaries. RESULT: Compared with baseline values, mean headache days reduced 51% after 4-week of intervention which continued to reduce by 78% by end of 12 weeks. Comparing from baseline, at 12-week, duration of each headache attack also significantly (P < 0.0001) shortened as well as headache intensity (p < 0.0001). Days with medication per four weeks at post intervention were lower than those at the baseline. CONCLUSION: The study provided preliminary evidence that yoga therapy can be clinically useful for chronic tension-type headache. Further randomised controlled trial is needed.

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Headache characteristics and chronification of migraine and tension-type headache: A population-based study

Cephalalgia ◽

10.1177/0333102409357958 ◽

2010 ◽

Vol 30 (8) ◽

pp. 943-954 ◽

Cited By ~ 31

Author(s):

Sait Ashina ◽

Ann Lyngberg ◽

Rigmor Jensen

Keyword(s):

Chronic Headache ◽

Clinical Characteristics ◽

Univariate Analysis ◽

Multivariate Logistic Regression Analysis ◽

Tension Type Headache ◽

Primary Headaches ◽

Headache Attack ◽

Poor Outcome ◽

Type Headache

Migraine and tension-type headache (TTH) can increase in frequency and transform from episodic to chronic forms. The process of transformation of these primary headaches is complex and involves multiple risk factors. In this cross-sectional and longitudinal population study, we aimed to investigate the relation of clinical characteristics of primary headaches to poor outcome: new-onset or persistent chronic headache (≥180 days/year). Individuals who had migraine + / − TTH and those who had pure TTH were studied separately. Of 740 individuals who entered this study in 1989, 673 were eligible for follow-up in 2001, and a total of 549 individuals participated in the follow-up study. At baseline in 1989, no difference was found between episodic and chronic migraine headache ( + / − TTH). Duration of headache episodes >72 hours ( p = .002) was associated with pure chronic TTH at baseline in 1989 whereas aggravation of headache by physical activity ( p = .045) was associated with pure frequent episodic TTH. Of 64 subjects with migraine + / − TTH, 12 had a poor outcome in 2001. For pure TTH, of 116 subjects at baseline, 11 had a poor outcome in 2001. Using multivariate logistic regression analysis with adjustment for medication overuse and use of preventive medications, poor outcome of migraine + / − TTH tended to be associated with a baseline pulsating quality and severe intensity of migraine, photophobia and phonophobia, as well as longer duration of an individual headache attack. For pure TTH, unilateral headache, nausea and individual headache attack duration greater than 72 hours was associated with poor outcome. Pooled data univariate analysis revealed that nausea, daily use of acute headache medications, use of headache preventive medications and coexistent headaches were significant predictors of chronic headache in 2001( p<.05). In conclusion, our study demonstrates that certain clinical characteristics of headaches are associated with poor outcome but alone may not predict the chronification of migraine or TTH.

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Tension-type headache in patients with concomitant musculoskeletal disorders

Russian Osteopathic Journal ◽

10.32885/2220-0975-2019-3-4-72-79 ◽

2020 ◽

pp. 72-79

Author(s):

Yu. O. Novikov ◽

I. E. Salakhov

Keyword(s):

Cervical Spine ◽

Drug Therapy ◽

Drug Treatment ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Tension Type Headache ◽

World Health ◽

Standard Drug ◽

Rehabilitation Treatment ◽

Type Headache

Introduction. According to the defi nition of the World Health Organization (WHO), tension-type headache (TTH) is the most common type of primary headache. Rehabilitation of patients with chronic tension-type headache continues to be an important socio-medical problem. Its main goal is the most complete restoration of the functions of the musculoskeletal system of the neck, the correction of vascular and psychoemotional problems, and the patient′s return to his everyday life and work. As a rule, the main emphasis in the treatment of such patients is placed primarily on drug therapy. At the same time, practitioners are faced with a number of problems — the low effectiveness of the treatment, the nonpersistency of the results, allergic reactions, polypharmacy and others. All this suggests that there is a need for differentiated rehabilitation treatment of patients with tension-type headache with the use of various non-pharaceutical methods. The goal of research — to evaluate the clinical effi cacy of complex non-drug therapy in patients with tension-type headache.Materials and methods. The prospective controlled randomized study, which was conducted from October 2017 to March 2019 at the Department of Medical Rehabilitation of the Bashkir State Medical University, included 110 patients with TTH from the age of 20 to 45 years. All patients, depending on the treatment methodology used, were randomly divided into two groups of 55 people. Patients of the main group received complex rehabilitation treatment with the use of non-drug methods: osteopathic correction, acupuncture and exercise therapy. Patients in the control group received treatment in accordance with the standard of medical care for TTH (analgesics, non-steroidal antiinfl ammatory drugs, antidepressants, vasoactive and nootropic drugs). The study of the clinical effectiveness of the therapy included: an assessment of the severity of pain with the use of a visual analogue scale and a tensoalgimeter, a goniometric study with an assessment of the volume of active movements in the cervical spine, transcranial ultrasound dopplerography with an assessment of quantitative indicators in the system of the middle cerebral artery.Results. The use of complex non-drug therapy in patients with TTH compared with standard drug therapy leads to a signifi cantly more important decrease in the severity of pain, an increase in pain threshold, an increase in the volume of active movements in the cervical spine. The effect of non-drug treatment methods on blood fl ow in the system of the middle cerebral artery is comparable in its effectiveness with the use of pharmaceutical drugs.Conclusion. The proposed complex rehabilitation treatment of patients with TTH with the use of non-drug methods has shown clinical effi cacy which is comparable, and in a number of indicators, superior to the effectiveness of conventional medical treatment. All this determines the necessity of wider implementation of multidisciplinary non-drug treatment of patients with this pathology.

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