Tension-type headache in the young

Hershey, Andrew D.; Kabbouche, Marielle A.; Powers, Scott W.

doi:10.1007/s11916-006-0080-5

Cited by 8 publications

(4 citation statements)

References 23 publications

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“…In fact, Lewis et al [8] estimated that about 20% of the children with primary headache need medical therapy. Furthermore, as tension type headache is also problematic for children, this headache needs further study [9, 10]. …”

Section: Introductionmentioning

confidence: 99%

Referred pain from myofascial trigger points in head and neck–shoulder muscles reproduces head pain features in children with chronic tension type headache

Fernández‐de‐las‐Peñas

Fernández-Mayoralas

Ortega‐Santiago

et al. 2011

J Headache Pain

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Our aim was to describe the referred pain pattern and areas from trigger points (TrPs) in head, neck, and shoulder muscles in children with chronic tension type headache (CTTH). Fifty children (14 boys, 36 girls, mean age: 8 ± 2) with CTTH and 50 age- and sex- matched children participated. Bilateral temporalis, masseter, superior oblique, upper trapezius, sternocleidomastoid, suboccipital, and levator scapula muscles were examined for TrPs by an assessor blinded to the children’s condition. TrPs were identified with palpation and considered active when local and referred pains reproduce headache pain attacks. The referred pain areas were drawn on anatomical maps, digitalized, and also measured. The total number of TrPs was significantly greater in children with CTTH as compared to healthy children (P < 0.001). Active TrPs were only present in children with CTTH (P < 0.001). Within children with CTTH, a significant positive association between the number of active TrPs and headache duration (rs = 0.315; P = 0.026) was observed: the greater the number of active TrPs, the longer the duration of headache attack. Significant differences in referred pain areas between groups (P < 0.001) and muscles (P < 0.001) were found: the referred pain areas were larger in CTTH children (P < 0.001), and the referred pain area elicited by suboccipital TrPs was larger than the referred pain from the remaining TrPs (P < 0.001). Significant positive correlations between some headache clinical parameters and the size of the referred pain area were found. Our results showed that the local and referred pains elicited from active TrPs in head, neck and shoulder shared similar pain pattern as spontaneous CTTH in children, supporting a relevant role of active TrPs in CTTH in children.

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Section: Introductionmentioning

confidence: 99%

Referred pain from myofascial trigger points in head and neck–shoulder muscles reproduces head pain features in children with chronic tension type headache

Fernández‐de‐las‐Peñas

Fernández-Mayoralas

Ortega‐Santiago

et al. 2011

J Headache Pain

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“…Although there has been an increasing knowledge in the pathogenesis of tension-type headache (TTH), the pathoanatomical mechanisms are not completely understood (3). As TTH has several negative repercussions for children, further studies are needed (4,5).…”

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confidence: 99%

Genetic Contribution of Catechol-O-Methyltransferase Polymorphism (Val158Met) in Children With Chronic Tension-Type Headache

Fernández‐de‐las‐Peñas¹,

Ambite-Quesada

Rivas-Martínez

et al. 2011

Pediatr Res

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ABSTRACT:Our aim was to investigate the relationship between Val158Met polymorphisms, headache, and pressure hypersensitivity in children with chronic tension-type headache (CTTH). A casecontrol study with blinded assessor was conducted. Seventy children with CTTH associated with pericranial tenderness and 70 healthy children participated. After amplifying Val158Met polymorphism by polymerase chain reactions, we assessed genotype frequencies and allele distributions. We classified children according to their T ension-type headache is the most common form of head pain in both adult (1) and child (2) population. Although there has been an increasing knowledge in the pathogenesis of tension-type headache (TTH), the pathoanatomical mechanisms are not completely understood (3). As TTH has several negative repercussions for children, further studies are needed (4,5).Genetic epidemiological studies have investigated the familial aggregation of TTH. In fact, in individuals with chronic TTH (CTTH), first-degree relatives have a 3.1-fold significantly increased risk of suffered from CTTH (6,7), suggesting a possible role of genetic factors in CTTH. The catechol-Omethyltransferase (COMT) gene is one of the several potential headache genetic determinants. The COMT is an enzyme involved in the metabolic degradation of dopamine, norepinephrin, and epinephrine (8). Several studies indicate that the genetic polymorphism due to a G3 A substitution at codon 158 of the COMT gene, which leads to a valine (Val) to methionine (Met) substitution, results in differences in COMT activity: a valine (Val) at codon 158 results in a heat-stable, high-activity COMT variant (Val/Val), whereas a methionine (Met) at this position (Val/Met, or Met/Met) results in heatlabile, low-activity variants (9,10). Zubieta et al. (11) demonstrated that individuals with Val/Val genotype have a 3-to 4-fold higher activity of the COMT enzyme and reduced pain sensitivity compared with those with the Met/Met genotype, suggesting that the presence of Met/Met genotype may predispose for chronic pain.Although it might be possibly an influence of COMT polymorphisms for chronic pain, few studies have examined the association between Val158Met polymorphisms and headache. In addition, results from the studies are controversial, as one study found that the frequency of Met/Met genotype was higher in subjects with migraine (12), whereas others reported no differences in genotype distribution and allele frequency of COMT polymorphisms between migraine and healthy subjects (13,14). Another study did not find relationship of Val158Met polymorphism at the COMT in individuals with medication overuse chronic daily headache, episodic migraine without aura, and without analgesic abuse and healthy controls (15). Therefore, more studies are required.In addition, mechanical hypersensitivity is considered a clear manifestation of hyperexcitability of peripheral and central nociceptive pain pathways in TTH, in both adults (16) and children (17). Jensen et al. (18) have recently rep...

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“…Personal approaches have been detailed. 16,33,54,55 Children should be allowed to use their own words in describing their symptoms. Families should be advised to keep detailed diaries prior to the first appointment so that prospective information is available to be reviewed time-effectively.…”

Section: History and Physical Examinationmentioning

confidence: 99%

Tension-Type Headache in Children: The Cinderella of Headache Disorders!

Seshia¹,

Abu‐Arafeh²,

Hershey³

2009

Can. j. neurol. sci.

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Tension-Type Headache (TTH) is the most common primary headache in adults. 1 In one study, the lifetime prevalence for migraine was 8% in men and 25% for women, while that for TTH was 69% and 88% respectively. 2 As a consequence, TTH has a greater personal and economic impact than migraine. 1,3 Despite its frequency and effect on individuals and society, TTH is a 'neglected headache disorder' that has 'to fight for its recognition '. 3,4 Relative to migraine, TTH is often overlooked by the clinician, neglected by the basic scientist and ignored by the pharmaceutical industry. 4 Additionally, TTH is socially minimized because of the psychological overtones associated with the name. Tension-type headache in children (the term will be used to include adolescents) has suffered a similar fate and deserves to be rescued from the cellars of pediatric headache. This review is aimed at this end. ClassificationThe sub-classification of TTH in the 2nd edition of the International Headache Society's 'The International Classification of Headache disorders' [ICHD-II] 1 is an expansion of that in the first [ICHD I].5 For the most part, the differences are not substantive. Table 1 is an abbreviated version.1 The ABSTRACT: Tension-type headache (TTH) may be as common a headache disorder as migraine in children and adolescents. TTH has a neurobiological basis with genetic and environmental factors making variable contributions to the different sub-types. The diagnostic criteria for TTH in the second edition of the "International Classification of Headache Disorders" appear to be applicable to children. Anxiety and mood disorders may be co-morbid with frequent episodic and chronic TTH. Psychosocial stressors play an important role in precipitating and maintaining TTH. Hence, a biopsychosocial approach should be adopted for care. Standardized histories and examinations together with prospective headache diaries are the foundations for good management; attention to 'red flags' will help identify secondary causes that present with headache similar to TT. There are no randomized controlled drug trials for the treatment of TTH. Relaxation and cognitive behavioral therapies are effective. TTH in children and adolescents warrants greater recognition from the clinician and scientist. Studies focusing on TTH are overdue.RÉSUMÉ: Céphalée de tension chez les enfants : la Cendrillon des céphalées! La céphalée de tension (CT) est peut-être aussi fréquente que la migraine chez les enfants et les adolescents. La CT a un fondement neurobiologique, et des facteurs génétiques et environnementaux contribuent de façon variable à différents sous-types de CT. Le critère diagnostique de la CT dans le ICHD-II paraît applicable aux enfants. L'anxiété et les troubles de l'humeur peuvent être des entités co-morbides chez ceux qui présentent une CT épisodique et chronique fréquente. Les facteurs de stress psychosociaux jouent un rôle important dans son déclenchement et son entretien. Une approche biopsychosociale de soins doit donc être préconisée. La base...

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Tension-type headache in the young

Cited by 8 publications

References 23 publications

Referred pain from myofascial trigger points in head and neck–shoulder muscles reproduces head pain features in children with chronic tension type headache

Referred pain from myofascial trigger points in head and neck–shoulder muscles reproduces head pain features in children with chronic tension type headache

Genetic Contribution of Catechol-O-Methyltransferase Polymorphism (Val158Met) in Children With Chronic Tension-Type Headache

Tension-Type Headache in Children: The Cinderella of Headache Disorders!

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