HA- Tension-Type

Question 1

Episodic tension-type HA diagnosis

Answer 1

Lasts 30 minutes-7 days

At least 2 of the following 4 characteristics:
Bilateral location
Pressing or tightening (non-pulsating) quality
Mild or moderate intensity
Not aggravated by routine physical activity like walking or climbing stairs

No N/V
No more than 1 of photophobia or phonophobia

Question 2

Chronic Tension-Type HA diagnosis

Answer 2

HA occurring on ≥15 days/month on average for >3 months (≥180 days/year), fulfilling criteria B-D
Lasting hours-days, or unremitting

At least 2/4 of the following characteristics
Bilateral location
Pressing or tightening (non-pulsating) quality
Mild or moderate intensity
Not aggravated by routine physical activity like walking or climbing stairs

Both of the following:
No more than 1 of photophobia, phonophobia, or mild nausea
No moderate or severe N/V

Question 3

Acute treatment of tension HA

Answer 3

APAP, NSAIDs, combination analgesics with caffeine, combination analgesics with butalbital or codeine (not preferred)

Question 4

Preventative treatment of tension HA: ADs

Answer 4

TCAs, mirtazapine, venlafaxine

Question 5

Preventative treatment of tension HA: AEDs

Answer 5

Gabapentin, topiramate

Question 6

Preventative treatment of tension HA: other/nonpharm

Answer 6

Trigger point injections

Question 7

What should you counsel patients on when they get a medication for tension-type HA?

Answer 7

MEDICATION OVERUSE HA