Neuro

Question 1

What is a tension type headache (TTH)?

Answer 1

A tension-type headache (TTH) is the most common type of headache and is often described as a dull, aching pain or pressure around the forehead, temples, or back of the head

Question 2

H&E of TTH

Answer 2

• Bifrontal/occipital pain
• Episodic in nature
• Pressure/band-like tightness around head
• Lasts a few hours

Question 3

RF of TTH

Answer 3

• Stress
• Fatigue
• Mental tension

Question 4

Investigations of TTH

Answer 4

First investigation is clinical diagnosis (normal neuro exam) and diagnosis via exclusion

Consider (if headache is refractory or progressing):
- CT sinus : exclude sphenoid sinusitis
- MRI : exclude brain tumour
- Lumbar puncture : exclude infective causes, sinus venous thrombosis or pseudotumour cerebri

Question 5

Management of TTH

Answer 5

Acute - simple analgesics (aspirin, paracetamol, ibuprofen or naproxen)

Chronic (> 7-9/month)
- antidepressant (amitriptyline or doxepin)
- muscle relaxant (tizanidine)
- consider non-drug therapies

Prophylactic acupuncture