Tension Type Headaches

Question 1

What are the types Tension headaches?

Answer 1

• Infrequent episodic TTH
• Frequent episodic TTH
• Chronic TTH

Question 2

Infrequent Episodic TTH: Criteria

Answer 2

• 10 or more episodes on <1 d/mo
• Length: 30 min - 7 days
• 2+ of the following
  bilateral location
  Pressing or tightening(non-pulsating)
  Mild or moderate
  Physical Activity does not aggravate
• Both of:
  No N & V
  Either Photophobia or Phonophobia
• No other ICHD-3 dx

Question 3

Frequent Epidsodic TTH: Critieria

Answer 3

• 10 or more episodes on 1-14/d/mo for > 3 mo
• Same as Infrequent episodic

Question 4

Chronic TTH: Criteria

Answer 4

• 15+ d/mo for > 3 mo
• length: Hours to days or unremitting
• Both of:
  either: Photophobia, phonophobia, mild nausea
  Not Moderate-Severe nausea or Vomitting
• Rest is same

Question 5

Tension Type Headaches: General

Answer 5

• Most common HA
• F>M
• Onset: 20-40 y.o

Question 6

Episodic TTH: General

Answer 6

• Bilateral (Band-like or cap-like)
• Location: Occiipital, parietal, temporal, frontal
• Quality: Pressure like, dull, or tightness
• Severity: Mild to moderate
• Duration: 30 mins-7days

Question 7

Episodic TTH: Precipitating or aggravating factors

Answer 7

• Stress
• fatigue
• disturbed meals
• menstruation
• alcohol
• lack of sleep
  NOT BY PHYSICAL ACTIVITY

Question 8

Episodic TTH: Associated Signs

Answer 8

• Disability to Pain:
  Pain severity
  frequency
• No Sleep
• Moderate Anorexia
• Mild Photophobia or phonophobia

Question 9

Chronic TTH: General

Answer 9

• Middle aged F w/past Hx of TTH
• Location: Bilateral
  frontal, temporal or frontotemporal
  sometimes occipital
• Quality: Pressure-like
• Moderate Pain
• Temporal Pattern: continous or daily HA
  23-30 HA/mo

Question 10

Chronic TTH: Associated signs

Answer 10

• Increased pericranial tenderness in muscles
• Photophobia or Phonophobia
• Physical activity worsens pain in a subgroup of pts
• Lack restorative sleep
• Depression
• Anxiety
• Nausea