Tension-Type Headache

Tension-type headache or TTH is a chronic headache syndrome which is characterized by tight, band like bilateral discomfort in head. Although the name (a misnomer) is “tension-type headache”, it is not related to any sort of nervous tension. The headache of tension-type headache starts slowly and progresses slowly with fluctuation of severity of headache (sometime headache is severe and sometime the severity decreases), although sometimes headache may be continuous in nature lasting for several days at times. The headache of tension-type headache may be episodic or chronic. Tension-type headache is termed chronic when headache is present for at least 15 days in a month.

Symptoms of Tension-type headache:

The symptoms of tension-type headache include bilateral chronic pain in head, better described as tight, band like discomfort. The headache of tension-type headache may be chronic or episodic in nature. The head pain of tension-type headache may fluctuate in severity.

What are the causes and pathophysiology of TTH?

The exact cause and pathophysiology of tension-type headache is not yet clearly understood. The most reasonable explanation of tension-type headache is that the TTH is due to pain modulation of central nervous system only, unlike migraine which is due to generalized disturbance in sensory modulation.

Some data suggests that there is a genetic factor in causation of tension-type headache, but the data seems to be not valid.

How to Differentiate Tension-type headache from Migraine?

Unlike migraine, tension-type headache (TTH) is not accompanied by symptoms such as nausea, vomiting, photophobia, phonophobia, osmophobia, throbbing, and aggravation of headache with movement, which can easily distinguish tension-type headache from migraine. But according to International Headache Society’s definition of tension-type headache, nausea, photophobia, or phonophobia may be present in tension-type headache, which makes it difficult to differentiate tension-type headache and migraine.

 

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