{{infobox disease | name | Tension headache | Image | Caption | DiseasesDB 12554 | ICD10 | ICD9 , | ICDO | OMIM | MedlinePlus 000797 | eMedicineSubj | eMedicineTopic | MeshID D018781 }} |
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A tension headache (renamed a tension-type headache by the International Headache Society in 1988) is the most common type of primary headache. The pain can radiate from the neck, back, eyes, or other muscle groups in the body. Tension-type headaches account for nearly 90% of all headaches. Approximately 3% of the population has chronic tension-type headaches.
One half of patients with TTH identify stress or hunger as a precipitating factor.
Tension headaches may be caused by muscle tension around the head and neck. One of the theories says that the main cause for tension type headaches and migraine is teeth clenching which causes a chronic contraction of the temporalis muscle.
Another theory is that the pain may be caused by a malfunctioning pain filter which is located in the brain stem. The view is that the brain misinterprets information, for example from the temporal muscle or other muscles, and interprets this signal as pain. One of the main neurotransmitters which is probably involved is serotonin. Evidence for this theory comes from the fact that chronic tension-type headaches may be successfully treated with certain antidepressants such as amitriptyline. However, the analgesic effect of amitriptyline in chronic tension-type headache is not solely due to serotonin reuptake inhibition, and likely other mechanisms are involved. Recent studies of nitric oxide (NO) mechanisms suggest that NO may play a key role in the pathophysiology of CTTH. The sensitization of pain pathways may be caused by or associated with activation of nitric oxide synthase (NOS) and the generation of NO. Patients with chronic tension-type headache have increased muscle and skin pain sensitivity, demonstrated by low mechanical, thermal and electrical pain thresholds. Hyperexcitability of central nociceptive neurons (in trigeminal spinal nucleus, thalamus, and cerebral cortex) is believed to be involved in the pathophysiology of chronic tension-type headache. Recent evidence for generalized increased pain sensitivity or hyperalgesia in CTTH strongly suggests that pain processing in the central nervous system is abnormal in this primary headache disorder. Moreover, a dysfunction in pain inhibitory systems may also play a role in the pathophysiology of chronic tension-type headache.
Botulinum toxin is a treatment trialled by some people with tension-type headache, though results are varied.
ca:Cefalàlgia tensional de:Spannungskopfschmerz et:Pingepeavalu es:Cefalea tensional fr:Céphalée de tension hr:Tenzijska glavobolja it:Cefalea di tipo tensivo ja:緊張性頭痛 nl:Spanningshoofdpijn no:Tensjonshodepine pt:Cefaleia de tensão sv:Spänningshuvudvärk
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