Tension-type headache.

Purpose Of Review: This article provides an update on the appropriate diagnosis and evaluation of patients with tension-type headache, with reviews of the latest concepts regarding pathogenesis and the evidence-based recommendations for management of this disorder.

Recent Findings: Pericranial myofascial mechanisms are probably of importance in episodic tension-type headache, whereas sensitization of central nociceptive pathways and inadequate endogenous antinociceptive circuitry seem to be more relevant in chronic tension-type headache. While acute treatment with simple analgesics is generally helpful, recent data attempting to document the efficacy of preventive therapies are unconvincing.

Neuromodulators for migraine prevention.

Migraine is a debilitating condition characterized by a cycle of painful headaches and headache-related symptoms interspersed with periods of worry, distress, and apprehension. The negative impact of migraine on patient functioning, workplace productivity, and other daily activities has been demonstrated through the use of a variety of clinician- and patient-reported assessment tools, including the Migraine-Specific Questionnaire and the Migraine Disability Assessment questionnaire. In addition to considering the frequency and severity of migraine, clinicians need to encourage more open dialogue with their patients about the impact of this disorder on daily activities and productivity.

Prevalence of migraine and response to sumatriptan in patients self-reporting tension/stress headache.

Objective: This study was conducted to evaluate the prevalence of migraine and its responsiveness to migraine-specific therapy in patients with self-reported tension-type headache.

Methods: Patients were adults (n = 423) consulting one of 54 North American study sites including primary care clinics, neurology clinics, and headache clinics. The study comprised an initial diagnosis phase to determine the headache diagnosis of patients entering the study with self-reported tension/stress headache, including that previously diagnosed by a health care provider.

Migraine and tension-type headache: an assessment of challenges in diagnosis.

The difficulty in distinguishing episodic tension-type headache from migraine headache is widely acknowledged. The misdiagnosis of migraine as tension-type headache has potentially significant consequences because it may preclude patients with disabling headaches from receiving appropriate treatment. This article explores the symptomatologic, epidemiologic, and pathophysiologic relationships among migraine and tension-type headaches with the aim of elucidating ways to improve their diagnosis and treatment.

Mixing sumatriptan: a prospective study of stratified care using multiple formulations.

Objective: To assess the acceptability, utility, and tolerability of a system of stratified care of acute migraine using multiple formulations of sumatriptan.

Background: Stratified care matches the treatment of a disease to its level of severity. Sumatriptan, with its multiple formulations, seems a logical option in a stratified care approach.