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Cephalalgia. 2018 Oct;38(12):1833-1840. doi: 10.1177/0333102418759784. Epub 2018 Feb 13.

Testing of diagnosis criteria of tension-type headache: A multicenter clinical study.

Author information

1
1 Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
2
2 Department of Neurology, Zhongshan Hospital of Chongqing, Chongqing, China.
3
3 Department of Neurology, Banan People's Hospital of Chongqing, Chongqing, China.
4
4 Department of Neurology, South-West Hospital, Third Military Medical University, Chongqing, China.
5
5 Department of Neurology, The Ninth People's Hospital of Chongqing, Chongqing, China.
6
6 Department of Neurology, The Third Affiliated Hospital of Third Military Medical University, Chongqing, China.
7
7 Department of Neurology, The People's Hospital of Yongchuan District, Chongqing, China.
8
8 Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
9
9 Department of Neurology, The First People's Hospital of Jiangbei District, Chongqing, China.
10
10 Department of Neurology, The Third People's Hospital of Chongqing, Chongqing, China.
11
11 Department of Neurology, Nanchuan People's Hospital of Chongqing Medical University, Chongqing, China.
12
12 Department of Neurology, People's Hospital of Qijiang District, Chongqing, China.
13
13 Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
14
14 Department of Neurology, Chongqing Sanxia Central Hospital, Chongqing, China.
15
15 Department of Neurology, People's Hospital of Bishan County, Chongqing, China.

Abstract

Objective Tension-type headache is *These authors contributed equally to this work. usually manifested as head pain without associated symptoms, and the validation of diagnostic criteria presented are lacking and highly required in the International Classification of Headache Disorders. The aim of the present study was to explore the diagnosis criteria of tension-type headache in a multicenter-based sample from Chongqing, China. Methods Clinical characteristics and demographics were systematically and prospectively collected between March 2014 and December 2015 from 15 participating hospitals in Chongqing, using a semi-structured face-to-face interview. All patients were asked to complete a headache diary for at least 4 weeks. Results Out of 1832 patients with headache, 150 patients (97 female/53 male, 44.56 ± 11.9 years old) were diagnosed with tension-type headache based on the standard International Classification of Headache Disorders, 3rd edition beta version, and interestingly, 114 (76%) patients were diagnosed with tension-type headache based on the alternative criteria. One patient was excluded because only two of the four characteristics were fulfilled. Thirty-five (23.3%) patients did not meet the alternative criteria because of associated symptoms, including mild nausea (n = 6), photophobia (n = 1), and phonophobia (n = 28). All patients with TTH had mild or moderate headaches, 98.0% of patients suffered from non-pulsating headaches, 99.3% of patients said their headaches were not aggravated by routine physical activity, and 77.3% of patients had bilateral headache. Conclusions Non-pulsating headaches and headaches that are not aggravated by routine physical activity may represent core criteria for screening patients with tension-type headache. Nausea might not be an exclusion feature for diagnosis of TTH, but an important criterion for screening. Further studies are needed.

KEYWORDS:

Clinical characteristics; associated symptoms; diagnostic criteria

PMID:
29436849
DOI:
10.1177/0333102418759784

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