Effect of episodic tension-type headache on the health-related quality of life in employees of a Brazilian public hospital.
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OBJECTIVE: To evaluate the impact of ETTH on HRQoL in a sample of employees of a Brazilian public hospital. METHOD: Three hundred and sixty Mario Gatti Hospital employees were asked about headache occurrence in the previous 6 months and completed a SF-36 and a pain questionnaires concerning impact of pain (0 to 10 scale) on daily activities, work efficiency, leisure and social activities in previous six months. Two groups were studied: 1. Episodic Tension-type headache group: 127 employees -- 81 (63.8%) female and 46 (36.2%), male. 2. CONTROL GROUP: 124, 71 (57.3%) female and 53 (42.7%) male. RESULTS: ETTH had lowers scores than control in all domains of SF-36; in vitality and bodily pain the difference was statistically significant. CONCLUSION: Our results indicate that ETTH suffers have impact on HRQoL predominantly in vitality. Psychological factors associated to pain may explain this finding. (+info)
The treatment of migraines and tension-type headaches with intravenous and oral niacin (nicotinic acid): systematic review of the literature.
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BACKGROUND: Migraine and tension-type headaches impose a tremendous economic drain upon the healthcare system. Intravenous and oral niacin has been employed in the treatment of acute and chronic migraine and tension-type headaches, but its use has not become part of contemporary medicine, nor have there been randomized controlled trials further assessing this novel treatment. We aimed to systematically review the evidence of using intravenous and/or oral niacin as a treatment for migraine headaches, tension-type headaches, and for headaches of other etiologic types. METHODS: We searched English and non-English language articles in the following databases: MEDLINE (1966-February 2004), AMED (1995-February 2004) and Alt HealthWatch (1990-February 2004). RESULTS: Nine articles were found to meet the inclusion criteria and were included in this systematic review. Hypothetical reasons for niacin's effectiveness include its vasodilatory properties, and its ability to improve mitochondrial energy metabolism. Important side effects of niacin include flushing, nausea and fainting. CONCLUSION: Although niacin's mechanisms of action have not been substantiated from controlled clinical trials, this agent may have beneficial effects upon migraine and tension-type headaches. Adequately designed randomized trials are required to determine its clinical implications. (+info)
The effects of laser acupuncture on chronic tension headache--a randomised controlled trial.
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OBJECTIVE: Headache affects the quality of life for many people throughout the world. Tension headache is among the commonest forms. Acupuncture is the most widely practised non-medicinal treatment for headaches. The purpose of this study was to explore the effects of laser acupuncture in this type of headache. METHODS: Fifty patients with chronic tension-type headache were randomly allocated to treatment or placebo groups. Patients in the treatment group received low energy laser acupuncture to LU7, LI4, GB14, and GB20 bilaterally. Points were irradiated for 43 seconds, and the intensity was 1.3J (approximately 13J/cm2). Ten sessions were given, three per week. The placebo group was treated in a similar way except that the output power of the equipment was set to zero. The outcome variables were headache intensity (VAS), duration of attacks, and number of days with a headache per month, by daily diary, assessed monthly to three months after treatment. RESULTS: There were significant differences between groups (P<0.001) in changes from baseline in months one, two and three, in median score for headache intensity (treatment group -5, -3 and -2, placebo group -1, 0 and 0), median duration of attacks (treatment group -6, -4 and -4, placebo group -1, 0 and 0 hours), and median number of days with headache per month (treatment group -15, -10 and -8, placebo group -2, 0 and 0). CONCLUSION: This study suggests that laser acupuncture may be an effective treatment for chronic tension-type headache, but the results should be confirmed in larger and more rigorous trials. (+info)
Incidence of primary headache: a Danish epidemiologic follow-up study.
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The incidence of migraine in a general population has been assessed in few longitudinal studies, and the incidence of tension-type headache has never been assessed. The authors aimed to assess the incidence of migraine and tension-type headache in Denmark by conducting a 12-year follow-up study of a general population (1989-2001). The design and methods of follow-up replicated the baseline study exactly, including use of the International Headache Society's diagnostic criteria and administration of headache diagnostic interviews by a physician. Of 740 persons aged 25-64 years examined in 1989, 673 were eligible in 2001 and 549 (81.6%) participated. The incidence of migraine was 8.1 per 1,000 person-years (male:female ratio, 1:6), and the incidence of frequent tension-type headache was 14.2 per 1,000 person-years (male:female ratio, 1:3). Both rates decreased with age. The incidence of migraine was higher than that previously calculated from cross-sectional studies. Risk factors for migraine were familial disposition, no vocational education, a high work load, and frequent tension-type headache. For tension-type headache, risk factors were poor self-rated health, inability to relax after work, and sleeping few hours per night. The gender difference for tension-type headache differed from that for migraine, and no association with educational level was observed. (+info)
Evaluation of visual evoked potentials in children with headache.
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Headache is a common problem in childhood. Visual evoked potential (VEP) P100 latencies were recorded in children with headache. Sixty-four patients, aged 10.7 +/- 1.2 years, met the criteria of the International Headache Society for the diagnosis of migraine. Fifty-eight patients, aged 10.2 +/- 1.3 years, with tension headache and 56 healthy subjects, aged 10.3 +/- 1.3 years, as the control group were also studied. Patients with migraine had slightly longer P100 latencies than the other two groups. We conclude that VEP latency recording is a valuable test in the diagnosis of migraine, and can be safely used in children. (+info)
Acupuncture in patients with tension-type headache: randomised controlled trial.
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OBJECTIVE: To investigate the effectiveness of acupuncture compared with minimal acupuncture and with no acupuncture in patients with tension-type headache. DESIGN: Three armed randomised controlled multicentre trial. SETTING: 28 outpatient centres in Germany. PARTICIPANTS: 270 patients (74% women, mean age 43 (SD 13) years) with episodic or chronic tension-type headache. INTERVENTIONS: Acupuncture, minimal acupuncture (superficial needling at non-acupuncture points), or waiting list control. Acupuncture and minimal acupuncture were administered by specialised physicians and consisted of 12 sessions per patient over eight weeks. MAIN OUTCOME MEASURE: Difference in numbers of days with headache between the four weeks before randomisation and weeks 9-12 after randomisation, as recorded by participants in headache diaries. RESULTS: The number of days with headache decreased by 7.2 (SD 6.5) days in the acupuncture group compared with 6.6 (SD 6.0) days in the minimal acupuncture group and 1.5 (SD 3.7) days in the waiting list group (difference: acupuncture v minimal acupuncture, 0.6 days, 95% confidence interval -1.5 to 2.6 days, P = 0.58; acupuncture v waiting list, 5.7 days, 3.9 to 7.5 days, P < 0.001). The proportion of responders (at least 50% reduction in days with headache) was 46% in the acupuncture group, 35% in the minimal acupuncture group, and 4% in the waiting list group. CONCLUSIONS: The acupuncture intervention investigated in this trial was more effective than no treatment but not significantly more effective than minimal acupuncture for the treatment of tension-type headache. TRIAL REGISTRATION NUMBER: ISRCTN9737659. (+info)
Serious neurological disorders in children with chronic headache.
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AIMS: To determine the prevalence of serious neurological disorders among children with chronic headache. METHODS: All children presenting to a specialist headache clinic over seven years with headache as their main complaint were assessed by clinical history, physical and neurological examination, neuroimaging where indicated, and by follow up using prospective headache diaries. RESULTS: A total of 815 children and adolescents (1.25-18.75 years of age, mean 10.8 years (SD 2.9); 432 male) were assessed. Mean duration of headache was 21.2 months (SD 21.2). Neuroimaging (brain CT or MRI) was carried out on 142 (17.5%) children. The vast majority of patients had idiopathic headache (migraine, tension, or unclassified headaches). Fifty one children (6.3%) had other chronic neurological disorders that were unrelated to the headache. The headache in three children (0.37%, 95% CI 0.08% to 1.1%) was related to active intracranial pathology which was predictable on clinical findings in two children but was unexpected until a later stage in one child (0.12%, 95% CI 0.006% to 0.68%). CONCLUSIONS: Chronic headache in childhood is rarely due to serious intracranial pathology. Careful history and thorough clinical examination will identify most patients with serious underlying brain abnormalities. Change in headache symptomatology or personality change should lower the threshold for imaging. (+info)
Diagnosing headache.
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BACKGROUND: A systematic approach to the diagnosis of primary and secondary headache disorders requires the measurement of the frequency and the duration of headache. OBJECTIVE: This article presents thumbnail sketches of the most important headache subtypes and discusses some of the new revisions and headache types included in the International Classification of Headache Disorders (ICHD 2). DISCUSSION: The clinical features that distinguish secondary headaches requiring urgent investigation (red flags) from those that can be more safely monitored (blue flags) are discussed. (+info)