Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • generalised head pain
  • frontal or occipital head pain
  • non-pulsatile head pain
  • constricting pain
  • normal neurological examination

Other diagnostic factors

  • pericranial tenderness
  • sternocleidomastoid muscle tenderness
  • trapezius muscle tenderness
  • temporalis muscle tenderness
  • lateral pterygoid muscle tenderness
  • masseter muscle tenderness
  • photophobia or phonophobia
  • regular analgesic use
  • anxiety and depression
  • somatisation

Risk factors

  • mental tension
  • stress
  • missing meals
  • fatigue
  • somatisation
  • female sex
  • age 20-39 years
  • lower socioeconomic status
  • analgesic overuse

Diagnostic investigations

Investigations to consider

  • CT sinus
  • MRI brain
  • lumbar puncture
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Mark W. Green

Professor of Neurology, Anesthesiology and Rehabilitation Medicine

Director of Headache and Pain Medicine

Icahn School of Medicine at Mount Sinai

New York

NY

Disclosures

MWG declares that he has no competing interests.

Assistant Professor of Neurology

Icahn School of Medicine at Mount Sinai

New York

NY

Disclosures

RC declares that she has no competing interests.

Peer reviewers VIEW ALL

Consultant Neurologist

Barts Health NHS Trust

London

UK

Disclosures

GE is involved in a number of clinical trials on multiple sclerosis sponsored by Genzyme, Roche, Teva, Novartis, Biogen, as well as one funded by the MRC. He is also involved in clinical trials sponsored by Allergan, NMT Medical, GlaxoSmithKline (GSK), Bristol-Myers, the UK's Parkinson's Disease Research Group, and Pharmacia. In addition, he has attended lectures, conferences, and symposia with the following companies - GSK, Astra Zeneca, MSD, Almirall, Pfizer, Menarini, Allergan, Biogen, Teva, Conference Plus, Infomed, BMJ.

Director

Walton Headache Center

Augusta

GA

Disclosures

MSH declares that he has no competing interests.

Consultant Neurologist

Northampton General Hospital

Northampton

UK

Disclosures

PD declares that he has no competing interests.

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