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Cefaleia tensional

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão: 18 Sep 2025
Última atualização: 01 Apr 2025

Resumo

Definição

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • dor de cabeça generalizada
  • dor de cabeça frontal ou occipital
  • dor de cabeça não pulsátil
  • dor constritiva
  • exame neurológico normal
Full details

Other diagnostic factors

  • sensibilidade pericraniana
  • sensibilidade do músculo esternocleidomastoideo
  • sensibilidade do músculo trapézio
  • sensibilidade do músculo temporal
  • sensibilidade do músculo pterigoideo lateral
  • sensibilidade do músculo masseter
  • fotofobia ou fonofobia
  • náuseas
  • uso regular de analgésicos
  • ansiedade e depressão
  • Somatização
Full details

Risk factors

  • tensão mental
  • estresse
  • pular refeições
  • fadiga
  • privação de sono
  • Somatização
  • sexo feminino
  • idade 20-39 anos
  • situação socioeconômica baixa
  • uso excessivo de analgésicos
Full details

Diagnostic tests

1st tests to order

  • diagnóstico clínico
Full details

Tests to consider

  • tomografia computadorizada (TC) dos seios da face
  • ressonância nuclear magnética (RNM) cranioencefálica
  • punção lombar
  • polissonografia
Full details

Treatment algorithm

ACUTE

ataque agudo

ONGOING

sintomas crônicos (>7 a 9 dias de cefaleia/mês)

Contributors

Authors

Mark W. Green, MD, FAAN
Mark W. Green

Professor of Neurology, Anesthesiology and Rehabilitation Medicine

Emeritus 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.

Rachel Colman, MD

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

Sait Ashina, MD

Assistant Professor of Neurology and Anesthesia

Harvard Medical School

Director of Comprehensive Headache Center

Beth Israel Deaconess Medical Centre

Boston

MA

Disclosures

SA has received honoraria from and is a consultant for Abbvie/Allergan, Eli Lilly, Linpharma, Lundbeck, Satsuma, Teva, Theranica, Percept, and Impel NeuroPharma. SA is an author of one of the references in this topic.

Giles Elrington, MBBS (Hons), MD, FRCP

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, AstraZeneca, MSD, Almirall, Pfizer, Menarini, Allergan, Biogen, Teva, Conference Plus, Infomed, BMJ.

Paul Davies, MA, MD, FRCP

Consultant Neurologist

Northampton General Hospital

Northampton

UK

Disclosures

PD declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan 25;38(1):1-211.Full text

Ashina S, Mitsikostas DD, Lee MJ, et al. Tension-type headache. Nat Rev Dis Primers. 2021 Mar 25;7(1):24. Abstract

Bendtsen L, Evers S, Linde M, et al. EFNS guideline on the treatment of tension-type headache - report of an EFNS task force. Eur J Neurol. 2010 Nov;17(11):1318-25.Full text  Abstract

Headaches in pregnancy and postpartum: ACOG clinical practice guideline No. 3. Obstet Gynecol. 2022 May 1;139(5):944-72. Abstract

Banzi R, Cusi C, Randazzo C, et al. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) for the prevention of tension-type headache in adults. Cochrane Database Syst Rev. 2015;(5):CD011681.Full text  Abstract

Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev. 2016;(4):CD007587.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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