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  • Title: [Clinical features of headache of tension type and principles of treatment].
    Author: Esin RG, Esin OR, Naprienko MV.
    Journal: Zh Nevrol Psikhiatr Im S S Korsakova; 2010; 110(9):27-32. PubMed ID: 21183902.
    Abstract:
    We examined 140 patients, aged from 23 to 47 years, with headache of tension type (HAT). Patients were stratified into two groups: HAT with trigger zones in pericranial muscles (HAT-1) and HAT without those (HAT-2). The study included the detection of pain threshold and pain tolerability in pericranial muscles using pressure algometer, quantitative assessment with the McGill Pain Questionnaire, evaluation of depression and anxiety. Loci of primary and secondary hyperalgesia, signs of anxiety disorder were observed in patients with HAT-1. Diclofenac sodium had a temporary effect and tizanidine had a stable positive effect. In patients with HAT-2, we found loci with signs of secondary hyperalgesia in pericranial muscles and symptoms of depression. There was no effect of diclofenac sodium, tizanidine had a subtle positive effect and venlafaxine exerted a good stable effect. In conclusion, there are different pathophysiological mechanisms of HAT with the presence of trigger zones in pericranial muscles and HAT without trigger zones.
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