소아 긴장형두통의 진단과 치료

Diagnosis and Treatment of Pediatric Tension Type Headache

The tension-type headache is at least as common as migraine, affecting 10-25% of schoolchildren and adolescents. The distinction of tension-type headache from migraine can be difficult; use of The International Classification of Headache Disorders (ICHD) criteria helps. In ICHD-2, the same diagnostic criteria are used for the diagnosis of tension-type headache in children, adolescents, and adults. These criteria divide tension-type headache into three subtypes: infrequent episodic, frequent episodic, and chronic. The pathophysiology of tension-type headache is largely unkown. Recently, many believe that tension-type headache and migraine represent the same pathophysiological spectrum. Some indications of effective treatment exist. For children with frequent headache, the antidepressant amitriptyline might be beneficial for prophylaxis. Restricted studies have suggested the efficacy of psychological and cognitive behavioural approaches in the treatment of childhood tension-type headache.