Céphalées de tension

Tension type headache (TTH) has a higher prevalence than migraine; thus it is a frequent reason for consultation and it must not be denied. The diagnostic criteria of TTH defined by the International Classification of Headache Disorders (ICHD) are non-specific, especially allowing to contrast with migraine, because tension type headache is a heterogeneous entity of multifactorial origin. So, explorations are sometimes necessary to exclude a secondary headache. A distinction is made between infrequent and frequent episodic TTH and chronic TTH. Depending on the type of TTH studies suggest different pathophysiological mechanisms. We retain an activation of peripheral myofascial structures and a central sensitization phenomenon. The management is based on the treatment of the pain with NSAIDs, sometimes associated with a prophylactic treatment for frequent and chronic TTH. Patients suffering from chronic TTH justify multidisciplinary management to prevent the risk of chronicization and analgesics abuse.