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Determinants of Tension-Type Headache in Children
Anttila P, Metsahonkala L, et al.
Posted: April 2003  
Cephalalgia 2002;22:401-408


The objective of this study was to study the prevalence, characteristics, and predisposing factors of tension-type headache in children. An unselected population-based questionnaire study was carried out in 1,409 Finnish schoolchildren aged 12 years. Of them, 1135 (81 percent) returned an acceptably completed questionnaire. The prevalence of episodic tension-type headache in children was 12 percent. Children with episodic tension-type headache also often reported characteristics of pain typical for migraine. Children with frequent and persistent episodic tension-type headache reported stabbing and severe occipital pain, phonophobia, and abdominal pain significantly more often than children with infrequent episodic tension-type headache. Neck-shoulder symptoms, symptoms of depression, and oromandibular dysfunction were each independently associated with episodic tension-type headache. The father’s occupation of a lower-level white-collar worker put the child at a 4-fold risk for episodic tension-type headache. The authors conclude that episodic tension-type headache is as common as migraine in children. It can be associated with depression, oromandibular dysfunction, and muscular stress. Children with frequent and persistent episodic tension-type headache especially report characteristics of pain typical for migraine.