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Tension-type headache in children

Hope O'Brien, MD, FAHS
Section Editors
Marc C Patterson, MD, FRACP
Jerry W Swanson, MD, MHPE
Deputy Editor
John F Dashe, MD, PhD


Headache is a common complaint of children and adolescents. When a child presents with headache, it is important to determine whether the cause is due to primary disorder, as in migraine or tension-type headache (TTH) versus secondary, due to a brain lesion or infection (table 1).

This topic will review TTH in children. Other aspects of pediatric headache are reviewed elsewhere. (See "Headache in children: Approach to evaluation and general management strategies" and "Classification of migraine in children" and "Pathophysiology, clinical features, and diagnosis of migraine in children".)


Based upon criteria from the International Classification of Headache Disorders, 3rd edition (ICHD-3), TTH is characterized by a bilateral, non-throbbing head pain of mild to moderate intensity, lasting 30 minutes to seven days [1]. TTH is not accompanied by nausea or vomiting. Either photophobia or phonophobia may be present (but not both). The headache is not aggravated by routine physical activity. The term "tension-type headache" replaces the previous terms "muscle contraction headache" and "tension headache".

The overlap of some of these symptoms with those of migraine can make differentiation between the two headache types difficult [2]. (See 'Evaluation and diagnosis' below and 'Differential diagnosis' below.)

The current classification distinguishes three subforms of TTH [1]:

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Literature review current through: Nov 2017. | This topic last updated: Jun 01, 2016.
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