Seshia Shashi S, Abu-Arafeh Ishaq, Hershey Andrew D
Division of Pediatric Neurology, Department of Pediatrics (SSS), University of Saskatchewan, Saskatoon, SK, Canada.
Can J Neurol Sci. 2009 Nov;36(6):687-95. doi: 10.1017/s0317167100008295.
Tension-type headache (TTH) may be as common a headache disorder as migraine in children and adolescents. TTH has a neurobiological basis with genetic and environmental factors making variable contributions to the different sub-types. The diagnostic criteria for TTH in the second edition of the "International Classification of Headache Disorders" appear to be applicable to children. Anxiety and mood disorders may be co-morbid with frequent episodic and chronic TTH. Psychosocial stressors play an important role in precipitating and maintaining TTH. Hence, a biopsychosocial approach should be adopted for care. Standardized histories and examinations together with prospective headache diaries are the foundations for good management; attention to 'red flags' will help identify secondary causes that present with headache similar to TT. There are no randomized controlled drug trials for the treatment of TTH. Relaxation and cognitive behavioral therapies are effective. TTH in children and adolescents warrants greater recognition from the clinician and scientist. Studies focusing on TTH are overdue.
紧张型头痛（TTH）在儿童和青少年中可能是一种与偏头痛同样常见的头痛疾病。TTH具有神经生物学基础，遗传和环境因素对不同亚型的影响各不相同。《国际头痛疾病分类》第二版中TTH的诊断标准似乎适用于儿童。焦虑和情绪障碍可能与频繁发作性和慢性TTH共病。心理社会压力源在TTH的诱发和维持中起重要作用。因此，应采用生物心理社会方法进行护理。标准化的病史和检查以及前瞻性头痛日记是良好管理的基础；关注“红旗”将有助于识别与TTH相似的头痛的继发原因。目前尚无治疗TTH的随机对照药物试验。放松和认知行为疗法是有效的。儿童和青少年中的TTH需要临床医生和科学家给予更多的认识。针对TTH的研究早就该进行了。
