Paediatrics: Tension-Type Headaches: Free MSRA Podcast

🎧 FREE MSRA Podcast: Tension-Type Headache (TTH)Let’s demystify one of the most common headache types — dull, pressing, band-like pain that almost everyone’s felt. Perfect for your MSRA prep or general clinical clarity! 💡💆‍♂️🧠🧠 Key Revision Points📌 Definition• Primary headache disorder: bilateral, dull, non-pulsating pain• Feels like a “tight band” around the head🧠 Mnemonic: BLT-NOTBilateralLess severeTightness/pressureNot aggravated by activityOccipital/frontalTypically no nausea📌 Diagnosis Criteria (Children)• ≥10 previous headaches• Duration: 30 mins to 7 days• At least 2 features:– Pressing/tightening (non-pulsatile)– Mild/moderate intensity– Bilateral– Not worsened by activity• No nausea/vomiting• At most 1 of photophobia or phonophobia📌 Types of TTH• Episodic: <15 days/month• Chronic: ≥15 days/month🚨 Chronic TTH linked with:• Medication overuse• Depression & anxiety📌 Causes & Risk Factors• Muscle tension (esp. neck/scalp)• Stress & psychological distress• Poor posture, screen time, lack of sleep• Pain processing dysfunction (central sensitisation)• Family history📌 Symptoms & Signs• Bilateral pressure/tightness• No aura, no vomiting• Able to function despite discomfort• Exam: Usually normal ± scalp/neck tenderness🧠 Mnemonic: PRESSTIGHTPressure painRare nauseaEpisodes last hours–daysSymmetrical (bilateral)Simple analgesics helpTender musclesInsidious onsetGeneral function intactHeightened stress linkTypically no aura📌 Differential Diagnosis• Migraine (throbbing, aura, photophobia + nausea)• Giant cell arteritis (esp. >50s)• Subarachnoid haemorrhage (sudden “thunderclap”)• Trigeminal neuralgia, TMJ, sinusitis• Cervical spondylosis, CO poisoning, encephalitis📌 Investigations• Clinical diagnosis• Neuroimaging only if red flags (e.g. sudden onset, neuro deficits, fever, age >50, cancer/HIV hx)❌ Avoid unnecessary CT/MRI, eye tests, C-spine x-rays unless atypical📌 Management✅ Lifestyle First• Reassure + educate• Reduce stress• Exercise, good posture• CBT or physiotherapy if needed❌ Avoid opioids, codeine, benzodiazepines✅ Acute Meds (Episodic TTH)• Ibuprofen 400 mg (1st line)• Paracetamol, naproxen, aspirin (if suitable)⚠️ Avoid frequent use (>10–15 days/month) → medication overuse headache✅ Preventive (Chronic TTH)• Amitriptyline (low-dose tricyclic antidepressant)• Consider withdrawal after 4–6 months• Nortriptyline if amitriptyline not tolerated❌ SSRIs, beta blockers, benzodiazepines not recommended📌 Prognosis• Good with lifestyle modification• Episodic TTH is manageable• Chronic TTH may affect QOL but improves with consistent care• Main complication: medication overuse headache📚 Useful Resources for MSRA Prep📝 Revision Notes:https://www.passthemsra.com/topic/tension-type-headache-tth-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/tension-type-headache-tth-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/tension-type-headache-tth-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/tension-type-headache-tth-rapid-quiz/🎓 Full Paediatrics Course:https://www.passthemsra.com/courses/paediatrics-for-the-msra/#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAFlashcards #MSRAQuestionBank #MSRAQandANotes #MSRAAccordions #TensionTypeHeadache #PrimaryHeadache #HeadacheMedicine #MSRAOnlineRevision #Paediatrics #PassTheMSRA