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Presentation
Both migraine and tension headaches are the main causes of headaches among the population. It is stated that around 36 million Americans suffer from migraine headaches (Lipton & Silberstein, 2015). In contrast, tension headache constitutes 90% of all headaches, but only 3% are manifested in the chronic form (Omidi & Zargar, 2015). Migraine is almost always more severe than tension headache due to the throbbing pain. The risk factors of a tension headache include stress, anxiety, or exhaustion, whereas migraine’s causes are well-established, and there is a possibility of genetic influences (Eidlitz-Markus et al., 2017). Therefore, both forms of headaches are common among the public.
Pathophysiology
The pathophysiological aspect of both headache types differs depending on the severity. It is stated that migraine is primarily linked to genes that cause brain disorders (Ferrari et al., 2015). These genes might be responsible for pain-sensing, synaptic function, glutamatergic neurotransmission, and vasculature (Ferrari et al., 2015). Thus, the clinical correlates of an incipient migraine attack are symptoms of the prodromal period. It includes the decreased concentration of attention, emotional lability, and increased sensitivity to light, which occur several hours before the onset of the headache. Typical triggers of an attack include emotional stress, sleep deprivation or excessive sleep, skipping meals, and sensory stimulation. However, tension headache is mostly multifactorial, and the primary involvers are facial muscles and stress-related brain changes.
Assessment
Assessment of both types of headaches is based on physical examination and patient history of diseases. Migraine headaches are distinctively assessed during the nighttime complaints, where a person’s sleep is disrupted due to the issue (Olesen, 2018). In the case of tension, one should be aware that the process might include an analysis of the prevalence of anxiety burden or emotional stress. These symptoms can be accompanied by natural bodily responses, such as muscle tightness around the face and skull (Omidi & Zargar, 2015). In addition, the presence of a wide range of migraine symptoms makes it necessary to proceed with diagnostic testing on the instance of their occurrences in a patient.
Diagnosis
Diagnosis of the given headache types needs to be determined on the basis of criteria defined by the International Headache Association (IHS). If the pain is pulsating, and ranges from moderate to severe, lasts for 4-72 hours, and it occurred five or more times, then the migraine is diagnosed (Olesen, 2018). However, tension headache is determined by two factors, such as non-throbbing tightness in the head and the pain ranging from mild to moderate, which cannot be affected by physical activity (Mock, 2016). Therefore, migraine diagnosis requires a stricter set of criteria for diagnosis, whereas tension headache needs only two.
Treatment
Migraine headache treatment in both acute and chronic cases focuses on alleviating symptoms. Non-drug approach can be used in the former case, where an individual avoids an unpleasant stimulus, such as loud noise, bright light, and high temperature (Lipton & Silberstein, 2015). In addition, analgesics can be utilized, such as acetaminophen and NSAIDs (Lipton & Silberstein, 2015). In the case of severe episodic forms, drugs such as triptans can be prescribed. Tension headaches require mostly non-pharmacological treatments, which might revolve around stress-reduction measures and rest. In addition, cognitive behavior therapy can be useful among patients suffering from chronic tension headaches (Omidi & Zargar, 2015). Therefore, migraine treatment procedures are more tuned and specific based on individual needs and drug tolerance.
References
Eidlitz-Markus, T., Zolden, S., Haimi-Cohen, Y., & Zeharia, A. (2017). Comparison of comorbidities of migraine and tension headache in a pediatric headache clinic. Cephalalgia, 37(12), 1135-1144.
Ferrari, M. D., Klever, R. R., Terwindt, G. M., Ayata, C., & van den Maagdenberg, A. M. J. M. (2015). Migraine pathophysiology: Lessons from mouse models and human genetics. The Lancet: Neurology, 14(1), 65-80.
Lipton, R. B., & Silberstein, S. D. (2015). Episodic and chronic migraine headache: Breaking down barriers to optimal treatment and prevention. Headache: The Journal of Head and Face Pain, 55, 103-122.
Mock, D. (2016). Diagnosing tension headaches and migraine. In A.J. Moule & M.L. Hicks (Eds.), Diagnosing Dental and Orofacial Pain: A Clinical Manual (pp. 103-105). John Wiley & Sons.
Olesen, J. (2018). International classification of headache disorders. The Lancet Neurology, 17(5), 396-397.
Omidi, A., & Zargar, F. (2015). Effects of mindfulness-based stress reduction on perceived stress and psychological health in patients with tension headache. Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences, 20(11), 1058-1063. Web.
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