eMedicine Specialties > Neurology > Headache and Pain

Muscle Contraction Tension Headache: Differential Diagnoses & Workup

Author: Manish K Singh, MD, Assistant Professor, Pain Management, Department of Neurology, Drexel College of Medicine, Hahnemann University Hospital
Contributor Information and Disclosures

Updated: Sep 18, 2008

Differential Diagnoses

Aseptic Meningitis
Lyme Disease
Migraine Headache
Migraine Variants
Pseudotumor Cerebri

Other Problems to Be Considered

Chronic daily headache
Transformed migraine
New daily persistent headache
Hemicrania continua
Posttraumatic headache
Cervical spine disorders
Intracranial vascular and nonvascular disorders associated with headache
Overuse of symptomatic analgesic medication
Fibromyalgia
Myofascial pain syndrome
Depression

Workup

Laboratory Studies

  • The diagnosis of tension-type headache (TTH) is clinical. As with the other primary headaches, no specific diagnostic test is available for TTH.
  • Occasionally, studies may be required to exclude secondary headache disorders.

Imaging Studies

  • Neuroimaging studies are important to rule out secondary causes of headache, including neoplasms and cerebral hemorrhage.
  • MRI imaging shows the greatest detail of cerebral structures and is especially useful in evaluating the posterior fossa.
  • CT scan with contrast is a viable alternative but is inferior to MRI for viewing structures in the posterior fossa.
  • Neuroimaging is indicated if the headaches are atypical in any way or if they are associated with abnormalities in the neurologic examination.

More on Muscle Contraction Tension Headache

Overview: Muscle Contraction Tension Headache
Differential Diagnoses & Workup: Muscle Contraction Tension Headache
Treatment & Medication: Muscle Contraction Tension Headache
Follow-up: Muscle Contraction Tension Headache
References
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Further Reading

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Keywords

episodic tension-type headache, ETTH (ICD code-339.11), chronic tension-type headache, CTTH (ICD code-339.12), tension-type headache, TTH (ICD code-339.10), tension headache, stress headache, muscle contraction headache, psychomyogenic headache, ordinary headache, psychogenic headache, muscle contraction tension headache, headache

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Contributor Information and Disclosures

Author

Manish K Singh, MD, Assistant Professor, Pain Management, Department of Neurology, Drexel College of Medicine, Hahnemann University Hospital
Manish K Singh, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Pain Medicine, American Association of Physicians of Indian Origin, American Headache Society, American Medical Association, and American Society of Regional Anesthesia and Pain Medicine
Disclosure: Nothing to disclose.

Medical Editor

Joseph Carcione Jr, DO, MBA, Consultant in Neurology and Medical Acupuncture, Medical Management and Organizational Consulting, Central Westchester Neuromuscular Care, PC; Medical Director, Oxford Health Plans
Joseph Carcione Jr, DO, MBA is a member of the following medical societies: American Academy of Neurology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

James H Halsey, MD, Professor, Department of Neurology, University of Alabama Medical Center
James H Halsey, MD is a member of the following medical societies: American Academy of Neurology, American Heart Association, American Medical Association, American Neurological Association, American Society of Neuroimaging, Medical Association of the State of Alabama, New York Academy of Sciences, Pan American Medical Association, Sigma Xi, Society for Neuroscience, and Southern Medical Association
Disclosure: Nothing to disclose.

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Nicholas Y Lorenzo, MD, Chief Editor, eMedicine Neurology; Consulting Staff, Neurology Specialists and Consultants
Nicholas Y Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Neurology
Disclosure: Nothing to disclose.

 
 
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