title: Extracephalic tenderness and pressure pain threshold in children with headache.
abstract: BACKGROUND
  Sensitisation of the pain detection system has been suggested to be involved in the pathogenesis of recurrent headache. In adults, increased sensitivity to pain has been found in patients with chronic tension type headache. Children with migraine or with unspecific headache report non-headache pains and interictal pericranial muscular tenderness more often than headache-free children.
  
  
  OBJECTIVE
  To study if children with different types of headache report non-headache pain more often than children with no headache and if extracephalic muscular tenderness is different in children with headache in comparison to headache-free children. To find out if interval to the headache episode has influence on the extracranial muscular tenderness.
  
  
  METHODS
  A population-based sample of 13-year-old children with migraine (n=48), episodic tension type headache (61) or no headache (59) were interviewed for the occurrence and characteristics of headache and fulfilled a questionnaire on non-headache pain. A structured manual palpation test on muscular tenderness and a pain threshold measurement were done on seven cephalic and three extracephalic points.
  
  
  RESULTS
  Children with migraine reported other pains, especially stomach pain and limb pain more often than children with episodic tension type or no headache. There were no significant differences in the extracephalic muscular tenderness or in the pressure pain thresholds between the three groups.
  
  
  CONCLUSIONS
  Children with migraine experience more non-headache pains than children with episodic tension type headache and with no headache. However, neither children with migraine nor children with episodic tension type headache show increased interictal extracephalic muscular sensitivity for palpation.
authors.affiliation: Department of Child Neurology, Helsinki University Hospital, Helsinki, Finland. liisa.metsahonkala@hus.fi <liisa.metsahonkala@hus.fi>
authors.forename: Liisa
authors.initials: L
authors.lastname: Metsahonkala
authors.forename: Pirjo
authors.initials: P
authors.lastname: Anttila
authors.forename: Katri
authors.initials: K
authors.lastname: Laimi
authors.forename: Minna
authors.initials: M
authors.lastname: Aromaa
authors.forename: Hans
authors.initials: H
authors.lastname: Helenius
authors.forename: Marja
authors.initials: M
authors.lastname: Mikkelsson
authors.forename: Eija
authors.initials: E
authors.lastname: Jäppilä
authors.forename: Suvi
authors.initials: S
authors.lastname: Viander
authors.forename: Matti
authors.initials: M
authors.lastname: Sillanpää
authors.forename: Jouko
authors.initials: J
authors.lastname: Salminen
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D000293:Adolescent; D002648:Child; D005121:Extremities / Q000503:physiopathology; D005260:Female; D006261:Headache / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D006930:Hyperalgesia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology*; D010173:Palpation; D011312:Pressure / Q000009:adverse effects; D011795:Surveys and Questionnaires; D018781:Tension-Type Headache / Q000150:complications / Q000503:physiopathology