Extracephalic tenderness and pressure pain threshold in children with headache.
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.
Metsahonkala
Liisa
L
Department of Child Neurology, Helsinki University Hospital, Helsinki, Finland. liisa.metsahonkala@hus.fi <liisa.metsahonkala@hus.fi>
Anttila
Pirjo
P
Laimi
Katri
K
Aromaa
Minna
M
Helenius
Hans
H
Mikkelsson
Marja
M
Jäppilä
Eija
E
Viander
Suvi
S
Sillanpää
Matti
M
Salminen
Jouko
J
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