Generalized mechanical nerve pain hypersensitivity in children with episodic tension-type headache.
OBJECTIVE
The objective of this study was to analyze the presence of generalized pressure pain hypersensitivity over nerve tissues in trigeminal and nontrigeminal regions in children with frequent episodic tension-type headache (FETTH).


METHODS
Thirty children, 7 boys and 23 girls (mean age: 8.8 +/- 1.7 years) with FETTH and 50 age- and gender-matched healthy children (14 boys, 36 girls; mean age: 8.5 +/- 2.1 years; P = .743) were recruited. Pressure pain thresholds (PPTs) were bilaterally assessed over supra-orbital (V1), infra-orbital (V2), mental (V3), median (C5), radial (C6), and ulnar (C7) nerves by an assessor who was blinded to the patient's condition.


RESULTS
The analysis of variance showed that PPT levels were significantly bilaterally decreased over both trigeminal (supra-orbital, infra-orbital, and mental) and nontrigeminal (median, ulnar, and radial) nerves in children with FETTH as compared with control subjects (all sites, P < .001). There was a greater magnitude of PPT decrease within trigeminal nerves as compared with nontrigeminal nerves (P < .03). PPTs over infra-orbital (r(s) = -0.4, P < .05) and radial (r(s) = -0.5, P < .01) nerves were negatively correlated with the duration of headache attacks (P < .05).


CONCLUSIONS
Our study revealed bilateral and generalized pressure hypersensitivity over both trigeminal and nontrigeminal nerves in children with FETTH. Diffuse hypersensitivity of peripheral nerves evidences the presence of hyperexcitability of the central nervous system in children with FETTH.
Department of Neuropediatry, Hospital Quirón de Madrid, Madrid, Spain.
Daniel M
DM
Fernández-Mayoralas
César
C
Fernández-de-las-Peñas
Ricardo
R
Ortega-Santiago
Silvia
S
Ambite-Quesada
Rodrigo
R
Jiménez-García
Alberto
A
Fernández-Jaén
D000704:Analysis of Variance; D016022:Case-Control Studies; D002648:Child; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D009437:Neuralgia / Q000175:diagnosis*; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology*; D010812:Physical Stimulation / Q000379:methods; D011312:Pressure; D011336:Probability; D011379:Prognosis; D012008:Recurrence; D012016:Reference Values; D018781:Tension-Type Headache / Q000503:physiopathology*; D014276:Trigeminal Nerve / Q000503:physiopathology*