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Tension-Type Headache or Migraine? Adolescents Pain Descriptions Are of Little Help
Headache: The Journal of Head and Face Pain, 08/02/2012
Clinical Article
Wager J et al. – Pain intensity and quality assessed by questionnaires are not suitable to discriminate tension–type headache (TTH) from TTH plus migraine. This may lead to inaccurate prevalence estimates in epidemiological studies and may mislead practitioners in forming diagnostic hypotheses. The exclusion of these pain descriptors in questionnaires should be considered. More research systematically assessing the diagnostic utility of verbal pain descriptors in primary care and epidemiological samples is needed.
Methods- One hundred twenty-two adolescents with pure TTH and 110 adolescents with TTH plus migraine aged 11-18 years presenting to a tertiary pediatric pain clinic were included in the study.
- Questionnaire reports of pain intensity and quality were compared with physician's diagnosis as the gold standard.
- Mean differences as well as receiver operating characteristics were analyzed.
- Adolescents with TTH plus migraine reported more pulsating and less intense pain compared with pure TTH.
- Receiver operating characteristic analysis indicated that pain descriptors did not discriminate between groups.
- Diagnostic utility of descriptors was similarly low for older adolescents and parental proxy reports.