A review of the literature on tension-type and other “nonmigrainous” primary headaches is presented from Children’s Hospital of the King’s Daughters, Eastern Virginia Medical School, Norfolk, VA. Tension-type headaches are mild to moderate in intensity, often frontal in location, duration minutes to hours, and lack autonomic features. Other primary headaches and neuralgias are brief, with or without autonomic symptoms. They include cluster headaches, paroxysmal hemicrania responsive to indomethacin, short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT), stabbing headache, cough headache, exertional, headache with sexual activity, hypnic (alarm clock) headache, thunderclap headache, cranial neuralgias, trigeminal neuralgia, glossopharyngeal neuralgia, occipital neuralgia, and ice cream headache, Cluster headaches, paroxysmal hemicrania, and SUNCT are similar in location (unilateral, orbital, and supraorbital), their duration differs widely from 15-180 minutes for cluster headaches, 2-30 min for paroxysmal hemicrania, and 5-240 seconds for SUNCT, the frequency of attacks is 8/day, 5/day, and 3-200/day, respectively, and a response to indomethacin occurs only for paroxysmal hemicrania. [1]

COMMENT. The prevalence of tension-type headache (TTH) in children and adolescents has been estimated variously from 11% to 73%. In one large series of 8255 adolescents in Norway, a 1-year-prevalence of TTH was 18%, compared to 7% for migraine [2]. Since the differentiation of TTH and migraine is questionable, except in terms of severity, treatment strategies are similar. Other primary headaches listed above would require more specific therapies.