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Key Features

  • Constant daily headaches that are often vise-like or tight in quality but not pulsatile

  • May be exacerbated by emotional stress, fatigue, noise, or glare

  • Patients also frequently complain of pericranial tenderness, poor concentration and other nonspecific symptoms

Clinical Findings

  • Usually generalized

  • May be most intense about the neck or back of the head

  • Not associated with focal neurologic symptoms


  • Diagnosis is made after exclusion of other causes of headache (see individual diagnoses, eg, Sinusitis, Acute)


  • Therapeutic approach similar to that of migraine, except triptan drugs are not indicated (see Headache, Migraine)

  • Behavioral therapies that may be effective include biofeedback and relaxation training

  • Treatment of comorbid anxiety or depression

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