Chronic tension headache in neurology outpatient clinics

Introduction. Headache is the commonest cause of neurological consultation in Spain. Chronic tension headache is a common reason for consultation, although diagnosis is difficult. Objectives. To emphasize the profile of a patient with chronic tension headache and analyze the differences from other groups of neurology patients. Patients and methods. We selected chronic tension headaches on the criteria of the International Headache Society, in patients who were seen for the first time in one of 18 Neurology Clinics of the Communidad Autonoma deAragon during a three month period in 1995. We analysed age, sex, place of origin, provisional diagnosis made by the referring doctor whether the referral was correct or had to be reviewed. These variables were compared with groups made up of all the patients, the other patients and headaches in general. Results. A total of 3,489 patients were seen: 889 had headache (25.5% of the total number of patients) and 268 had chronic tension headache (7.6% of all the patients). The average age was 47.4 years (SD: +/-18.7) and 72% were women. Family doctors referred 89.5%. The provisional diagnosis was correct in 52.6% and 17% required further visits. Conclusions. Chronic tension headache leads to frequent neurological consultation. This was only exceeded by cerebral vascular pathology (12%) and migraine (10.5%), making up 29.4% of all headaches. There was a marked predominance of women, who were younger than patients with other neurological disorders. In spite of the frequency, the family doctors were correct in their provisional diagnosis less often than in other neurological conditions. Although the condition is chronic, the neurologist acted mainly as a consultant and saw few follow-up cases.