Abstract：
OBJECTIVE: Tension-type headache (TTH) continues to be the most prevalent type of headache across all age groups worldwide, and the global burden of migraine and TTH together account for 7% of all-cause years lived with disability (YLDs). TTH has been shown to have a prevalence of up to 80% in several studies and presents a wide range and high variability in clinical settings. The aim of this review is to identify gaps in diagnostics, nosology, and variability in the treatment of children and adolescents who present with headaches without an identifiable etiology.
RESULTS: Migraine and TTH have been debated to have more similarities than distinctions, increasing chances of misdiagnosis and leading to significant cases diagnosed as probable TTH or probable migraine. The lack of specificity and sensitivity for TTH classification often leads to the diagnosis being made by negating associated migraine symptoms. Although pathology is not well understood, some studies have suggested a neurological basis for TTH, in need of further validation. Some research indicates that nitric oxide signaling plays an integral part in the pain mechanisms related to TTH. Analgesics and non-steroidal anti-inflammatories are usually the first lines of treatment for children with recurring headaches, and additional treatment options include medication and behavioral therapies. With high prevalence and socioeconomic burden among children and adolescents, it\'s essential to further study Tension-type headaches and secondary headaches without known cause and potential interventions. Treatment studies involving randomized controlled trials are also needed to test the efficacy of various treatments further.
RESULTS: Migraine and TTH have been debated to have more similarities than distinctions, increasing chances of misdiagnosis and leading to significant cases diagnosed as probable TTH or probable migraine. The lack of specificity and sensitivity for TTH classification often leads to the diagnosis being made by negating associated migraine symptoms. Although pathology is not well understood, some studies have suggested a neurological basis for TTH, in need of further validation. Some research indicates that nitric oxide signaling plays an integral part in the pain mechanisms related to TTH. Analgesics and non-steroidal anti-inflammatories are usually the first lines of treatment for children with recurring headaches, and additional treatment options include medication and behavioral therapies. With high prevalence and socioeconomic burden among children and adolescents, it\'s essential to further study Tension-type headaches and secondary headaches without known cause and potential interventions. Treatment studies involving randomized controlled trials are also needed to test the efficacy of various treatments further.
摘要：
目的：紧张型头痛（TTH）仍然是全球所有年龄段最普遍的头痛类型。偏头痛和TTH的全球负担合计占全因残疾年(YLDs)的7%。在几项研究中，TTH的患病率高达80％，并且在临床环境中具有广泛的范围和高度的变异性。这项审查的目的是找出诊断方面的差距，nosology,以及在没有明确病因的情况下出现头痛的儿童和青少年的治疗差异。
结果：偏头痛和TTH有更多的相似之处而不是区别，增加了误诊的机会，并导致被诊断为可能的TTH或可能的偏头痛的重大病例。TTH分类缺乏特异性和敏感性通常导致通过否定相关的偏头痛症状进行诊断。虽然病理学不是很清楚，一些研究提出了TTH的神经学基础，需要进一步验证。一些研究表明，一氧化氮信号在与TTH相关的疼痛机制中起着不可或缺的作用。镇痛药和非甾体抗炎药通常是复发性头痛儿童的一线治疗方法，和额外的治疗选择包括药物和行为疗法。儿童和青少年的高患病率和社会经济负担，在没有已知原因和潜在干预措施的情况下，进一步研究紧张型头痛和继发性头痛是至关重要的。还需要涉及随机对照试验的治疗研究来进一步测试各种治疗的功效。
结果：偏头痛和TTH有更多的相似之处而不是区别，增加了误诊的机会，并导致被诊断为可能的TTH或可能的偏头痛的重大病例。TTH分类缺乏特异性和敏感性通常导致通过否定相关的偏头痛症状进行诊断。虽然病理学不是很清楚，一些研究提出了TTH的神经学基础，需要进一步验证。一些研究表明，一氧化氮信号在与TTH相关的疼痛机制中起着不可或缺的作用。镇痛药和非甾体抗炎药通常是复发性头痛儿童的一线治疗方法，和额外的治疗选择包括药物和行为疗法。儿童和青少年的高患病率和社会经济负担，在没有已知原因和潜在干预措施的情况下，进一步研究紧张型头痛和继发性头痛是至关重要的。还需要涉及随机对照试验的治疗研究来进一步测试各种治疗的功效。
