Evaluation of the nosology of chronic tension-type headache.

Tension-type headache is one of the problematic classes of the IHS classification of headache. Based on the data of 211 cases of chronic tension-type headache modified criteria are proposed for the diagnosis of chronic tension-type headache. In order to provide optimal discrimination between migraine and tension-type headache it is recommended that the severity of characteristic migraine symptoms, which also frequently occur at a mild level of intensity among patients with tension-type headache, be incorporated into the diagnostic criteria for this headache. Specifically, mild photophobia and phonophobia, and headache aggravation by physical activity should not be used as exclusion criteria for tension-type headache.