Headache
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Previous studies have not found a significant correlation between location of pain and electromyogram levels in chronic headache patients. However, these studies only examined a limited number of muscle groups and did not assess subjective tension levels. ⋯ Neither subjective pain nor tension ratings were found to be significantly related to electromyogram levels. The site-specificity relationship between chronic headache pain, subjective report of muscular tension, and electromyogram levels remains unclear.
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Comparative Study
Specificity and sensitivity of temporalis ES2 measurements in the diagnosis of chronic primary headaches.
We have evaluated the specificity and sensitivity of temporalis ES2 measurements for the diagnosis of primary headaches. Ninety-four outpatients diagnosed according to IHS criteria were prospectively included: 25 had chronic tension-type headache (code 2.2.), 15 episodic tension-type headache (code 2.1.), 20 migraine without aura (code 1.1.) and 34 chronic daily headaches with daily analgesics/ergotamine abuse (code 8.2.). In chronic tension-type, the sensitivity of the ES2 test was 84% at the 0.1 and the 0.5 Hz, but only 56% at the 2Hz stimulation rates. ⋯ For diagnostic purposes, the 0.1Hz stimulation rate seems optimal. The 2Hz stimulation rate is the least sensitive, although it may induce total disappearance of ES2 in up to 40% of patients. ES2 is of limited usefulness for separating chronic tension-type headache and chronic drug-abuse headache, possibly because the latter group comprises both tension-type headache and migraine patients.