Tension Headaches are very common .They are episodic with no typical pattern, i.e. none of the characters of migraine being present- non-pulsatile, generalized all over the head, absence of photo/phonophobia, no nausea/vomiting. Thus tension type headaches present with generalized aching/heaviness/tightness. Though psychogenic factors should be actively looked for in all children with headaches, this is especially true in this group. Amitriptyline(triptomer-tablet 10mg) is the only drug with any proof of efficacy in tension type headaches. Start with half tablet at night and can be increased by 5mg every week upto maximum of 1 mg/kg/day .
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