387:'s most current classification system for headache disorders is the International Classification of Headache Disorders 3rd edition (ICHD-3) as of 2018. This classification system separates tension-type headache (TTH) into two main groups: episodic (ETTH) and chronic (CTTH). CTTH is defined as fifteen days or more per month with headache for greater than three months, or one-hundred eighty days or more, with headache per year. ETTH is less than fifteen days per month with headache or less than one-hundred eighty days with headache per year. However, ETTH is further sub-divided into frequent and infrequent TTH. Frequent TTH is defined as ten or more episodes of headache over the course of one to fourteen days per month for greater than three months, or at least twelve days per year, but less than one-hundred eighty days per year. Infrequent TTH is defined as ten or more episodes of headache for less than one day per month or less than twelve days per year. Furthermore, all sub-classes of TTH can be classified as having presence or absence of pericranial tenderness, which is tenderness of the muscles of the head. Probable TTH is utilized for patients with some characteristics, but not all characteristics of a given sub-type of TTH.
689:
hands-on work may reduce both the frequency and the intensity of chronic tension-type headaches. More current literature also appears to be mixed however, CTTH patients may benefit from massage and physiotherapy as suggested by a systemic review examining these modalities via RCTs specifically for this patient population
Despite being helpful, the review also makes a point to note that there is no difference in effectiveness long term (6 months) between those CTTH patients utilizing TCAs and physiotherapy. Another systemic review comparing manual therapy to pharmacologic therapy also supports little long term difference in outcome regarding TTH frequency, duration, and intensity.
613:), can be effective but tend to only be helpful as a treatment for a few times in a week at most. For those with gastrointestinal problems (ulcers and bleeding), and/or kidney problems, acetaminophen is the better choice over aspirin, though both provide roughly equivalent pain relief. It is important to note that large daily doses of paracetamol should be avoided as it may cause liver damage especially in those that consume 3 or more drinks/day and those with pre-existing liver disease. Ibuprofen, one of the NSAIDs listed above, is a common choice for pain relief but may also lead to gastrointestinal discomfort.
318:(NOS) forms NO which ultimately results in vasodilatation and activation of central nervous system pain pathways. Serotonin may also be of significant importance and involved in malfunctioning pain filter located in the brain stem. The view is that the brain misinterprets informationâfor example from the temporal muscle or other musclesâand interprets this signal as pain. Evidence for this theory comes from the fact that chronic tension-type headaches may be successfully treated with certain antidepressants such as
376:
235:
causal factor for TTH, but may instead act to trigger a chronic pain cycle. This is when the peripheral pain response is transformed over time into a centralized pain response. These prolonged alterations in the peripheral pain pathways can lead to increased excitability of the central nervous system pain pathways, resulting in the transition of ETTH into chronic tension-type headache (CTTH). Specifically, the hyperexcitability occurs in central
48:
331:
well as the molecular pathways activated upon synaptic transmission. Lower pain thresholds of CTTH result from this homosynaptic facilitation. In contrast, heterosynaptic facilitation occurs when synapses not normally involved in pain pathways become involved. Once this occurs innocuous signals are interpreted as painful signals. Allodynia and hyperalgesia of CTTH represent this heterosynaptic facilitation clinically.
226:
factors, environmental factors, and alteration of both peripheral and central pain pathways. Peripheral pain pathways receive pain signals from pericranial (around the head) myofascial tissue (protective tissue of muscles) and alteration of this pathway likely underlies episodic tension-type headache (ETTH). In addition, pericranial muscle tenderness,
136:
impart significant disability on patients as well as burden on society at large. In 2016, the global burden of TTH was reported to be 7.2 million years of life lived with disability (YLDs). The YLD was calculated using TTH prevalence and average time spent with TTH multiplied by percentage health loss caused by TTH (3.7%).
225:
Although the musculature of the head and neck and psychological factors such as stress may play a role in the overall pathophysiology of TTH, neither is currently believed to be the sole cause of the development of TTH. The pathologic basis of TTH is most likely derived from a combination of personal
1584:
Varatharajan S, Ferguson B, Chrobak K, Shergill Y, CÎté P, Wong JJ, et al. (July 2016). "Are non-invasive interventions effective for the management of headaches associated with neck pain? An update of the Bone and Joint Decade Task Force on Neck Pain and Its
Associated Disorders by the Ontario
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manipulation for tension headache, and that it was probably more effective for tension headache than for migraine. Two other systematic reviews published between 2000 and May 2005 did not find conclusive evidence in favor of spinal manipulation. A 2012 systematic review of manual therapy found that
651:
Classes of medications involved in treatment of CTTH include tricyclic antidepressants (TCAs), SSRIs, benzodiazepine (Clonazepam in small evening dose), and muscle relaxants. The most commonly utilized TCA is amitriptyline due to the postulated role in decreasing central sensitization and analgesic
330:
Regarding synaptic level changes, homosynaptic facilitation and heterosynaptic facilitation are both likely to be involved in central sensitization. Homosynaptic facilitation occurs when synapses normally involved in pain pathways undergo changes involving receptors on the post-synaptic membrane as
234:
have been postulated in headache literature to be causal factors in the peripheral pathophysiology of TTH. However, multiple studies have failed to illustrate evidence for a pathologic role of either ischemia or inflammation within the muscles. Pericranial tenderness is also not likely a peripheral
697:
As of 2016 tension headaches affect about 1.89 billion people and are more common in women than men (23% to 18% respectively). Despite its benign character, tension-type headache, especially in its chronic form, can impart significant disability on patients as well as burden on society at large.
135:
The 2016 Global Burden of
Disease study revealed that TTHs affect about 1.89 billion people and are more common in women than men (30.8% to 21.4% respectively). TTH was most prevalent between ages 35 and 39. Despite its benign character, tension-type headache, especially in its chronic form, can
576:
Evidence supports simple neck and shoulder exercises in managing ETTH and CTTH for headaches associated with neck pain. Exercises include stretching, strengthening and range of motion exercises. CTTH can also benefit from combined therapy from stress therapy, exercises and postural correction.
2014:
Mesa-JimĂ©nez JA, Lozano-LĂłpez C, Angulo-DĂaz-Parreño S, RodrĂguez-FernĂĄndez ĂL, De-la-Hoz-Aizpurua JL, FernĂĄndez-de-Las-Peñas C (December 2015). "Multimodal manual therapy vs. pharmacological care for management of tension type headache: A meta-analysis of randomized trials".
616:
Analgesic/caffeine combinations are popular such as the aspirin-caffeine combination or the aspirin, paracetamol and caffeine combinations. Frequent use (daily or skipping just one day in between use for 7â10 days) of any of the above analgesics may, however, lead to
519:
People who have 15 or more headaches in a month may be treated with certain types of daily antidepressants which act to prevent continued tension headaches from occurring. In those who are predisposed to tension type headaches the first-line preventative treatment is
3458:
3431:
3408:
3311:
1679:"Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology"
3390:
684:. Studies of effectiveness are mixed. A 2006 systematic review found no rigorous evidence supporting manual therapies for tension headache. A 2005 structured review found only weak evidence for the effectiveness of
104:
usually radiates from the lower back of the head, the neck, the eyes, or other muscle groups in the body typically affecting both sides of the head. Tension-type headaches account for nearly 90% of all headaches.
655:
These medications however, are not effective if concurrent overuse of over the counter medications or other analgesics is occurring. Stopping overuse must occur prior to proceeding with other forms of treatment.
2184:
2169:
652:
relief. Another popular TCA used is
Doxepine. SSRIs may also be utilized for management of CTTH. For patients with concurrent muscle spasm and CTTH, the muscle relaxant Tizanidine can be a helpful option.
668:
is slight. A 2016 systematic review suggests better evidence among those with frequent tension headaches, but concludes that further trials comparing acupuncture with other treatment options are needed.
322:. However, the analgesic effect of nortriptyline, as well as amitriptyline in chronic tension-type headache, is not solely due to serotonin reuptake inhibition, and likely other mechanisms are involved.
1775:
Fernåndez-de-Las-Peñas C, Alonso-Blanco C, Cuadrado ML, Miangolarra JC, Barriga FJ, Pareja JA (2006). "Are manual therapies effective in reducing pain from tension-type headache?: a systematic review".
3286:
3339:
2751:
1257:
Ashina M, Lassen LH, Bendtsen L, Jensen R, Olesen J (January 1999). "Effect of inhibition of nitric oxide synthase on chronic tension-type headache: a randomised crossover trial".
3256:
339:
In the literature, stress is mentioned as a factor and may be implicated via the adrenal axis. This ultimately results in downstream activation of NMDA receptor activation,
1022:
Headache
Classification Committee of the International Headache Society (IHS): The International Classification of Headache Disorders,3rd edition. Cephalalgia 33(9) 629â808
3381:
3137:
3132:
3247:
3149:
3127:
395:
Extensive testing is not needed as TTH is diagnosed by history and physical examination. However, if symptoms indicative of a more serious diagnosis are present, a
2300:
314:(NO). Of the neurotransmitters, NO plays a major role in central pain pathways and likely contributes to the process of central sensitization. Briefly, the enzyme
282:. Evidence also suggests that dysfunction in supraspinal descending inhibitory pain pathways may contribute to the pathogenesis of central sensitization in CTTH.
2060:"Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010"
924:"Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) for the prevention of tension-type headache in adults"
259:
of CTTH. Additionally, CTTH patients exhibit decreased thermal and pain thresholds which further bolsters support for central sensitization occurring in CTTH.
976:"Global, regional, and national burden of migraine and tension-type headache, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016"
639:
Muscle relaxants are typically used for and are helpful with acute post-traumatic TTH rather than ETTH. Opioid medications are not utilized to treat ETTH.
145:
1501:
Nestoriuc Y, Rief W, Martin A (June 2008). "Meta-analysis of biofeedback for tension-type headache: efficacy, specificity, and treatment moderators".
2496:
2491:
1138:
2293:
3119:
3109:
2286:
1356:
1179:
Jay GW, Barkin RL (December 2017). "Primary
Headache Disorders- Part 2: Tension-type headache and medication overuse headache".
3089:
2762:
1383:
3114:
2746:
1312:
2952:
2940:
2402:
438:
262:
The alterations in physiology that leads to the overall process of central sensitization, involves changes at the level of
1059:
Chen Y (December 2009). "Advances in the pathophysiology of tension-type headache: from stress to central sensitization".
403:
should be considered in those 50 years of age and beyond. Screening for giant cell arteritis involves the blood tests of
3230:
3171:
3104:
2659:
355:
With TTH, the physical exam is expected to be normal with perhaps the exception of either pericranial tenderness upon
2874:
2677:
1434:
1114:
17:
1476:
1328:
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2508:
2484:
2314:
404:
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2700:
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3421:
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3156:
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299:
192:
Tension-type headaches may be accompanied by tenderness of the scalp on manual pressure during an attack.
3444:
2666:
974:
Stovner LJ, Nichols E, Steiner TJ, Abd-Allah F, Abdelalim A, Al-Raddadi RM, et al. (November 2018).
618:
443:
536:
appear to be useful for prevention. Tricyclic antidepressants have been found to be more effective than
3144:
2694:
2366:
396:
3094:
3062:
3036:
3014:
2863:
2442:
1965:"Manual therapies for primary chronic headaches: a systematic review of randomized controlled trials"
533:
117:
3496:
3161:
2935:
2349:
2273:
2203:
3166:
3099:
2855:
2673:
2525:
2515:
2359:
2278:
880:"Lack of benefit for prophylactic drugs of tension-type headache in adults: a systematic review"
3491:
3481:
3299:
3223:
3031:
3023:
2978:
2654:
2626:
2474:
590:
72:
2243:
2013:
3046:
2920:
2738:
2716:
2631:
2554:
2464:
2451:
2376:
1677:
Simpson DM, Hallett M, Ashman EJ, Comella CL, Green MW, Gronseth GS, et al. (May 2016).
826:
Jackson JL, Shimeall W, Sessums L, Dezee KJ, Becher D, Diemer M, et al. (October 2010).
498:
might develop headaches, and getting treatment from a dentist might prevent those headaches.
344:
315:
279:
1214:
Ashina S, Bendtsen L, Ashina M (December 2005). "Pathophysiology of tension-type headache".
3517:
3466:
3352:
2983:
2800:
2689:
451:
400:
200:
Various precipitating factors may cause tension-type headaches in susceptible individuals:
2254:
2058:
Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. (December 2012).
8:
3471:
3347:
2912:
2559:
2414:
2354:
2188:
677:
673:
1541:
Bendtsen L, Jensen R (May 2011). "Treating tension-type headache -- an expert opinion".
560:
Treatment for a current tension headache is to drink water and confirm that there is no
3543:
3082:
3067:
3055:
2805:
2756:
2593:
2456:
2344:
2193:
2132:
2084:
2059:
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1991:
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773:
744:
719:
681:
481:
408:
240:
2197:
2075:
1774:
1270:
991:
290:
Specific neuronal receptors and neurotransmitters thought to be most involved include
3522:
3216:
2845:
2811:
2783:
2774:
2706:
2682:
2549:
2397:
2214:
2124:
2089:
2044:
2032:
1996:
1942:
1893:
1836:
1832:
1793:
1757:
1726:
Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Shin BC, et al. (April 2016).
1708:
1659:
1602:
1570:
1558:
1518:
1308:
1274:
1231:
1196:
1120:
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803:
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502:
60:
2136:
1848:
1805:
1286:
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1192:
1088:
3319:
3276:
2968:
2834:
2619:
2614:
2116:
2079:
2071:
2024:
1986:
1976:
1932:
1924:
1883:
1875:
1828:
1785:
1747:
1743:
1739:
1698:
1690:
1649:
1645:
1641:
1614:
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1550:
1510:
1266:
1223:
1188:
1068:
995:
987:
943:
935:
891:
847:
839:
793:
785:
739:
735:
731:
565:
549:
271:
267:
129:
1410:
3367:
3357:
2890:
2581:
2208:
1694:
1554:
640:
564:. If symptoms do not resolve within an hour for a person who has had water, then
457:
248:
1819:
Biondi DM (June 2005). "Physical treatments for headache: a structured review".
789:
3486:
3416:
3329:
2947:
2896:
2724:
2433:
2310:
2219:
1879:
1514:
307:
2178:
2120:
1928:
1598:
1227:
1072:
939:
828:"Tricyclic antidepressants and headaches: systematic review and meta-analysis"
167:
not aggravated by routine physical activity such as walking or climbing stairs
3537:
2973:
2925:
2795:
2564:
2520:
2371:
2028:
1124:
629:
521:
319:
295:
291:
1981:
896:
879:
2469:
2339:
2322:
2128:
2093:
2036:
2000:
1946:
1897:
1840:
1797:
1761:
1712:
1663:
1606:
1562:
1522:
1235:
1200:
1080:
1009:
957:
905:
861:
807:
753:
720:"Ibuprofen for acute treatment of episodic tension-type headache in adults"
685:
311:
263:
256:
227:
1278:
2428:
2389:
2331:
2238:
1630:"Aspirin for acute treatment of episodic tension-type headache in adults"
1439:
ICHD-3 The
International Classification of Headache Disorders 3rd edition
1415:
ICHD-3 The
International Classification of Headache Disorders 3rd edition
1388:
ICHD-3 The
International Classification of Headache Disorders 3rd edition
1361:
ICHD-3 The
International Classification of Headache Disorders 3rd edition
665:
633:
594:
561:
545:
529:
525:
508:
488:
375:
364:
360:
236:
183:
179:
125:
109:
2161:
3512:
3398:
2539:
2409:
610:
843:
2649:
2600:
2588:
2571:
2503:
2249:
922:
Banzi R, Cusi C, Randazzo C, Sterzi R, Tedesco D, Moja L (May 2015).
625:
598:
474:
356:
347:
with subsequent production of NO leading to pain as described above.
303:
252:
113:
65:
878:
Verhagen AP, Damen L, Berger MY, Passchier J, Koes BW (April 2010).
251:) resulting in central sensitization, which manifests clinically as
3439:
3264:
3239:
3124:
Spinal muscular atrophy with lower extremity predominance (SMALED)
2829:
2821:
2787:
2641:
2544:
1583:
606:
415:
244:
231:
97:
77:
47:
1864:"A systematic review of systematic reviews of spinal manipulation"
2308:
1913:"Manual therapies for cervicogenic headache: a systematic review"
602:
495:
275:
2107:
Lenaerts ME (December 2006). "Burden of tension-type headache".
1585:
Protocol for Traffic Injury Management (OPTIMa) Collaboration".
1107:
Rosen's emergency medicine : concepts and clinical practice
340:
2868:
2609:
2576:
2173:
540:
but have greater side effects. Evidence is poor for the use of
973:
1333:
ICHD-3 The International Classification of Headache Disorders
541:
537:
121:
1470:
1468:
1466:
1464:
1462:
1460:
1458:
1456:
1454:
877:
3208:
2268:
1676:
1104:
825:
101:
1256:
1728:"Acupuncture for the prevention of tension-type headache"
1451:
120:
appear to be useful for prevention. Evidence is poor for
717:
2057:
1725:
921:
624:
Analgesic/sedative combinations are widely used (e.g.,
116:, are effective for the treatment of tension headache.
1105:
Walls RM, Hockberger RS, Gausche-Hill M (2017-03-09).
718:
Derry S, Wiffen PJ, Moore RA, Bendtsen L (July 2015).
2151:
1213:
155:
At least two of the following four characteristics:
1500:
448:
Secondary headache (headache due to other disorder)
1109:(Ninth ed.). Philadelphia, PA. p. 1269.
146:International Classification of Headache Disorders
473:Good posture might prevent headaches if there is
3535:
1627:
1474:
505:and relaxing often makes headaches less likely.
148:, the attacks must meet the following criteria:
1536:
1534:
1532:
1357:"2.1 Infrequent episodic tension-type headache"
379:Classification system for tension-type headache
1540:
969:
967:
359:of the cranial muscles, or presence of either
161:pressing or tightening (non-pulsating) quality
3224:
2294:
1962:
1910:
1628:Derry S, Wiffen PJ, Moore RA (January 2017).
1503:Journal of Consulting and Clinical Psychology
1384:"2.2 Frequent episodic tension-type headache"
767:
765:
763:
1529:
771:
672:People with tension-type headache often use
152:A duration of between 30 minutes and 7 days.
55:A woman experiencing a tension-type headache
3013:
1861:
1732:The Cochrane Database of Systematic Reviews
1634:The Cochrane Database of Systematic Reviews
1477:"Tension Headache Treatment and Prevention"
964:
928:The Cochrane Database of Systematic Reviews
917:
915:
724:The Cochrane Database of Systematic Reviews
3231:
3217:
2301:
2287:
1137:: CS1 maint: location missing publisher (
821:
819:
817:
760:
484:can make headaches more likely or severe.
96:(TTH), is the most common type of primary
2083:
1990:
1980:
1936:
1887:
1751:
1702:
1653:
1178:
999:
947:
895:
873:
871:
851:
797:
743:
713:
711:
390:
2106:
1868:Journal of the Royal Society of Medicine
1307:. Philadelphia: Elsevier. p. 1348.
912:
374:
2051:
814:
14:
3536:
3090:Distal hereditary motor neuronopathies
2763:Template:Demyelinating diseases of CNS
1818:
1174:
1172:
1170:
1168:
868:
708:
491:helps in preventing tension headache.
144:According to the third edition of the
3212:
2282:
1963:Chaibi A, Russell MB (October 2014).
1958:
1956:
1405:
1403:
1378:
1376:
1351:
1349:
1302:
1298:
1296:
1166:
1164:
1162:
1160:
1158:
1156:
1154:
1152:
1150:
1148:
1054:
1052:
1050:
1048:
552:for prevention of tension headaches.
139:
2941:Idiopathic intracranial hypertension
2330:
1435:"2.4 Probable tension-type headache"
1100:
1098:
1058:
1046:
1044:
1042:
1040:
1038:
1036:
1034:
1032:
1030:
1028:
439:Idiopathic intracranial hypertension
285:
1329:"2.3 Chronic tension-type headache"
772:Loder E, Rizzoli P (January 2008).
532:are second-line treatment options.
24:
3172:Infantile progressive bulbar palsy
2100:
1953:
1911:Chaibi A, Russell MB (July 2012).
1790:10.1097/01.ajp.0000173017.64741.86
1475:Consumer Reports (28 April 2016).
1400:
1373:
1346:
1293:
1145:
682:myofascial trigger point treatment
25:
3555:
2875:Template:Cerebrovascular diseases
2678:Frontotemporal lobar degeneration
2147:
2109:Current Pain and Headache Reports
1862:Ernst E, Canter PH (April 2006).
1543:Expert Opinion on Pharmacotherapy
1216:Current Pain and Headache Reports
1095:
1061:Current Pain and Headache Reports
1025:
659:
370:
182:(sensitivity to bright light) or
41:Tension headache, stress headache
2895:For more detailed coverage, see
2873:For more detailed coverage, see
2844:For more detailed coverage, see
2810:For more detailed coverage, see
2761:For more detailed coverage, see
1969:The Journal of Headache and Pain
1917:The Journal of Headache and Pain
1833:10.1111/j.1526-4610.2005.05141.x
1411:"2. Tension-type headache (TTH)"
636:combinations such as Fiorinal).
580:
343:activation, and upregulation of
46:
2007:
1904:
1855:
1812:
1768:
1719:
1670:
1621:
1577:
1494:
1427:
1321:
1250:
1207:
1193:10.1016/j.disamonth.2017.05.001
692:
643:does not appear to be helpful.
195:
1744:10.1002/14651858.CD007587.pub2
1646:10.1002/14651858.CD011888.pub2
1016:
736:10.1002/14651858.CD011474.pub2
514:
432:Infection in immunocompromised
405:erythrocyte sedimentation rate
399:may be utilized. Furthermore,
385:International Headache Society
13:
1:
3477:External compression headache
3363:New daily persistent headache
3325:Chronic paroxysmal hemicrania
3188:Amyotrophic lateral sclerosis
3073:Hereditary spastic paraplegia
2931:Normal pressure hydrocephalus
2076:10.1016/S0140-6736(12)61729-2
1271:10.1016/S0140-6736(98)01079-4
992:10.1016/S1474-4422(18)30322-3
701:
463:
3422:Post-dural-puncture headache
3238:
3157:Progressive muscular atrophy
2269:National Headache Foundation
1778:The Clinical Journal of Pain
1695:10.1212/WNL.0000000000002560
1555:10.1517/14656566.2011.548806
555:
487:Drinking water and avoiding
468:
350:
220:
186:(sensitivity to loud sounds)
7:
3445:Medication overuse headache
2667:Primary progressive aphasia
790:10.1136/bmj.39412.705868.AD
619:medication overuse headache
585:
571:
444:Medication overuse headache
325:
33:Tension-type headache (TTH)
10:
3560:
2989:Hashimoto's encephalopathy
2695:Posterior cortical atrophy
2516:Striatonigral degeneration
2367:Cavernous sinus thrombosis
1880:10.1177/014107680609900418
1515:10.1037/0022-006X.76.3.379
646:
511:techniques may also help.
164:mild or moderate intensity
108:Pain medications, such as
3505:
3457:
3430:
3407:
3389:
3380:
3338:
3310:
3285:
3255:
3246:
3095:Spinal muscular atrophies
3063:Primary lateral sclerosis
3045:
3022:
3006:
2961:
2921:Intracranial hypertension
2911:
2883:
2854:
2820:
2782:
2771:
2737:
2715:
2701:CreutzfeldtâJakob disease
2640:
2450:
2441:
2427:
2387:
2321:
2229:
2155:
2121:10.1007/s11916-006-0078-z
1929:10.1007/s10194-012-0436-7
1599:10.1007/s00586-016-4376-9
1228:10.1007/s11916-005-0021-8
1073:10.1007/s11916-009-0078-x
940:10.1002/14651858.CD011681
568:might resolve the issue.
534:Tricyclic antidepressants
420:Oromandibular dysfunction
334:
241:trigeminal spinal nucleus
118:Tricyclic antidepressants
71:
59:
54:
45:
37:
32:
3162:Progressive bulbar palsy
2953:Intracranial hypotension
2936:Choroid plexus papilloma
2350:Herpesviral encephalitis
2029:10.1177/0333102415576226
1305:Ferri's Clinical Advisor
632:combinations, analgesic/
2674:Frontotemporal dementia
2360:Encephalitis lethargica
2274:World Headache Alliance
1982:10.1186/1129-2377-15-67
774:"Tension-type headache"
172:Both of the following:
3492:Postherpetic neuralgia
3482:Cold-stimulus headache
3300:Mixed tension migraine
2979:Hepatic encephalopathy
1587:European Spine Journal
591:Over-the-counter drugs
429:Cervical spine disease
391:Differential diagnosis
380:
280:post-synaptic membrane
73:Differential diagnosis
3037:Ataxiaâtelangiectasia
2994:Static encephalopathy
2717:Mitochondrial disease
2555:Spasmodic torticollis
2465:Basal ganglia disease
980:The Lancet. Neurology
897:10.1093/fampra/cmp089
664:Current evidence for
397:contrast enhanced MRI
378:
316:nitric oxide synthase
175:no nausea or vomiting
94:tension-type headache
3497:TolosaâHunt syndrome
3467:Trigeminal neuralgia
3353:Thunderclap headache
2984:Toxic encephalopathy
2690:Lewy bodies dementia
452:Giant cell arteritis
401:giant cell arteritis
178:no more than one of
3472:Occipital neuralgia
3348:Hemicrania continua
3270:Familial hemiplegic
3032:Friedreich's ataxia
2415:Meningoencephalitis
2355:Limbic encephalitis
2070:(9859): 2163â2196.
678:soft tissue therapy
674:spinal manipulation
3068:Pseudobulbar palsy
2806:Status epilepticus
2757:Multiple sclerosis
2594:Myoclonic epilepsy
2457:movement disorders
2403:Acute disseminated
2345:Viral encephalitis
2230:External resources
454:(â„50 years of age)
409:c-reactive protein
381:
158:bilateral location
140:Signs and symptoms
3531:
3530:
3453:
3452:
3376:
3375:
3206:
3205:
3202:
3201:
3198:
3197:
3002:
3001:
2907:
2906:
2846:Template:Headache
2812:Template:Epilepsy
2733:
2732:
2707:Vascular dementia
2550:Status dystonicus
2423:
2422:
2398:Encephalomyelitis
2264:
2263:
2023:(14): 1323â1332.
1689:(19): 1818â1826.
1314:978-0-323-53042-2
1265:(9149): 287â289.
844:10.1136/bmj.c5222
503:stress management
435:Intracranial mass
286:Neurotransmitters
268:neurotransmitters
83:
82:
27:Medical condition
18:Tension headaches
16:(Redirected from
3551:
3387:
3386:
3277:Retinal migraine
3253:
3252:
3233:
3226:
3219:
3210:
3209:
3020:
3019:
3011:
3010:
2969:Brain herniation
2780:
2779:
2620:Intention tremor
2615:Essential tremor
2480:Postencephalitic
2448:
2447:
2439:
2438:
2328:
2327:
2309:Diseases of the
2303:
2296:
2289:
2280:
2279:
2153:
2152:
2141:
2140:
2104:
2098:
2097:
2087:
2055:
2049:
2048:
2011:
2005:
2004:
1994:
1984:
1960:
1951:
1950:
1940:
1908:
1902:
1901:
1891:
1859:
1853:
1852:
1816:
1810:
1809:
1772:
1766:
1765:
1755:
1723:
1717:
1716:
1706:
1674:
1668:
1667:
1657:
1625:
1619:
1618:
1593:(7): 1971â1999.
1581:
1575:
1574:
1549:(7): 1099â1109.
1538:
1527:
1526:
1498:
1492:
1491:
1489:
1487:
1481:Consumer Reports
1472:
1449:
1448:
1446:
1445:
1431:
1425:
1424:
1422:
1421:
1407:
1398:
1397:
1395:
1394:
1380:
1371:
1370:
1368:
1367:
1353:
1344:
1343:
1341:
1340:
1325:
1319:
1318:
1303:Smith J (2019).
1300:
1291:
1290:
1254:
1248:
1247:
1211:
1205:
1204:
1176:
1143:
1142:
1136:
1128:
1102:
1093:
1092:
1056:
1023:
1020:
1014:
1013:
1003:
971:
962:
961:
951:
919:
910:
909:
899:
875:
866:
865:
855:
823:
812:
811:
801:
769:
758:
757:
747:
715:
566:stress reduction
550:muscle relaxants
494:People who have
130:muscle relaxants
86:Tension headache
50:
30:
29:
21:
3559:
3558:
3554:
3553:
3552:
3550:
3549:
3548:
3534:
3533:
3532:
3527:
3501:
3449:
3426:
3403:
3372:
3368:Hypnic headache
3358:Sexual headache
3334:
3306:
3281:
3242:
3237:
3207:
3194:
3120:Congenital DSMA
3041:
2998:
2957:
2903:
2891:Sleep disorders
2879:
2856:Cerebrovascular
2850:
2816:
2773:
2767:
2729:
2711:
2636:
2582:Choreoathetosis
2455:
2432:
2419:
2383:
2317:
2307:
2265:
2260:
2259:
2255:article/1142908
2225:
2224:
2164:
2150:
2145:
2144:
2105:
2101:
2056:
2052:
2012:
2008:
1961:
1954:
1909:
1905:
1860:
1856:
1817:
1813:
1773:
1769:
1738:(4): CD007587.
1724:
1720:
1675:
1671:
1640:(1): CD011888.
1626:
1622:
1582:
1578:
1539:
1530:
1499:
1495:
1485:
1483:
1473:
1452:
1443:
1441:
1433:
1432:
1428:
1419:
1417:
1409:
1408:
1401:
1392:
1390:
1382:
1381:
1374:
1365:
1363:
1355:
1354:
1347:
1338:
1336:
1327:
1326:
1322:
1315:
1301:
1294:
1255:
1251:
1212:
1208:
1187:(12): 342â367.
1181:Disease-a-Month
1177:
1146:
1130:
1129:
1117:
1103:
1096:
1057:
1026:
1021:
1017:
986:(11): 954â976.
972:
965:
934:(5): CD011681.
920:
913:
884:Family Practice
876:
869:
824:
815:
784:(7635): 88â92.
770:
761:
730:(7): CD011474.
716:
709:
704:
695:
662:
649:
641:Botulinum toxin
588:
583:
574:
558:
517:
471:
466:
458:Dermatochalasis
393:
373:
353:
337:
328:
288:
249:cerebral cortex
223:
198:
142:
90:stress headache
28:
23:
22:
15:
12:
11:
5:
3557:
3547:
3546:
3529:
3528:
3526:
3525:
3520:
3515:
3509:
3507:
3503:
3502:
3500:
3499:
3494:
3489:
3487:Optic neuritis
3484:
3479:
3474:
3469:
3463:
3461:
3455:
3454:
3451:
3450:
3448:
3447:
3442:
3436:
3434:
3428:
3427:
3425:
3424:
3419:
3417:Ictal headache
3413:
3411:
3405:
3404:
3402:
3401:
3395:
3393:
3384:
3378:
3377:
3374:
3373:
3371:
3370:
3365:
3360:
3355:
3350:
3344:
3342:
3336:
3335:
3333:
3332:
3327:
3322:
3316:
3314:
3308:
3307:
3305:
3304:
3303:
3302:
3291:
3289:
3283:
3282:
3280:
3279:
3274:
3273:
3272:
3261:
3259:
3250:
3244:
3243:
3236:
3235:
3228:
3221:
3213:
3204:
3203:
3200:
3199:
3196:
3195:
3193:
3192:
3191:
3190:
3179:
3178:
3177:
3176:
3175:
3174:
3169:
3159:
3154:
3153:
3152:
3147:
3142:
3141:
3140:
3135:
3130:
3122:
3117:
3112:
3107:
3102:
3092:
3078:
3077:
3076:
3075:
3070:
3065:
3051:
3049:
3043:
3042:
3040:
3039:
3034:
3028:
3026:
3017:
3008:
3004:
3003:
3000:
2999:
2997:
2996:
2991:
2986:
2981:
2976:
2971:
2965:
2963:
2959:
2958:
2956:
2955:
2950:
2948:Cerebral edema
2945:
2944:
2943:
2938:
2933:
2928:
2917:
2915:
2909:
2908:
2905:
2904:
2902:
2901:
2900:
2899:
2897:Template:Sleep
2887:
2885:
2881:
2880:
2878:
2877:
2871:
2866:
2860:
2858:
2852:
2851:
2849:
2848:
2842:
2837:
2832:
2826:
2824:
2818:
2817:
2815:
2814:
2808:
2803:
2798:
2792:
2790:
2777:
2769:
2768:
2766:
2765:
2759:
2754:
2749:
2743:
2741:
2735:
2734:
2731:
2730:
2728:
2727:
2725:Leigh syndrome
2721:
2719:
2713:
2712:
2710:
2709:
2698:
2697:
2692:
2687:
2686:
2685:
2671:
2670:
2669:
2664:
2663:
2662:
2646:
2644:
2638:
2637:
2635:
2634:
2629:
2624:
2623:
2622:
2617:
2606:
2605:
2604:
2603:
2598:
2597:
2596:
2586:
2585:
2584:
2574:
2569:
2568:
2567:
2562:
2557:
2552:
2536:
2535:
2534:
2533:
2528:
2523:
2518:
2513:
2512:
2511:
2501:
2500:
2499:
2489:
2488:
2487:
2482:
2477:
2461:
2459:
2452:Extrapyramidal
2445:
2436:
2434:encephalopathy
2425:
2424:
2421:
2420:
2418:
2417:
2412:
2407:
2406:
2405:
2394:
2392:
2385:
2384:
2382:
2381:
2380:
2379:
2369:
2364:
2363:
2362:
2357:
2352:
2347:
2336:
2334:
2325:
2319:
2318:
2311:nervous system
2306:
2305:
2298:
2291:
2283:
2277:
2276:
2271:
2262:
2261:
2258:
2257:
2246:
2234:
2233:
2231:
2227:
2226:
2223:
2222:
2211:
2200:
2181:
2165:
2160:
2159:
2157:
2156:Classification
2149:
2148:External links
2146:
2143:
2142:
2115:(6): 459â462.
2099:
2050:
2006:
1952:
1923:(5): 351â359.
1903:
1874:(4): 192â196.
1854:
1827:(6): 738â746.
1811:
1784:(3): 278â285.
1767:
1718:
1669:
1620:
1576:
1528:
1509:(3): 379â396.
1493:
1450:
1426:
1399:
1372:
1345:
1335:(3rd ed.)
1320:
1313:
1292:
1249:
1222:(6): 415â422.
1206:
1144:
1115:
1094:
1067:(6): 484â494.
1024:
1015:
963:
911:
890:(2): 151â165.
867:
813:
759:
706:
705:
703:
700:
694:
691:
661:
660:Manual therapy
658:
648:
645:
587:
584:
582:
579:
573:
570:
557:
554:
516:
513:
470:
467:
465:
462:
461:
460:
455:
449:
446:
441:
436:
433:
430:
427:
424:
421:
418:
392:
389:
372:
371:Classification
369:
352:
349:
336:
333:
327:
324:
287:
284:
222:
219:
218:
217:
214:
211:
210:Sleep problems
208:
205:
197:
194:
190:
189:
188:
187:
176:
170:
169:
168:
165:
162:
159:
153:
141:
138:
81:
80:
75:
69:
68:
63:
57:
56:
52:
51:
43:
42:
39:
35:
34:
26:
9:
6:
4:
3:
2:
3556:
3545:
3542:
3541:
3539:
3524:
3521:
3519:
3516:
3514:
3511:
3510:
3508:
3504:
3498:
3495:
3493:
3490:
3488:
3485:
3483:
3480:
3478:
3475:
3473:
3470:
3468:
3465:
3464:
3462:
3460:
3456:
3446:
3443:
3441:
3438:
3437:
3435:
3433:
3429:
3423:
3420:
3418:
3415:
3414:
3412:
3410:
3406:
3400:
3397:
3396:
3394:
3392:
3388:
3385:
3383:
3379:
3369:
3366:
3364:
3361:
3359:
3356:
3354:
3351:
3349:
3346:
3345:
3343:
3341:
3337:
3331:
3328:
3326:
3323:
3321:
3318:
3317:
3315:
3313:
3309:
3301:
3298:
3297:
3296:
3293:
3292:
3290:
3288:
3284:
3278:
3275:
3271:
3268:
3267:
3266:
3263:
3262:
3260:
3258:
3254:
3251:
3249:
3245:
3241:
3234:
3229:
3227:
3222:
3220:
3215:
3214:
3211:
3189:
3186:
3185:
3184:
3181:
3180:
3173:
3170:
3168:
3165:
3164:
3163:
3160:
3158:
3155:
3151:
3148:
3146:
3143:
3139:
3136:
3134:
3131:
3129:
3126:
3125:
3123:
3121:
3118:
3116:
3113:
3111:
3108:
3106:
3103:
3101:
3098:
3097:
3096:
3093:
3091:
3088:
3087:
3086:
3084:
3080:
3079:
3074:
3071:
3069:
3066:
3064:
3061:
3060:
3059:
3057:
3053:
3052:
3050:
3048:
3044:
3038:
3035:
3033:
3030:
3029:
3027:
3025:
3021:
3018:
3016:
3012:
3009:
3005:
2995:
2992:
2990:
2987:
2985:
2982:
2980:
2977:
2975:
2974:Reye syndrome
2972:
2970:
2967:
2966:
2964:
2960:
2954:
2951:
2949:
2946:
2942:
2939:
2937:
2934:
2932:
2929:
2927:
2926:Hydrocephalus
2924:
2923:
2922:
2919:
2918:
2916:
2914:
2910:
2898:
2894:
2893:
2892:
2889:
2888:
2886:
2882:
2876:
2872:
2870:
2867:
2865:
2862:
2861:
2859:
2857:
2853:
2847:
2843:
2841:
2838:
2836:
2833:
2831:
2828:
2827:
2825:
2823:
2819:
2813:
2809:
2807:
2804:
2802:
2799:
2797:
2794:
2793:
2791:
2789:
2785:
2781:
2778:
2776:
2770:
2764:
2760:
2758:
2755:
2753:
2750:
2748:
2745:
2744:
2742:
2740:
2739:Demyelinating
2736:
2726:
2723:
2722:
2720:
2718:
2714:
2708:
2705:
2704:
2703:
2702:
2696:
2693:
2691:
2688:
2684:
2681:
2680:
2679:
2675:
2672:
2668:
2665:
2661:
2658:
2657:
2656:
2653:
2652:
2651:
2648:
2647:
2645:
2643:
2639:
2633:
2630:
2628:
2627:Restless legs
2625:
2621:
2618:
2616:
2613:
2612:
2611:
2608:
2607:
2602:
2599:
2595:
2592:
2591:
2590:
2587:
2583:
2580:
2579:
2578:
2575:
2573:
2570:
2566:
2565:Blepharospasm
2563:
2561:
2558:
2556:
2553:
2551:
2548:
2547:
2546:
2543:
2542:
2541:
2538:
2537:
2532:
2529:
2527:
2524:
2522:
2521:Hemiballismus
2519:
2517:
2514:
2510:
2507:
2506:
2505:
2502:
2498:
2495:
2494:
2493:
2490:
2486:
2483:
2481:
2478:
2476:
2473:
2472:
2471:
2468:
2467:
2466:
2463:
2462:
2460:
2458:
2453:
2449:
2446:
2444:
2440:
2437:
2435:
2430:
2426:
2416:
2413:
2411:
2408:
2404:
2401:
2400:
2399:
2396:
2395:
2393:
2391:
2386:
2378:
2375:
2374:
2373:
2372:Brain abscess
2370:
2368:
2365:
2361:
2358:
2356:
2353:
2351:
2348:
2346:
2343:
2342:
2341:
2338:
2337:
2335:
2333:
2329:
2326:
2324:
2320:
2316:
2312:
2304:
2299:
2297:
2292:
2290:
2285:
2284:
2281:
2275:
2272:
2270:
2267:
2266:
2256:
2252:
2251:
2247:
2245:
2241:
2240:
2236:
2235:
2232:
2228:
2221:
2217:
2216:
2212:
2210:
2206:
2205:
2201:
2199:
2195:
2191:
2190:
2186:
2182:
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596:
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496:jaw clenching
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320:nortriptyline
317:
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274:, the neural
273:
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264:neural tracts
260:
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250:
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239:neurons (the
238:
233:
230:, and muscle
229:
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36:
31:
19:
3294:
3182:
3081:
3054:
3015:Degenerative
2839:
2752:Inflammatory
2699:
2632:Stiff-person
2470:Parkinsonism
2443:Degenerative
2340:Encephalitis
2323:Inflammation
2313:, primarily
2248:
2237:
2213:
2202:
2183:
2168:
2112:
2108:
2102:
2067:
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2020:
2016:
2009:
1972:
1968:
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1916:
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927:
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727:
723:
696:
693:Epidemiology
686:chiropractic
671:
663:
654:
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623:
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589:
575:
559:
518:
507:
500:
493:
486:
479:
472:
394:
382:
354:
338:
329:
312:nitric oxide
289:
261:
257:hyperalgesia
228:inflammation
224:
199:
196:Risk factors
191:
143:
134:
107:
93:
89:
85:
84:
3518:Orthostatic
3167:FazioâLonde
3007:Both/either
2801:Generalised
2660:Early-onset
2655:Alzheimer's
2390:spinal cord
2239:MedlinePlus
2017:Cephalalgia
666:acupuncture
634:barbiturate
595:paracetamol
581:Medications
562:dehydration
546:propranolol
530:venlafaxine
526:mirtazapine
515:Medications
509:Biofeedback
489:dehydration
426:Eye disease
365:phonophobia
361:photophobia
308:ÎČ-endorphin
298:receptors,
237:nociceptive
216:Poor health
184:phonophobia
180:photophobia
126:propranolol
110:paracetamol
38:Other names
3513:Eye strain
3399:Migralepsy
2775:paroxysmal
2747:Autoimmune
2540:Dyskinesia
2410:Meningitis
2388:Brain and
2215:DiseasesDB
1444:2019-01-12
1420:2019-01-12
1393:2019-01-12
1366:2019-01-12
1339:2019-01-12
702:References
611:ketoprofen
524:, whereas
464:Prevention
407:(ESR) and
278:, and the
270:and their
3544:Headaches
3382:Secondary
2772:Episodic/
2650:Tauopathy
2601:Akathisia
2589:Myoclonus
2572:Athetosis
2504:Tauopathy
2250:eMedicine
2045:206521242
1975:(1): 67.
1683:Neurology
1571:207478957
1133:cite book
1125:989157341
838:: c5222.
626:analgesic
599:ibuprofen
556:Treatment
480:Drinking
475:neck pain
469:Lifestyle
357:palpation
351:Diagnosis
304:serotonin
300:glutamate
272:receptors
253:allodynia
221:Mechanism
213:Young age
114:ibuprofen
66:Neurology
61:Specialty
3538:Category
3523:Vascular
3440:Hangover
3265:Migraine
3240:Headache
3138:SMALED2B
3133:SMALED2A
2830:Migraine
2822:Headache
2788:epilepsy
2784:Seizures
2642:Dementia
2545:Dystonia
2137:24409468
2129:17087872
2094:23245607
2037:25748428
2001:25278005
1947:22460941
1898:16574972
1849:42640492
1841:15953306
1821:Headache
1806:23367185
1798:16514329
1762:27092807
1713:27164716
1664:28084009
1607:26851953
1563:21247362
1523:18540732
1287:25448414
1244:21527308
1236:16282042
1201:28886861
1089:36447117
1081:19889292
1010:30353868
958:25931277
906:20028727
862:20961988
808:18187725
754:26230487
607:naproxen
586:Episodic
572:Exercise
416:Migraine
326:Synapses
306:(5-HT),
245:thalamus
232:ischemia
98:headache
78:Migraine
3459:ICHD 13
3320:Cluster
3295:Tension
3248:Primary
3150:SMA-PME
3145:SMA-PCH
3128:SMALED1
2840:Tension
2835:Cluster
2560:Meige's
2377:Amoebic
2209:D018781
2085:6350784
1992:4194455
1938:3381059
1889:1420782
1753:4955729
1704:4862245
1655:6464783
1615:4393529
1279:9929022
1001:6191530
949:6864942
853:2958257
799:2190284
745:6457940
647:Chronic
603:aspirin
593:, like
482:alcohol
276:synapse
204:Anxiety
3432:ICHD 8
3409:ICHD 7
3391:ICHD 5
3340:ICHD 4
3312:ICHD 3
3287:ICHD 2
3257:ICHD 1
2869:Stroke
2683:Pick's
2610:Tremor
2577:Chorea
2244:000797
2194:307.81
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335:Stress
310:, and
247:, and
207:Stress
100:. The
3506:Other
3330:SUNCT
3183:both:
3115:DSMA1
3110:SMAX2
3105:SMAX1
3085:only:
3058:only:
2962:Other
2884:Other
2796:Focal
2429:Brain
2332:Brain
2220:12554
2198:339.1
2179:G44.2
2133:S2CID
2041:S2CID
1845:S2CID
1802:S2CID
1611:S2CID
1567:S2CID
1283:S2CID
1240:S2CID
1085:S2CID
542:SSRIs
538:SSRIs
122:SSRIs
92:, or
2786:and
2497:PKAN
2492:NBIA
2204:MeSH
2189:9-CM
2125:PMID
2090:PMID
2033:PMID
1997:PMID
1943:PMID
1894:PMID
1837:PMID
1794:PMID
1758:PMID
1709:PMID
1660:PMID
1603:PMID
1559:PMID
1519:PMID
1488:2016
1309:ISBN
1275:PMID
1232:PMID
1197:PMID
1139:link
1121:OCLC
1111:ISBN
1077:PMID
1006:PMID
954:PMID
932:2015
902:PMID
858:PMID
804:PMID
750:PMID
728:2015
528:and
383:The
345:iNOS
341:NFÎșB
296:AMPA
294:and
292:NMDA
255:and
128:and
112:and
102:pain
3100:SMA
3083:LMN
3056:UMN
3047:MND
2913:CSF
2864:TIA
2509:PSP
2485:NMS
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2315:CNS
2185:ICD
2170:ICD
2117:doi
2080:PMC
2072:doi
2068:380
2025:doi
1987:PMC
1977:doi
1933:PMC
1925:doi
1884:PMC
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1740:doi
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1267:doi
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996:PMC
988:doi
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936:doi
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840:doi
836:341
832:BMJ
794:PMC
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782:336
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732:doi
363:or
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