Tension Headache: The Daily PANCE Blueprint
A 31-year-old male complains of dull, tight, “band-like” headaches that have been happening almost every day for the past few months. He has tried NSAIDs without much improvement. Which of the following would be the most appropriate abortive treatment option?
A. Aspirin/paracetamol/caffeine
B. Naproxen
C. Verapamil
D. Amitriptyline
E. Sumatriptan
Answer and topic summary
The answer is A. Aspirin/paracetamol/caffeine
Tension-type headaches are the most common type of headache worldwide, often described as a bilateral, dull, non-pulsatile “band-like” headache. They are multifactorial in origin, often triggered by stress and mental tension. First-line treatment involves NSAIDs, but when these fail, caffeine-containing medications like Excedrin (aspirin/paracetamol/caffeine) are the next best abortive option. Caffeine enhances the analgesic effect of NSAIDs and can help alleviate the headache. For chronic cases, amitriptyline can be considered for prophylaxis, while behavioral therapies may also play a role.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Neurology ⇒ ⇒
Also covered as part of the Internal Medicine PAEA EOR topic list
