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There was no neck tenderness.
There was swelling to the left side of the neck, tenderness, mild erythema and left-sided sublingual swelling (Fig. 1).
Table 4 Correlations between headache clinical parameters and total tenderness score (TTS), cephalic and neck tenderness score in multiple regression Variable Total TS Cephalic TS Neck TS Regr.
Similarly, neck tenderness score (neck TS) was significantly higher in those with migraine (13.2 vs. 11.2, p = 0.03) while no significant differences were found in cephalic tenderness score (cephalic TS).
The pericranial muscles were divided into two groups, i.e. a cephalic muscle group (frontal, temporal, lateral pterygoid and masseter muscles) and a neck muscle group (insertions at mastoid processes, sternocleidomastoid and trapezius muscles and neck muscle insertions), thus giving a maximum cephalic tenderness score (cephalic TS) of 24 and a maximum neck tenderness score (neck TS) of 24.
This raises the question whether neck tenderness is an indicator for distinct subtypes of migraine: patients with neck pain as a simple symptom prior or during the attack without any identifiable changes in the periphery, and patients where the neck plays a crucial role either as a trigger or as a perpetuator for migraine attacks.
Similar(51)
Of note, there was no neck pain, tenderness or mass.
We also found that 94% of patients with neck muscle tenderness had a ≥ 50% reduction in cervicalgia intensity.
The most common include back or neck pain, tenderness to spinal palpation and restricted range of motion, or torticollis; spinal instability and neurological symptoms are uncommon [5, 15, 21, 22, 23, 24, 25].
de Laat et al. [ 11] found that, on palpation, 23 67% of the patients with TMD had neck muscle tenderness in the sternocleidomastoid and upper trapezius as well as other cervical and shoulder muscles, which was only rarely present in the control group.
Prolonged neuronal activation during a migraine attack is thought to induce peripheral and central sensitization along the trigeminovascular pathway, which stands to explain the throbbing headache [48], accompanying scalp and neck-muscle tenderness [49], and whole-body cutaneous allodynia [50].
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