A 42-year-old accountant presents with a 3-month history of bilateral, band-like headaches occurring 3-4 times a week. The pain is typically mild to m...

Question

A 42-year-old accountant presents with a 3-month history of bilateral, band-like headaches occurring 3-4 times a week. The pain is typically mild to moderate, not aggravated by routine physical activity, and not associated with nausea or photophobia. He denies any red flag symptoms. What is the most appropriate initial management?

Accepted Answer

Regular paracetamol or NSAIDs, with advice on medication overuse headache

Answer

Amitriptyline 10mg at night

Answer

Sumatriptan 50mg at onset

Answer

Propranolol 40mg BD

Answer

Referral for MRI brain

mrcgp akt MCQ (SBA): Tension-Type Headache