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August 1993

Coexisting Migraine and Tension-Type Headache

Author Affiliations

Diamond Headache Clinic 5252 N Western Ave Chicago, IL 60625

Arch Neurol. 1993;50(8):795. doi:10.1001/archneur.1993.00540080008002

To the Editor.  —I would like to congratulate Rasmussen et al1 for their excellent epidemiologic survey in the September 1992 issue of the Archives. Their approach to this enormous task was concise and comprehensive. Although it is currently in vogue to group all headache types in the same "catchall" category, these authors testify to the importance of differentiating these diagnoses. As a clinician, with 30 years' experience of treating patients with headache, I could not agree more with the authors' views.Many of our contemporaries2-5 have described a "chronic daily headache" as a continuum of all head pain. Their views are based on their experiences in specialized headache centers, with many of their patients' histories obscured by prior bouts of habituations to analgesics, both prescribed and over-the-counter, as well as ergotamine rebound headaches. Within these specialized centers, a myriad of patients will present with coexisting migraine and tension-type

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