[Chronic recurrent headache without neurological abnormalities. Practice guidelines of the Netherlands Society of Neurology].

The diagnosis of chronic recurrent headache without neurological abnormalities is based on the anamnesis and physical examination; EEG or other supplementary examinations as a rule are not indicated. Regarding treatment of migraine, a distinction is made between attack treatment, preferably with non-specific drugs (analgetics and non-steroid anti-inflammatory agents (NSAIDs)) after aural symptoms if any, and prophylactic treatment (agents of choice: beta-receptor blockers). Cluster headache requires adequate treatment as soon as possible after the diagnosis, usually with attack treatment (sumatriptan s.c. or oxygen) as well as prophylactic treatment (agent of choice: verapamil). In the treatment of tension headache, a non-pharmaceutical treatment (relaxation) is to be preferred to pharmacotherapy (tricyclic antidepressants). Patients with chronic recurrent headache should be asked about excessive use of analgetics and caffeine-containing beverages, because these (or abstinence from them) may be the cause of the symptoms.