[Management of chronic headache]

Chronic headache is an important public health issue since 30p. cent of the French population complains of recurrent headaches. An accurate diagnosis, going beyond approximations, is based on careful questioning and physical examination. Three nosologic entities may be specified: migraine, tension-type headache, and symptomatic headaches which are frequently overvalued. An accurate pathophysiological knowledge is necessary to approach suitable therapeutics. It is also necessary to explain the pathophysiological basis to the patient. It is essential to breath through the frequent nosophobia. When headaches are infrequent, symptomatic treatment is to be favored. Empirical therapy should be explained to obtain good therapeutic observance based on a confidence relationship essential for good patient care.