The main challenges to the primary care physician are:
Migraine | Tension-type headache | |
Pain features of acute attacks | throbbing, unilateral head pain worsening of pain with movement | boring or squashing, bilateral head pain no effect of head movement |
Associated features | nausea and vomiting may occur phonophobia or photophobia may be associated | none |
Trigger factors | altered sleep patterns (too little or too much sleep may precipitate migraine) overexertion skipping meals changes in stress level - may be too much or too little relaxation excess of afferent stimuli e.g. bright lights changes in the weather may precipitate migraine attacks menstruation chemical trigger e.g. delayed headache after glyceryl trinitrate or alcohol | psychological stress |
Therefore:
Reference:
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