comparison of features of migraine and tension headache and cluster headache

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Comparison of migraine and tension headache

migraine tension headache
often unilateral generally bilateral
pain often described as 'throbbing' pain often described as 'tight band'
possible associated features include nausea, vomiting, phonophobia, photophobia, may be neurological features e.g. hemiplegic migraine generally no associated features
trigger factors include. specific foods such as cheese, hormonal, alchohol, stress precipitating factors include exposure to environmental factors, psychological stress
responds to specific migraine therapy non-specific response to migraine therapy

NICE have suggested comparative features of migraine, tension headache and cluster headache in young people and adults (1):

 

Headache feature Tension-type headache Migraine (with or without aura) Cluster Headache

Location of Pain

  • Headache pain can be felt in the head, face or neck
Bilateral Bilateral or Unilateral Unilateral (around the eye, above the eye and along the side of the head/face)
Quality of Pain Pressing/tightening (nonpulsating) Pulsating (throbbing or banging in young people aged 12-17 years) Variable (can be sharp, boring, burning, throbbing or tightening)
Intensity of Pain Mild or moderate Moderate or severe Severe or very severe
How does headache affect activities Not aggravated by routine activities of daily living Aggravated by, or causes avoidance of, routine activities of daily living Restlessness or agitation
Other symptoms None

Unusual sensitivity to light and/or sound or nausea and/or vomiting

Aura

Symptoms can occur with or without headache and:

  • are fully reversible
  • develop over at least 5 minutes
  • last 5-60 minutes

Typical aura symptoms include visual symptoms such as flickering lights, spots or lines and/or partial loss of vision; sensory symptoms such as numbness and/or pins and needles; and/or speech

On the same side as the headache:

  • red and/or watery eye
  • nasal congestion and/or runny nose
  • swollen eyelid
  • forehead and facial sweating
  • constricted pupil and/or drooping eyelid
Duration of headache 30 minutes-continuous

4-72 hours in adults

1-72 hours in young people aged 12-17 years

15-180 minutes
Frequency of headache

< 15 days per month

  • Episodic tension type headache

>= 15 days per month for more than 3 months

  • Chronic tension-type headache

 

< 15 days per month

  • Episodic migraine (with or without aura)

>= 15 days per month for more than 3 months

  • Chronic migraine 6 (with or without aura)

1 every other day to 8 per day (the frequency of recurrent headaches during a cluster headache bout), with remission (pain-free period between cluster headache bouts)> 1 month

  • Episodic cluster headache

1 every other day to 8 per day, with a continuous remission <1 month in a 12-month period

  • Chronic cluster headache

 

Reference:

Last reviewed 07/2021

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