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
| 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:
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:
|
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
>= 15 days per month for more than 3 months
| < 15 days per month
>= 15 days per month for more than 3 months
| 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
1 every other day to 8 per day, with a continuous remission <1 month in a 12-month period
|
Reference:
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