Characteristics of migraine, tension-type, and cluster headache syndromes

LocationUnilateral in 60 to 70 percent; bifrontal or global in 30 percentBilateralAlways unilateral, usually begins around the eye or temple
CharacteristicsGradual in onset, crescendo pattern; pulsating; moderate or severe intensity; aggravated by routine physical activityPressure or tightness which waxes and wanesPain begins quickly, reaches a crescendo within minutes; pain is deep, continuous, excruciating, and explosive in quality
Patient appearancePatient prefers to rest in a dark, quiet roomPatient may remain active or may need to restPatient remains active
Duration4 to 72 hoursVariable30 minutes to 3 hours
Associated symptomsNausea, vomiting, photophobia, phonophobia; may have aura (usually visual, but can involve other senses or cause speech or motor deficits)NoneIpsilateral lacrimation and redness of the eye; stuffy nose; rhinorrhea; pallor; sweating; Horner’s syndrome; focal neurologic symptoms rare; sensitivity to alcohol

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