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

Symptom	Migraine	Tension-type	Cluster
Location	Unilateral in 60 to 70 percent; bifrontal or global in 30 percent	Bilateral	Always unilateral, usually begins around the eye or temple
Characteristics	Gradual in onset, crescendo pattern; pulsating; moderate or severe intensity; aggravated by routine physical activity	Pressure or tightness which waxes and wanes	Pain begins quickly, reaches a crescendo within minutes; pain is deep, continuous, excruciating, and explosive in quality
Patient appearance	Patient prefers to rest in a dark, quiet room	Patient may remain active or may need to rest	Patient remains active
Duration	4 to 72 hours	Variable	30 minutes to 3 hours
Associated symptoms	Nausea, vomiting, photophobia, phonophobia; may have aura (usually visual, but can involve other senses or cause speech or motor deficits)	None	Ipsilateral lacrimation and redness of the eye; stuffy nose; rhinorrhea; pallor; sweating; Horner’s syndrome; focal neurologic symptoms rare; sensitivity to alcohol