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

Characteristics of migraine, tension-type, and cluster headache syndromes
Symptom Migraine Tension-type Cluster
Location

Adults: Unilateral in 60 to 70%, bifrontal or global in 30%

Children and adolescents: Bilateral in majority

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 30 minutes to 7 days 15 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 syndrome; restlessness or agitation; focal neurologic symptoms rare; sensitivity to alcohol
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