Table 1.

Diagnosis of tension-type headache, migraine, and cluster headache

Headache featureTension-type headacheMigraine (with or without aura)Cluster headache
Pain locationaBilateralUnilateral or bilateralUnilateral (around the eye, above the eye, and along the side of the head/face)
Pain qualityPressing/tightening (non-pulsating)Pulsating (throbbing or banging in young people aged 12–17 years)Variable (can be sharp, boring, burning, throbbing, or tightening)
Pain intensityMild or moderateModerate or severeSevere or very severe
Effect on activitiesNot aggravated by routine activities of daily livingAggravated by, or causes avoidance of, routine activities of daily livingRestlessness or agitation
Other symptomsNoneUnusual sensitivity to light and/or sound or nausea and/or vomiting
Aura
Aura symptoms can occur with or without headache:

  • 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 disturbance.		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 headache30 minutes–continuous4–72 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 >3 months<15 days per month≥15 days per month for >3 months1 every other day to 8 per day,c with remissiond >1 month1 every other day to 8 per day,c with a continuous remissiond <1 month in a 12-month period
DiagnosisEpisodic tension-type headacheChronic tension-type headachebEpisodic migraine (with or without aura)Chronic migraine (with or without aura)Episodic cluster headacheChronic cluster headache

  • ↵a Headache pain can be felt in the head, face, or neck.

  • ↵b Chronic migraine and chronic tension-type headache commonly overlap. If there are any features of migraine, diagnose chronic migraine.

  • ↵c The frequency of recurrent headaches during a cluster headache bout.

  • ↵d The pain-free period between cluster headache bouts.