Quick Answer
Pulsating, photophobic, nauseated —— the migraine pattern vs ordinary tension-type headache.
Medically reviewed by Dr. Jitendra Prasad Yadav • NMC 8029 • Kathmandu Neurology Clinic & Cognitive Center
Tension-type headache is typically pressing or tightening, mild-moderate, bilateral, not worsened by routine activity, with little nausea or photophobia. Migraine is often pulsating, moderate-severe, unilateral at times, worsened by activity, with nausea and/or photophobia/phonophobia, and sometimes aura (visual flashes, scotoma, tingling 5-60 min before pain).
Tension-type may last 30 min to days; migraine typically 4-72 hours without treatment; cluster is strictly unilateral orbital excruciating 15-180 min with tearing and restlessness. Frequency matters: migraine on 15+ days/month with 8+ migrainous = chronic migraine.
Dr. Jitendra Prasad Yadav — consultant neurologist & headache specialist at Kathmandu Neurology Clinic & Cognitive Center provides evidence-based evaluation for migraine.
Diagnosis is clinical via history/exam using ICHD-3; imaging only for red flags or atypical features. A headache diary (date, duration, severity, associated symptoms, triggers prior 24h, medication and relief) is more informative than a scan for primary headache.
For personalized assessment, see /migraine and /conditions/migraine at Kathmandu Neurology Clinic & Cognitive Center (Dr. Jitendra Prasad Yadav NMC 8029). This article does not replace clinical diagnosis.
Migraine vs Other Headaches — Quick Comparison
| Feature | Migraine | Tension-Type |
|---|---|---|
| Pain | Throbbing, often one-sided | Pressure, band-like, bilateral |
| Severity | Moderate–severe | Mild–moderate |
| Other | Nausea, photophobia, aura | No nausea/vomiting, mild photophobia only |
Table for comprehension — see Migraine guide → for full criteria.
Frequently asked questions
Answers reviewed by Dr. Jitendra Prasad Yadav • MBBS, MD (Internal Medicine), FICN (Neurology), FCNV, FIHM • NMC 8029
Migraine is a neurological condition; headache is one feature. Associated symptoms and functional impact are important for diagnosis.
Aura refers to visual, sensory, or speech symptoms that precede the headache in some people. Both types are migraine; the presence of aura may influence management discussion.
It is often manageable, but new or changing patterns should be evaluated to exclude secondary causes.
Tension-type headache involves multiple mechanisms, not solely muscle tightness. Relaxation, posture, and stress management may help, but it is not purely a muscular problem.
Migraine typically presents as moderate-severe throbbing headache with nausea and/or sensitivity to light or sound, worsened by routine activity. Duration 4–72 hours. Dr. Jitendra Prasad Yadav (NMC 8029) uses ICHD-3 criteria plus your headache diary (frequency, aura, medication days) and red-flag screen to distinguish …
Prevention is discussed after 4–8 weeks of diary shows ≥8 migrainous days/month or medication-overuse pattern. Options include lifestyle regularity, comorbidity treatment and preventive medicines selected per history and contraindications. No preventive works instantly; follow-up with the same consultant tracks days/mo…
More: All FAQs → · Ask Dr. Jitendra →
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References & Review
Reviewed by Dr. Jitendra Prasad Yadav • Last reviewed: 2026-09-04
- International Classification of Headache Disorders, 3rd edition (ICHD-3).
- Harrison's Principles of Internal Medicine — Neurology sections.
- American Academy of Neurology guidelines for selected conditions (where applicable).
Content is educational and aligns with standard medical references; individual evaluation may vary. External links provide context and do not imply endorsement.