Related to the (peripheral) mechanisms involved in causing the
pain, the migraine headache is localized whereas the tension-type
headache is more diffuse in location. The migraine headache is localized
not only to one side of the head but, within the side of the head,
to areas such as the temple or eye. The pain tends to be throbbing
or sharp, steady in nature, whereas the pain of tension-type headache
is dull and steady. Also related to the mechanisms involved in causing
the pain, the migraine headache is affected by movement and activity,
which is not the case with tension-type headache. The migraine headache
often develops during the night and is present on awakening in the
morning or wakes the patient from sleep at night, usually between
4 am and 6 am. Episodic tension-type headache, on the other hand,
generally develops during the day, often in the late afternoon,
between 4 pm and 6 pm. The episodic tension-type headache lasts
a couple of hours, whereas the migraine headache lasts from part
of a day to several days. Related to the low intensity of the pain,
tension-type headache has few, if any, symptoms associated with
it, and when symptoms are present, they are mild in intensity. Migraine
headache, on the other hand, has intense associated symptoms related
to the high intensity of the pain. Almost universally present in
migraine are photophobia and phonophobia; however, nausea also is
common and with the most intense migraine headaches, vomiting occurs
as well.