Diagnosis and management of headaches in young people and adults: summary of NICE guidance

Headache feature Tension-type headache Migraine (with or without aura) Cluster headache Pain location* Bilateral Unilateral or bilateral Unilateral (around the eye, above the eye, and along the side of the head or face) Pain quality Pressing or tightening (non-pulsating) Pulsating (throbbing or banging in young people aged 12-17 years) Variable (can be sharp, boring, burning, throbbing, or tightening) Pain intensity Mild or moderate Moderate or severe Severe or very severe Effect on activities Not aggravated by routine activities of daily living Aggravated by, or causes avoidance of, routine activities of daily living Restlessness or agitation Other symptoms None Unusual sensitivity to light or sound (or both), or nausea or vomiting (or both). †Aura symptoms can occur with or without headache; they are fully reversible, develop over at least 5 minutes, and last for 5-60 minutes.Typical aura symptoms include visual symptoms such as flickering lights, spots or lines, or partial loss of vision (or a combination thereof); sensory symptoms such as numbness or pins and needles (or both); and speech disturbance On the same side as the headache: red or watery eye (or both); nasal congestion or runny nose (or both); swollen eyelid; forehead and facial sweating; constricted pupil or drooping eyelid (or both) Duration of headache 30 minutes to continuous 4-72 hours in adults; 1-72 hours in people aged 12-17 years 15-180 minutes Frequency =15 days a month for more than 3 months =15 days a month for more than 3 months 1 every other day to 8 per day,‡ with continuous remission§ >1 month 1 every other day to 8 per day,‡ with continuous remission§