| Condition | Distinguishing Features | |-----------|--------------------------| | | Bilateral, pressing/light pressure (not throbbing), mild/moderate, no nausea or photophobia+phonophobia simultaneously | | Sinus headache | Facial pressure, purulent nasal discharge, fever; actually most "sinus headaches" meet migraine criteria | | Cluster headache | Severe, orbital/periorbital, 15–180 min, autonomic features (tearing, rhinorrhea, ptosis), circadian periodicity | | Medication-overuse headache | Worsening headache with frequent acute medication use; improves after withdrawal | | Thunderclap headache | Sudden onset to peak <1 min—consider subarachnoid hemorrhage, reversible cerebral vasoconstriction syndrome (RCVS) |
An EM attack is dynamic, unfolding in up to 4 phases, though not every patient experiences all phases. what is episodic migraine