Precipitating and aggravating factors of migraine versus tension-type headache

Objective.-We conducted the present study to determine whether there are he adache precipitating and aggravating factors that differentiate migraine fr om tension-type headache and headache precipitating and aggravating factors that differentiate tension-type headache from migraine. Methods.-We interviewed 38 patients with migraine and 17 patients with tens ion-type headache (diagnosed using International Headache Society criteria) by telephone, using a questionnaire. The questionnaire inquired about the following precipitating and aggravating headache factors: (1) physical acti vity, (2) straining, (3) bending over, (4) stress/tension, (5) coughing/sne ezing, (6) fatigue, (7) reading, (8) driving, (9) lack of sleep, (10) speci fic foods/drinks, (11) alcohol, (12) not eating on time, (13) smoke, (14) s mell, (15) light, (16) noise, (17) menstruation, and (18) weather. Results.-The most common precipitating factors acknowledged by both groups of patients were stress/tension, not eating on time, fatigue, and lack of s leep, Weather, smell, smoke, and light were the precipitating factors that differentiated migraine from tension-type headache. Excluding those factors that are part of the International Headache Society migraine diagnosis, th e aggravating factors were straining, bending over, and smell, We found no precipitating or aggravating factors differentiating tension-type headache from migraine. Conclusion.-Apparently there are precipitating and aggravating factors diff erentiating migraine from tension-type headache but not vice versa. It is i nteresting that three of the migraine-specific precipitating factors tie, w eather, smell, and smoke) involve the nose/sinus system, suggesting a great er significance of this system in headache than is generally considered.