Which feature most strongly suggests a migraine rather than a tension-type headache?

• A. Bilateral band-like pressure.
• B. Unilateral throbbing pain with photophobia and nausea.
• C. Pain worsened by activity with no nausea.
• D. No associated symptoms.

Answer: (B)

Unilateral throbbing pain with photophobia and nausea is most characteristic of a migraine because migraines typically present with pulsatile, one-sided pain and accompanying symptoms like light sensitivity and nausea. This combination of unilateral location, throbbing quality, and associated photophobia and nausea strongly points toward migraine over tension-type headache, which usually causes bilateral, pressing or tightening pain without prominent nausea or photophobia. So the presence of unilateral, pulsating pain plus photophobia and nausea is the strongest clue for migraine.