What's in a name? tension-type headache versus migraine

For years clinicians and researchers have debated the nosology of headache generally and of "migraine" versus "tension-type headache" in particular, an exhaustive process that arguably has done little to improve patient management and clinical outcome. New research data now indicate that the migraine versus tension-type distinction indeed may possess some clinical use, because patients with migraine or "mixed" headache syndromes may respond differently to a specific therapeutic intervention than patients with "pure" tension-type headache. This variable response to treatment intervention would seem to imply that similarly distinctive biologies are generating the respective headache syndromes, but to date we have insufficient evidence to support that conclusion.