Tension headache and migraine are opposite ends of a benign recurrent headache spectrum.To provide an approach to the diagnosis of benign recurrent headache.Tension headache is characterised by symmetry, non-disabling severity and the absence of vascular features (throbbing quality, nausea and photophobia). The differentiation between tension headache and attacks with more vascular features has important therapeutic implications as attacks with significant vascular features tend to respond better to antimigrainous approaches rather than those employed in the management of tension headache.