Your
Sinus Headache May be Migraines
This
article first appeared in the October 1, 2001 issue of Sinus
News:
For
most people, the changing of seasons means warmer weather
and summer flowers; however, for others, changing seasons
means the onset of severe sinus pressure and nasal congestion
that is frequently associated with so-called sinus headaches.
Yet according to new research presented today at the 44th
Annual Scientific Meeting of the American Headache Society,
these sinus-related symptoms may actually be caused by migraine,
an underdiagnosed and debilitating neurobiologicial condition.
The study, conducted by the Headache Care Center in Springfield, Mo., reveals
90 percent of patients who have self-diagnosed sinus headache, and even those
with a physician diagnosis of sinus headache, actually met established criteria
for the diagnosis of migraine. (1)
" We are seeing a growing body of evidence that suggests symptoms typically
associated with sinus or allergy conditions can actually be part of migraine," said
Curtis Schreiber, M.D., a neurologist at the Headache Care Center and co-author
of the study. "Because of the location of the pressure and pain, many patients,
as well as healthcare providers, assume the sinuses or nasal passages are to
blame. The wide variability of migraine symptoms probably explains why 90 percent
of patients in our study who were previously diagnosed with 'sinus' headache
actually had symptoms fulfilling a migraine diagnosis."
One possible explanation for the confusion between migraine and sinus headache
relates to the mechanism of migraine. The same nerves that carry migraine pain
also go to the sinus area. Pain in the sinuses, face or around the eyes can be
felt during a migraine on one or both sides of the head. Also, the nerves that
cause stuffy or runny nose and watery eyes can be activated during a migraine.
" I thought my painful sinus pressure and congestion were sinus headaches
for years, even though over-the-counter medications were not relieving my symptoms," said
Crystal Kuntaroglu, a migraine sufferer. "When I finally kept track of my
symptoms and talked to my doctor, we determined I was actually suffering from
migraine. Now, with the right medicine, I can get on with my life."
Like Crystal, 66 percent of study participants expressed dissatisfaction with
their current headache treatment, which included non-narcotic analgesics (74%),
nonsteroidal anti-inflammatory drugs (NSAIDs) (72%), decongestants (57%) and
antihistamines (48%).
Migraine affects 28 million Americans, yet only 48 percent of patients who meet
the clinical definition of migraine have been diagnosed with migraine by a healthcare
provider. Without proper diagnosis and treatment, migraine can often be a highly
debilitating disease that takes a heavy toll on the patients' work/school productivity
and affects household work and family/leisure activities.
" This data could be very helpful for patients who thought they were suffering
from sinus headache," Dr. Schreiber said. "The results should encourage
people to discuss all their symptoms with their physician to get a proper diagnosis,
and a treatment plan that will be most effective for them."
About the Study
The study was conducted in more than 450 sites around the country evaluating
2,524 people ages 18-65 who had not had a previous migraine diagnosis, but who
went to their primary care physician with self-described or physician-diagnosed
sinus headache. Patients were asked to describe the symptoms associated with
their typical sinus headache, and physicians used International Headache Society
(IHS) criteria to diagnose the headache as migraine with or without aura, migrainous,
tension-type or other headache type. Patients also completed the Headache Impact
Test (HIT-6), an effective assessment tool used to standardize and measure the
impact headaches have on a sufferer's daily life. Data was captured via a central
touch-tone telephone entry system.
Additional Information
Migraine is a neurobiological disorder that affects 28 million Americans and
can result in missed days of work, lost time with family and friends and a disrupted
daily routine. Often, migraine can be characterized by symptoms including moderate
to severe headache pain, nausea, vomiting, and sensitivity to light and sound,
but migraine can also have other symptoms that are commonly interpreted as signs
of sinus or tension headache (i.e., nasal congestion, runny nose, watery eyes,
bilateral head pain and neck pain).
Because migraine can have many different symptoms, and look like other types
of headaches, it can be difficult for patients to recognize and for physicians
to diagnose.
(1) International Headache Society diagnostic criteria for migraine without
aura include: (A) At least five headache attacks lasting 4-72 hours (untreated
or unsuccessfully treated), which has at least two of the four following characteristics:
(1) Unilateral location; (2) Pulsating quality; (3) Moderate or severe intensity
(inhibits or prohibits daily activities); (4) Aggravated by walking stairs or
similar routine physical activity. (B) During headache at least one of the two
following symptoms occur: (1) Phonophobia and photophobia; (2) nausea and/or
vomiting. Migraine disorder not fulfilling above criteria: Headache attacks which
are believed to be a form of migraine but which do not quite meet the operational
diagnostic criteria for any of the forms of migraine. Diagnostic criteria include:
(A) Fulfills all criteria but one or more forms of migraine (specify type(s)).
(B) Does not fulfill criteria for tension type headache.
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