" 'Sinus Headache' May Be Migraine: Study Finds 97%
of Self-described Sinus Headaches Were
Actually Migraine Attacks"
FROM: About.com: Headaches and Migraine
DATE: Reference to study - May 09, 2001
Ever have one of those horrendous headaches where your forehead hurts, your face hurts along your cheekbones, even your teeth hurt? When experiencing this type of pain, many "headachers" find themselves wondering if they have a "sinus headache" or a Migraine attack
At the Annual meeting of the American Academy of Neurology (May 9, 2001), the findings of a study conducted by The Headache Care Center in Springfield, Missouri were presented.
A startling 97% of the participants, self-described sinus headache sufferers, actually had symptoms consistent with Migraine attacks as defined by the criteria of the International Headache Society.
The study was co-authored by neurologist Curtis P. Schreiber, M.D., of The Headache Care center. He explained:
["We initiated this study after seeing many patients in our headache clinic who complained of sinus headache. While there were sinus symptoms present during these headaches, it was apparent that they also had typical characteristics that occur with Migraine headaches. Many of our patients consequently responded very well to Migraine-specific treatments. Of course, not all pain and pressure in the sinus cavity is Migraine, but we believe this study shows we should continue research in this area. We may find more effective ways to relieve patients' pain and get them back to their normal activities sooner."]
There are many reasons headachers have difficulty distinguishing between a sinus headache and the pain of a Migraine attack:
[Although many people associate Migraine with strange visual aura symptoms, only 20% of migraineurs actually experience the aura phase of a Migraine attack.
Both sinus headaches and Migraine attacks can be triggered by weather changes.
Sinus headaches and Migraine attacks can produce pain in the same areas.
Both can cause drainage and other sinus symptoms such as teary eyes.]
Dr. Schreiber explained:
["Many headache sufferers describe pressure or pain in the area around their sinuses. Because of the location, many patients presume that their symptoms are caused by problems with the sinuses themselves. What may actually be happening is that the trigeminal nerve, which has branches in the forehead, cheeks and jaw, may have become inflamed. Migraine causes inflammation of nerves and blood vessels in the head. In the typical Migraine headache, the upper branches of the nerve, which supply the coverings of the brain, are involved and head pain is the predominant symptom. What may actually be happening in many cases of sinus headache is inflammation starts within lower branches of the nerve causing sinus symptoms to be predominant at the start of the headache."]
Study participants were 18 to 65 years of age, were self-described sinus headache sufferers, had never been diagnosed with Migraine, and were from the general population. Other criteria included having experience one or more symptoms of Migraine, such as moderate to severe head pain, light or sound sensitivity, or nausea and vomiting; reporting at least six headache attacks within the previous six months; and exhibiting no signs of contagious bacterial infection. In addition to standard clinical examinations, the patients evaluated their headache pain with the Headache Impact Test, which is a very effective tool used to measure the impact of headaches on daily life.
Implications of the Study
From the results of the study, Dr. Schreiber concludes that patients need to "see their physician to discuss their symptoms, get a proper diagnosis, and get a treatment plan that will be most effective for them."
A headache diary is one of the most effective ways to ensure that you report your symptoms effectively. Proper diagnosis of headache symptoms is critical, not only for relief of the symptoms, but because they can be indicators of other medical problems.
The findings of this study are especially important given the difference in treatment plans for sinus headaches versus migraine attacks. Should the diagnosis indeed be migraine, there are migraine-specific abortive medications available that are quite different from medications prescribed for sinus headaches.
Migraine-specific abortives include:
Triptans:
Imitrex: (sumatriptan, GlaxoSmithKline) available in tablets, nasal spray, or self-injection forms.
olmitriptan, Zeneca) available in tablets, dissolvable tablet form, Zomig ZMT, and nasal spray
izatriptan, Merck) available in tablets or Maxalt MLT, a dissolvable tablet.
naratriptan, Glaxo Wellcome) available in tablet form.
Axert: (almotriptan malate, Pharmacia Corporation) available in tablet form.
Frova: (frovatriptan, Elan Pharmacueticals) available in tablet form.
Relpax: (eletriptan, Pfizer, Inc.) available in tablet form.
Ergotamine drugs:
Cafergot: (ergotamine tartrate, Novartis) available in tablet or suppository forms.
DHE-45: (dihydroergotamine, Novartis) injection form.
Migranal: (dihydroergotamine, Novartis) nasal spray form.
Ergomar: (ergotamine tartrate, Lotus) available in sublingual tablets.
Sinus or migraine? It can be terribly difficult to distinguish between them. Keeping a headache diary to take to your doctor for proper diagnosis and a treatment plan that's right for you is the best way to help you figure it out and be on your way to relief.
The study conducted at The Headache Care Center was conducted with a grant from GlaxoSmithKline.
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