New Study Shows Migraine Often Mistaken For Sinus Headaches
June 21, 2002
Findings Presented at the 44th Annual Scientific Meeting of the American Headache Society
SEATTLE, June 20 /PRNewswire/ -- 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
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
"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
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.
This study was sponsored by GlaxoSmithKline. GlaxoSmithKline, one of the
world's leading research-based pharmaceutical and health care companies, is
committed to fighting disease by bringing innovative medicines and services to
patients and to the healthcare providers who serve them. U.S. headquarters
are in Philadelphia, Pa., and Research Triangle Park, N.C.
(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
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