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Migraine Mix-up
Use Your Head to Determine What Kind
of Headache You Have
By Melinda T. Willis
June 24 — Think sinus pain, pressure and congestion are sure signs
of a sinus headache? You could be wrong, and the error could be hurting
you.
The vast majority of people who believe they are having sinus headaches
are actually having migraines,
according to new research presented last week at a meeting of the American
Headache Society in Seattle.
Closer scrutiny of the 2,524 subjects in the study found that their
physician-diagnosed or self-described sinus
headaches were migraine-type headaches a full 90 percent of the
time.
"People think they have sinus headaches. It's the association of pain
in the front of the face and pressure under the eyes," explains Dr. Joel
Saper, director of the Michigan Pain and Neurological Institute in Ann
Arbor. "It's an innocent misunderstanding."
Adds Dr. Curtis Schreiber, associate director of the Headache Center
in Springfield, Mo., who presented
the research: "We would find that they had symptoms that involved their
sinus or nasal passages, but as they described the rest
of their symptoms, they had other features that really led us to think
they had migraine underlying all of
their symptoms."
Sinus Pain in Migraine
An estimated 28 million Americans suffer from migraine headaches,
but only about half of these are
ever diagnosed.
Diagnosis of migraines relies upon using a checklist of symptoms that
include intensity and type of pain, nausea or vomiting and sensitivity
to light or sound.
"We have a kind of an understanding of what migraine is based on a certain
set of symptoms," says Schreiber. "But I think that there are a lot of
people who have migraines who do not necessarily follow the textbook."
Involvement of the sinuses is not part of the typical list and
may lead many physicians to favor a sinus headache diagnosis.
"The way that doctors have been trained to diagnose migraine really
does not incorporate any of these sinus-like symptoms," says Schreiber.
"We discount those from a diagnostic perspective."
There are also other types of headaches involving the sinuses
that are unrelated to migraine, so it may be hard to tell the difference
on your own without a doctor's evaluation. But here are a few distinguishing
features:
A major culprit of true sinus headache is sinus infection, which will
generally involve yellow, green or dirty gray discharge, fever, and will
last from seven to 10 days.
People with self-described sinus headaches who are actually experiencing
migraine generally will have sinus pain, congestion and headaches, but
these symptoms will usually resolve within two to three days and are not
accompanied by fever or discharge.
Proper Diagnosis, Proper Treatment
The proper diagnosis of headache pain is important because it
ensures proper treatment. Treating sinus headaches that are actually migraines
with over-the-counter sinus medications can confuse this process.
"The over-the-counter medicines do contain ingredients that can help
migraine — painkillers like aspirin or acetaminophen and decongestants,"
says Saper. But he warns these treatments may offer migraine sufferers
no real, lasting relief for their pain.
In the end, some may be driven to seek inappropriate surgical treatments
for their perceived chronic sinus pain. "If they know they have migraine,
they will know which way to go and get help," he says.
Headache suffers may benefit either way from the use of migraine medications.
In a separate study presented at the American Headache Society Meeting,
Schreiber reports that those with perceived sinus headaches obtained pain
relief when they were treated with the migraine drug sumatriptan.
"The issue here isn't necessarily that every individual that has sinus
headaches should take a migraine pill," says Schreiber. "The idea here
is trying to get people to understand that this can be one of the ways
that migraine shows up. We're trying to expand the checklist so that people
incorporate other symptoms." |
