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9 in 10 Sinus Headaches Really Migraines

Untreated Migraine Cause of Most 'Sinus Headaches'
WebMD Health News

June 10, 2004 -- Got a bad sinus headache? Odds are, it's really a migraine.

If your head hurts, does it really matter what you call it? Yes, says headache specialist Eric Eross, DO, associate consultant in neurology at the Mayo Clinic in Scottsdale, Ariz.

People spend lots of money on over-the-counter "sinus headache" remedies. But they get little relief, Eross says, until they get proper treatment for migraine.

"The vast majority of people with self-diagnosed sinus headache have migraine," Eross tells WebMD. "These individuals often have a delay in getting a correct diagnosis. On average, they waited 25 years. These are headaches affecting people in the prime of their lives. The vast majority had severe disability."

Eross and colleagues advertised a free evaluation to people suffering from "sinus headaches." They signed up the first 100 people, and gave them a rigorous 1.5-hour evaluation. It turned out 90 of the 100 patients were really suffering from migraines.

Eross presented the findings at this week's meeting of the American Headache Society in Vancouver, British Columbia, Canada.

What Is a Sinus Headache?

If you have an active sinus infection, your head hurts. Typical symptoms include fever, swollen lymph nodes, and a green or yellow nasal discharge. But most people who think they have sinus headaches don't have these symptoms -- just pain high in their cheeks. They likely have migraines, Eross says.

What do sinus doctors think? It is a controversial issue, says Bradley Marple, MD, chair of the rhinology and paranasal sinus committee of the American Academy of Otolaryngology -- Head and Neck Surgery (AAO-HNS), and vice chair of the department of otolaryngology at the University of Texas Southwest Medical Center in Dallas.

"This is a really difficult and controversial area right now. It hasn't completely been resolved," Marple tells WebMD. "There are headaches caused by sino-nasal disease. There is also a whole host of other types of headaches. It is difficult to clinically separate the two. But I think it's credible that if you do thorough neurological exams on sinus headache patients, you may find a number have other types of neurogenic headaches."

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