Prevalence of migraine in patients with a history of self-reported or physician-diagnosed "sinus" headache

• Published in: Archives of internal medicine (1960) Vol. 164; no. 16; p. 1769
• Main Authors: Schreiber, Curtis P, Hutchinson, Susan, Webster, Christopher J, Ames, Michael, Richardson, Mary S, Powers, Connie
• Format: Journal Article
• Language: English
• Published: United States 13.09.2004
• Subjects: Adolescent; Adult; Aged; Analgesics - therapeutic use; Diagnosis, Differential; Female; Headache - diagnosis; Headache - drug therapy; Headache - epidemiology; Humans; Male; Middle Aged; Migraine Disorders - diagnosis; Migraine Disorders - drug therapy; Migraine Disorders - epidemiology; Paranasal Sinus Diseases - diagnosis; Paranasal Sinus Diseases - drug therapy; Paranasal Sinus Diseases - epidemiology; Prevalence; Prospective Studies; Self Disclosure; Treatment Outcome
• ISSN: 0003-9926
• DOI: 10.1001/archinte.164.16.1769

Symptoms referable to the sinus area are frequently reported during migraine attacks, but are not recognized in diagnostic criteria. Underrecognition of migraine may be partly attributed to a variable clinical presentation, and migraines with "sinus" symptoms contribute to this problem. This study was conducted to determine the prevalence of migraine-type headache (International Headache Society [IHS]-defined migraine without aura [IHS 1.1], migraine with aura [IHS 1.2], or migrainous disorder [IHS 1.7]) in patients with a history of self-described or physician-diagnosed "sinus" headache. During a clinic visit, patients with a history of "sinus" headache, no previous diagnosis of migraine, and no evidence of infection were assigned an IHS headache diagnosis on the basis of headache histories and reported symptoms. A total of 2991 patients were screened. The majority (88%) of these patients with a history of self-described or physician-diagnosed "sinus" headache were diagnosed at the screening visit as fulfilling IHS migraine criteria (80% of patients) or migrainous criteria (8% of patients). The most common symptoms referable to the sinus area reported by patients at screening were sinus pressure (84%), sinus pain (82%), and nasal congestion (63%). In this study, 88% of patients with a history of "sinus" headache were determined to have migraine-type headache. In patients with recurrent headaches without fever or purulent discharge, the presence of sinus-area symptoms may be part of the migraine process. Migraine should be included in the differential diagnosis of these patients.