Sinus headache, migraine, and the otolaryngologist.
Migraine – Diagnosis; Migraine – Drug Therapy; Headache – Classification; Migraine – Symptoms
Mehle ME; Schreiber CP
Otolaryngology-Head & Neck Surgery
2005
2005-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.otohns.2005.05.659" target="_blank" rel="noreferrer noopener">10.1016/j.otohns.2005.05.659</a>
Sinus CT Scan Findings in 'Sinus Headache' Migraineurs.
Prospective Studies; Tomography; Human; Evaluation Research; Severity of Illness Indices; X-Ray Computed – Methods; Migraine – Complications; Migraine – Radiotherapy; Paranasal Sinus Diseases – Complications; Paranasal Sinus Diseases – Radiography; Paranasal Sinuses – Abnormalities; Paranasal Sinuses – Radiography
Objective.- To evaluate the sinus CT scan findings in 'sinus headache' migraineurs, and to compare the findings to nonmigraine 'sinus headache' patients. Background.- The majority of patients presenting with 'sinus headache' satisfy the International Headache Society (IHS) criteria for migraine headache. Few studies have correlated the rhinologic complaints and computed tomography (CT) findings in these patients. Methods.- Thirty-five patients with 'sinus headache' were evaluated prospectively and referred for CT of the paranasal sinuses. The CT scans were assessed for sinus abnormality (recorded as a Lund-Mackay [L-M] score) and were analyzed for concha bullosa and septal deviation. The findings in the migraine cohort were compared with the nonmigraine 'sinus headache' patients. Findings.- Twenty-six patients (74.3%) satisfied the IHS criteria for migraine. The mean CT scan L-M score did not differ significantly between the migraine (2.07) and nonmigraine cohort (2.66). Five of the migraine group had substantial sinus disease radiographically (with L-M scores of 5 or above). Concha bullosa of at least 1 middle turbinate was more common in the nonmigraine cohort. An analysis of the sidedness of the headaches, sinus disease, concha bullosa, and/or septal deviation is presented. Conclusions.- The majority of 'sinus headache' patients satisfy the IHS criteria for migraine. Surprisingly, these patients often have radiographic sinus disease. This raises the possibility of selection bias in otolaryngology patients, inaccurate diagnosis, or radiographic sinus disease and migraine as comorbid conditions. Positive migraine histories apparently do not obviate the need for a thorough ENT workup, possibly including CT scanning.
Mehle ME; Kremer PS
Headache: The Journal of Head & Face Pain
2008
2008-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/j.1526-4610.2007.00811.x" target="_blank" rel="noreferrer noopener">10.1111/j.1526-4610.2007.00811.x</a>
Allergy and migraine: is there a connection?
Human; Diagnosis; Differential; Migraine – Diagnosis; Migraine – Etiology; Hypersensitivity – Complications
PURPOSE OF REVIEW: In the last 10 years, otolaryngologists and allergists have become increasingly aware of migraine headaches in their practices. This is partially due to a better understanding of the high incidence of migraine and a realization that the majority of patients presenting as 'sinus headache' are actually suffering from migraine headaches. Considering that the incidence of migraine is approximately 20% in women and 6% in men and that 10-30% of people have allergies (US Department of Health and Human Services. Evidence Report/Technology Assessment No. 54; May 2002. AHRQ Publication No. 02-E024. pp. 1-198), there is obviously a large population of patients who suffer from both conditions. The question then arises that are migraine and allergy comorbid conditions, or is any association between the two a random occurrence? RECENT FINDINGS: The present study addresses this association, which has remained controversial for over 100 years. Newer studies focusing on familial trends, shared biochemical pathways and underlying mechanisms are presented. RELEVANCE: This study will provide a foundation to support future clinical studies.
Mehle ME
Current Opinion in Otolaryngology & Head & Neck Surgery
2008
2008-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/moo.0b013e3282f6a629" target="_blank" rel="noreferrer noopener">10.1097/moo.0b013e3282f6a629</a>