THE SINUS-MIGRAINE CONNECTION
DO MIGRAINES DISRUPT THE QUALITY OF YOUR LIFE?
WHAT ARE MIGRAINES?
Migraine headaches are a very common form of headache. Typically, they affect one half of the head and are associated with nausea, vomiting, and light sensitivity. They usually last for hours and sometimes more than a day and may be associated with an aura or a feeling that the migraine is coming. However, there are many variants of migraine, some that may affect the entire head, or may be restricted to the eye, be associated with stroke-like symptoms, vision loss or impairment, dizziness or tinnitus or hearing sensitivity. They occur in children, adults, and the elderly. They occur in all genders. They can be debilitating in some individuals.
WHAT CAUSES OR TRIGGERS MIGRAINES?
There appears to be an underlying genetic basis for migraines. It often occurs in families. It can be triggered by certain foods such as wine, chocolate, cheese or skipping a meal, change in weather or atmospheric pressure, sleep disruption, anxiety and stress. Sinus infection or sinus flare-ups may trigger migraines.
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HOW ARE SINUS HEADACHES DIFFERENT THAN MIGRAINES?
In general sinus headaches can occur in the same areas as migraines but are more likely to be a dull ache or a sense of head fullness or sinus pressure in the face or head. In acute sinus infections or acute baropressure, the pain may be more acute and severe. In general, there is no nausea or vomiting, or aura associated. Headaches may occur every day and may last for hours or longer. However, they can masquerade migraines and variant migraines may present as sinus headaches. When there is doubt, a CT scan of the sinus can help identify which type of headache it may be
WHAT IS THE SINUS-MIGRAINE CONNECTION?
There are areas within the nose/sinus passage that when irritated, seem to trigger headaches or even migraines. Sinus flare-ups or infections may trigger migraines. Changes in atmospheric pressure, temperature and humidity, may alter the thickening of the mucosal lining of the nose and create contact between certain trigger areas in the nose or may plug up the sinus openings causing “vacuum” headaches or migraines. While the science behind this is evolving and still light, clinical observation suggests that improving nasal contact or sinus blockage via medication or surgery may improve headaches and migraines. In patients with chronic migraines that have undergone sinus surgery or balloon sinuplasty, personal observation suggests improvement in perhaps more than 50% of migraines. While this is not scientific and one could suggest that it may be a placebo effect, often the migraine headaches do not return for several years suggesting otherwise. Detailed randomized studies have not yet been performed to prove a linkage. Nonetheless, clinical experience suggests that there is a sinus migraine connection.
WOULD SINUS SURGERY, BALLOON SINUPLASTY, OR NASAL SURGERY HELP MY MIGRAINE?
By studying each individual’s symptoms, examination, and sinus CT scan findings a decision can be made regarding which individual might benefit from surgery.